Eat the foods that sound good until you are able to eat more, even if it’s the same thing again and again. You might also drink liquid meal replacements for extra

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1-800-4-CANCER (1-800-422-6237) ˜e Use of Product or Brand Names Product or brand names that appear in this booklet are for example only. ˜e U.S. Government does not endorse any speci˚c product or brand. If products or brands are not mentioned, it does not mean or imply that they are not satisfactory.

PAGE – 3 ============ iAbout this Book Eating Hints is written for youŠsomeone who is about to get, or is now getting, cancer treatment. Your family, friends, and others close to you may also want to read this book. You can use this book before, during, and a˛er cancer treatment. It has hints about common types of eating problems, along with ways to manage them. ˜is book covers: ˜What you should know about cancer treatment, eating well, and eating problems ˜How feelings can a˚ect appetite ˜Hints to manage eating problems ˜How to eat well after cancer treatment ends ˜Foods and drinks to help with certain eating problems ˜Ways to learn more Talk with your doctor, nurse, or dietitian about any eating problems that might a˝ect you during cancer treatment. He or she may suggest that you read certain sections or follow some of the tips. ˇ

PAGE – 5 ============ iiiTable of Contents What You Should Know bout Cancer Treatment, Eating Well, and Eating Problems ..1Feelings Can A˚ect Your Appetite .7List of Eating Problems ..9Appetite Loss .10Constipation .13Diarrhea 15Dry Mouth .17Lactose Intolerance ..19Nausea 21Sore Mouth (Mucositis) ..23Sore ˜roat and Trouble Swallowing (Esophagitis) .26Taste or Smell Changes 29Vomiting ..31Weight Gain ..33Weight Loss 35After Cancer Treatment ..38Eating Problems that May Be Caused by Certain Cancer Treatments 39

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ivLists of Foods and Drinks 41Clear Liquids .41Full-Liquid Foods 42Foods and Drinks that Are Easy on the Stomach .43Low-Fiber Foods .45High-Fiber Foods 46Foods and Drinks that Are Easy to Chew and Swallow 47Quick and Easy Snacks 48Ways to Add Protein .49Way to Add Calories .52Recipes Banana Milkshake ..12Apple/Prune Sauce .14Lactose-Free Double Chocolate Pudding ..20Fruit and Cream ..25Protein-Forti˚ed Milk .36High-Protein Milkshake .37Peanut Butter Snack Spread .37Table of Contents (continued)

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2Getting Ready for Cancer Treatment ˜Until treatment starts you will not know what, if any, side e˝ects or eating problems you may have. If you do have problems, they may be mild. Many side e˝ects can be controlled and many problems go away when cancer treatment ends. ˜Eat a healthy diet and stay about the same weight before treatment starts. Eating a healthy diet and maintaining weight before treatment helps you stay strong, lower your risk for infection, cope with side e˝ects better, and have a greater chance of receiving treatment without unplanned breaks. ˜Go to the dentist. It is important to have a healthy mouth before you start cancer treatment. ˜Ask your doctor, nurse, or dietitian about medicine that can help with eating problems. ˜Discuss your fears and worries with your doctor, nurse, or social worker. He or she can discuss ways to manage and cope with these feelings. ˜Learn about your cancer and its treatment. Many people feel better when they know what to expect. Ways You Can Get Ready to Eat Well ˜Fill the refrigerator, cupboard, and freezer with healthy foods. Make sure to include items you can eat even when you feel sick. ˜Stock up on foods that need little or no cooking, such as frozen dinners and ready-to-eat cooked foods. ˜Cook foods ahead of time and freeze in meal-sized portions. ˜Ask friends or family to help you shop and cook during treatment. Maybe a friend can set up a schedule of the tasks that need to be done and the people who will do them. ˜Create a grocery list of items you usually buy so that it is easy for friends and family to shop for you. ˜Talk with your doctor, nurse, or dietitian about what to expect. You can ˚nd lists of foods and drinks to help with many types of eating problems on pages 41 to 53.

PAGE – 9 ============ 3Everyone Is D i˚erent Because everyone is di˝erent, there is no way to know if you will have eating problems and, if so, how bad they will be. You may have just a few problems or none at all. In part, this depends on the type of cancer you have, where it is in your body, what kind of treatment you have, how long treatment lasts, and the doses of treatment you receive. During treatment, there are many helpful medicines and other ways to manage eating problems. Your doctor, nurse, or dietitian can tell you more about the types of eating problems you might expect and ways to manage them. If you start to have eating problems, tell your doctor or nurse right away. ˇ ˇ Talk with Your Doctor, Nurse, or Dietitian Talk with your doctor or nurse if you are not sure what to eat during cancer treatment. Ask him or her to refer you to a dietitian. A dietitian is the best person to talk with about your diet. He or she can help choose foods and drinks that are best for you during treatment and a˛er. Make a list of questions for your meeting with the dietitian. Ask about your favorite foods and recipes and if you can eat them during cancer treatment. You might want to ˚nd out how other patients manage their eating problems. You can also bring this book and ask the dietitian to mark sections that are right for you. If you are already on a special diet for diabetes, kidney or heart disease, or other health problem, it is even more important to speak with a doctor and dietitian. Your doctor and dietitian can advise you about how to follow your special diet while coping with eating problems caused by cancer treatment. For more information on how to ˚nd a dietitian, visit the Academy of Nutrition and Dietetics at˚nd- an-expert .

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4Ways to Get the Most from Foods and Drinks During treatment, you may have good days and bad days when it comes to food. Here are some ways to manage: ˜Eat plenty of protein and calories when you can. ˜is helps you keep up your strength and helps rebuild tissues harmed by cancer treatment. ˜Eat when you have the biggest appetite. For many people, this is in the morning. You might want to eat a bigger meal early in the day and drink liquid meal replacements later on. ˜It™s okay if you feel like you can™t eat a lot of di˝erent foods. Eat the foods that sound good until you are able to eat more, even if it™s the same thing again and again. You might also drink liquid meal replacements for extra nutrition. ˜Do not worry if you cannot eat at all some days. Spend this time ˚nding other ways to feel better and start eating when you can. Tell your doctor if you cannot eat for more than 2 days. ˜Drink plenty of liquids. It is even more important to get plenty to drink on days when you cannot eat. Drinking a lot helps your body get the liquid it needs. Most adults should drink 8 to 12 cups of liquid a day. You may ˚nd this easier to do if you keep a water bottle nearby. Also, try some of the clear liquids listed on page 41 . Taking Special Care with Food to Avoid Infections Some cancer treatments can make you prone to infections. When this happens, you need to take specia l care in the way you handle and prepare food. Be careful to: ˜Keep hot foods hot and cold foods cold. ˜Put le˛overs in the refrigerator as soon as you have ˚nished eating. ˜Scrub all raw fruits and vegetables with a brush and water before you eat them. ˜Soak berries and other foods that are not easily scrubbed in water, then rinse. ˜Scrub fruits and vegetable that have rough surfaces and peels, such as melons, oranges, and avocados, with a brush and water before you cut or peel them.

PAGE – 11 ============ 5 ˜Soak frozen fruits and vegetables in water and rinse if you are not going to cook them (for a smoothie, for instance). If cooking, you do not need to wash frozen fruits and vegetables. ˜Wash your hands, knives, and counter tops before and a˛er you prepare food. ˜is step is most important when preparing raw meat, chicken, turkey, and ˚sh. ˜Wash your hands each time you touch raw meat, chicken, turkey, ˚sh. ˜Use one cutting board for meat and another one for fruits and vegetables. ˜˜aw meat, chicken, turkey, and ˚sh in the refrigerator or defrost them in the microwave. Cook meat, chicken, turkey, and eggs thoroughly. Eggs should be hard, not runny. Meats should not have any pink inside. To be sure meat, chicken, turkey, and ˚sh is safe, use a meat thermometer and cook to the safe temperature. Refer to a safe minimum cooking temperature chart, such as the one available at: ˜Make sure your juices and milk products are pasteurized. ˜Eat nuts that are shelled and roasted. Do not: ˜Eat raw ˚sh or shell˚sh, such as sushi and uncooked oysters. ˜Eat raw nuts. ˜Use foods, condiments, or drinks that are past their freshness date. ˜Buy foods from bulk bins. ˜Eat at bu˝ets, salad bars, or self-service restaurants. ˜Eat foods that show signs of mold, including moldy cheeses such as bleu cheese and Roquefort. ˜Eat any perishable foods that have been sitting at room temperature longer than 2 hours. ˜Eat le˛overs that have been in the refrigerator longer than 3 days. ˜Leave meat, chicken, turkey, or ˚sh sitting out to thaw. For more information about infection and cancer treatment, see Chemotherapy and You: Support for People with Cancer , a booklet from the National Cancer Institute, available at .

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