What to Eat During Cancer Treatment

100 Great-Tasting, Family-Friendly Recipes to Help You Cope

By Jeanne Besser, Kristina Ratley, Sheri Knecht, Michele Szafranski

American Cancer Society / Health Promotions

Copyright © 2009 American Cancer Society
All rights reserved.
ISBN: 978-1-60443-005-9

Contents

Note to the Reader,
Recipe List by Symptom,
Introduction,
Advice for the Caregiver,
Recipes According to Symptom,
Chapter 1. Nausea,
Chapter 2. Diarrhea,
Chapter 3. Constipation,
Chapter 4. Sore Mouth and Difficulty Swallowing,
Chapter 5. Taste Alterations,
Chapter 6. Unintentional Weight Loss,
Additional Resources,
The Survival Kit,
Kitchen Staples,
Tips for Dining Out,
Avoiding Excess Weight Gain During Treatment,
Resource List,
Index,
About the Authors,

CHAPTER 1

NAUSEA

You may experience nausea and vomiting while you are going through cancer treatment. The occurrence of these side effects varies widely and depends on the person and the type of treatment received. Some people undergoing cancer treatment may have nausea and vomiting, whereas others may have only nausea. Many have neither.

The most common causes of nausea and vomiting are chemotherapy and radiation therapy to areas of the body such as the stomach, abdomen, and brain. If chemotherapy or radiation therapy is causing nausea or vomiting, controlling it with the proper medication is very important. If you are prescribed anti-nausea medication, take it as directed. Nausea is often easier to prevent than treat. If the medication does not relieve the nausea and/or vomiting, ask your physician whether a different medicine might be more beneficial. If you cannot keep the anti-nausea medication down, ask for one in suppository form. No matter the cause of your nausea or vomiting, this may be a time of trial and error as you and your doctor work to find the best way to deal with these side effects.

Dehydration can occur quite easily if you are vomiting. Though it may be difficult, try to sip small amounts of liquid every few minutes. You can suck on ice chips or juice bars to get fluids or sip liquids such as fruit juice, flat soda, slushies, water, cool broth, sports drinks, and tea. Once clear liquids stay down, you can add easy-to-digest foods such as crackers, toast, and dry cereals.

Your once-favorite foods may no longer be appealing, and food likes and dislikes can change frequently. Experiment with different foods and flavors to see what works for you.

The recipes in this chapter are designed to meet the needs of someone dealing with nausea. Many of the recipes make small, manageable portions or small, almost bite-sized foods. The flavors tend to be fairly mild. Many of the recipes are easy to serve at room temperature in order to minimize odors and tastes. We have also included recipes for drinks and slushies — things that will help keep you hydrated while also providing some nutrition. As nausea improves, it is easy to add more flavor to these recipes by including your favorite ingredients or increasing the amounts of spices used.

Managing Nausea

• Eat a small, light meal or snack before chemotherapy and radiation treatments unless otherwise directed.

• Keep food in your stomach by eating small frequent snacks throughout the day. Snack ideas include smoothies, trail mix, fruit, or half of a sandwich.

• Try starchy foods such as pretzels, crackers, noodles, potatoes, bagels, dry cereals, breadsticks, or rice.

• Try bland foods such as soups, smoothies, gelatin, and cream of wheat. Avoid fried, greasy, and rich foods.

• Suck on frozen fruit such as watermelon, peaches, grapes, strawberries, and cherries.

• Eat food cool or cold to decrease its smell and taste. Sometimes strong odors and flavors can trigger nausea.

• Do not take medications (especially pain medications) on an empty stomach unless the pharmacist directs otherwise.

• Don’t eat your favorite foods when you don’t feel well. If you consume your favorite foods during this difficult time, you may associate them with nausea and find them unappealing when treatment is over.

Managing Sensitivity to Smells

• Others may not be aware you are sensitive to smells or that they can trigger nausea. Don’t hesitate to discuss which smells are offensive, for example, those of certain foods, perfume, cologne, air fresheners, or candles.

• Foods with strong odors may cause nausea and loss of appetite. If the smell of food being cooked is bothersome, ask others preparing food in your home to cook in a separate part of the house, grill outdoors, or use a slow cooker on the back porch or in the garage.

• Sipping broths and soups from insulated travel mugs with lids will help block odor (and help keep the liquid warm).

• To minimize the smell of canned nutritional supplements, try drinking them through a straw in a lidded cup.

• Try eating take-out or prepared foods instead of cooking for yourself. However, avoid eating at buffet-style restaurants or take-out foods from buffets.

• Cold, cool, or room-temperature foods will give off fewer odors than warm or hot foods. Chicken salad, fruit salads, yogurt, cold sandwiches, cereal, and deviled eggs are all good choices.

• Ask another person to cook for you. Ask that he or she remove any food covers to release food odors before entering your room or eating area.

Lemon-Lime Smoothie

A balance of tart and sweet helps this smoothie go down easily. For a more tart flavor, choose plain yogurt instead of vanilla or add fresh lemon and/or lime juice. For stronger citrus flavor without the acidity, substitute lemon- or lime-flavored yogurt.

1 serving
Prep Time: 15 minutes or less
Total Time: 15 minutes or less

Nutritional Information Per Serving
Calories 350
Total Fat 3.5 g
Total Carbohydrate 73 g
Dietary Fiber 0 g
Sugars 70 g
Protein 10 g
Sodium 160 mg

This recipe may not be appropriate if you have mouth sores.

5 to 6 ice cubes
1 cup vanilla or plain low-fat or nonfat yogurt
2 tablespoons frozen lemonade concentrate, partially thawed, but still icy
2 tablespoons frozen limeade concentrate, partially thawed, but still icy

1. In a blender, crush 5 ice cubes. Add the yogurt, lemonade, and limeade and blend until smooth. For a colder shake, add the remaining ice cube and blend until combined.

Chicken Noodle Soup

A store-bought rotisserie chicken is a mealtime lifesaver. It can be made into salads, sandwiches, or, as in this recipe, a classically loved soup.

This version uses all of the white breast meat from the chicken. Sautéing the wings and other bones with the aromatic vegetables adds richer flavor. If you prefer a less chunky soup, start with just 1 cup of chicken and add more to taste. If you want a thicker noodle-filled broth, increase the amount of noodles in the recipe by ½ cup. Unused dark meat can be saved for another meal.

8 servings
Prep Time: 15 minutes or less
Total Time: 1 hour or less

Nutritional Information Per Serving (about 1 cup)
Calories 120
Total Fat 3.5 g
Total Carbohydrate 6 g
Dietary Fiber 1 g
Sugars 2 g
Protein 16 g
Sodium 420 mg

If your stomach is queasy, choose a rotisserie chicken with mild seasoning. Both traditional and lemon-pepper work well. If you are looking for stronger flavor, pick a spicier variety.

Avoid getting a rotisserie chicken that has been sitting out for a while. Try asking the deli staff whether they can give you a fresh one or tell you which are the freshest in the warmer.

1 rotisserie chicken full breast or 3 cups chopped cooked chicken
1 tablespoon vegetable oil
1 onion, chopped
1 large carrot (or 2 small), sliced
1 large celery stalk (or 2 small), sliced 6 cups reduced-sodium chicken broth
2 cups water
½ to 1 cup egg noodles
2 tablespoons chopped fresh Italian parsley
Salt and freshly ground black pepper

1. Remove the wings from the chicken breast and reserve. Remove the skin from the breast and discard. Shred the meat off the breastbone and break the breastbone into two pieces. Reserve the meat and bones separately.

2. In a stockpot over medium-high heat, add the oil. Sauté the onion, carrot, celery, chicken wings, and breastbone for 8 to 10 minutes, or until vegetables soften.

3. Add the broth and water and stir to combine. Bring to a boil. Reduce the heat, cover, and simmer for 15 to 20 minutes, stirring occasionally. Add the noodles and cook for 5 minutes, stirring occasionally. Add reserved chicken and parsley and cook for 2 to 3 minutes. Discard the bones before serving. Season with salt and pepper.

Ginger-Mint Tea

Ginger has long been thought to calm gastric distress. This recipe pairs ginger with mint tea for a soothing drink. Using an herbal mint tea allows you to enjoy this relaxing drink at any time, day or night.

1 serving
Prep Time: 15 minutes or less
Total Time: 15 minutes or less

Nutritional Information Per Serving

Calories 70
Total Fat 0 g
Total Carbohydrate 18 g
Dietary Fiber 0 g
Sugars 17 g
Protein 0 g
Sodium 15 mg

For more acidic flavor, add 1 tablespoon of fresh lemon juice. For a sweeter drink, add more honey.

1 cup water
1 (1-inch) piece fresh ginger, peeled and thinly sliced
1 mint tea bag
1 tablespoon honey

1. In a saucepan over low heat, combine the water and ginger. Simmer for 5 minutes. Remove from heat, cover, and let steep for 5 minutes.

2. Strain into a mug and add the tea bag and honey. Let steep for another 3 to 5 minutes.

Mini Cheese Frittatas

Make these miniature frittatas — an egg dish that’s similar to a baked omelet — in advance, and you can snack on them throughout the day. Reheat leftovers in the microwave for 12 to 15 seconds. If you’re not in the mood for this filling, customize your own by using your favorite cheese, cooked meat, vegetable, or herb.

Eat as is, or sandwich a frittata inside a toasted English muffin for a heartier meal.

10 frittatas
Prep Time: 15 minutes or less
Total Time: 30 minutes or less

Nutritional Information Per Serving (2 frittatas)

Calories 140
Total Fat 10 g
Total Carbohydrate 2 g
Dietary Fiber 0 g
Sugars 1 g
Protein 11 g
Sodium 160 mg

For added calories, choose whole milk or half-and-half and full-fat cheese. To reduce calories, use low-fat or reduced-fat options.

6 eggs
½ cup shredded regular or reduced-fat Cheddar or mozzarella cheese
¼ cup low-fat or whole milk or half-and-half
2 scallions, white and light green parts only, thinly sliced
Pinch dried thyme
Salt and freshly ground black pepper

1. Preheat the oven to 350 degrees. Generously coat a muffin tin with nonstick cooking spray.

2. In a bowl, beat the eggs. Add the cheese, milk, scallions, and thyme. Sprinkle with salt and pepper and stir well to combine. Spoon the mixture evenly into muffin cups.

3. Bake for 13 to 15 minutes, or until set. Leave in the tin for 1 minute before removing.

“On the Go” Snack Mix

Snack mixes are handy to have preassembled for a quick snack. Keep the mix in a tightly sealed container in the car or by the couch.

You can adapt the ingredients, depending on your symptoms. If you’re experiencing constipation, include dried fruits and cereals with at least 5 grams of fiber, such as Mini Wheats, Crunchy Corn Bran, or Wheat Chex. A sprinkling of nuts adds protein. And, of course, a little chocolate rarely hurts!

9 servings
Prep Time: 15 minutes or less
Total Time: 15 minutes or less

Nutritional Information Per Serving (about ½ cup)

Calories 145
Total Fat 7 g
Total Carbohydrate 19 g
Dietary Fiber 2 g
Sugars 7 g
Protein 4 g
Sodium 170 mg

Nuts provide protein and are relatively low in saturated fat.

1 cup pretzels
1 cup peanut butter Ritz bits, Wheat Thins, or other small
crackers 1 cup whole grain cereal,
such as Cheerios or Quaker Oatmeal Squares
½ cup almonds (dry roasted)
½ cup raisins
½ cup plain or peanut M&Ms, optional

1. In a container with an airtight lid, combine the pretzels, crackers, cereal, almonds, raisins, and M&Ms.

Twice-Baked Potatoes

Twice-baked potatoes transform a standard baked potato into a creamy and comforting small meal. The potato skin becomes an edible shell for mildly flavored mashed potatoes, the ultimate comfort food.

For a more substantial meal, keep the potatoes whole instead of halving them. Slice a ½ inch off the top of each potato lengthwise and hollow out the skins. For stronger flavor, top with minced fresh chives or additional Parmesan cheese.

If you’re trying to increase calories, add butter, substitute heavy cream for the milk, and choose full-fat cheeses. If you’re trying to control your weight, choose reduced-fat options.

Instead of being microwaved, the potatoes can also be baked for 1 hour at 350 degrees.

4 servings
Prep Time: 15 minutes or less
Total Time: 45 minutes or less

Nutritional Information Per Serving

Calories 205
Total Fat 6 g
Total Carbohydrate 33 g
Dietary Fiber 3 g
Sugars 1 g
Protein 5 g
Sodium 70 mg

2 large (12 to 14 ounces) Russet potatoes, scrubbed
1 tablespoon butter, room temperature
2 to 3 tablespoons low-fat milk
2 to 3 tablespoons regular or reduced-fat sour cream
2 to 3 tablespoons regular or reduced-fat shredded Cheddar cheese
Salt and freshly ground black pepper
1 tablespoon grated Parmesan cheese

1. Pierce potatoes in several places with a fork. Microwave on high for 6 to 8 minutes, turning halfway through the cooking time if your microwave does not have a carousel or tends to heat unevenly. Remove and set aside to cool briefly.

2. Preheat the oven to 375 degrees.

3. When potatoes are cool enough to handle (but still very warm), cut them in half lengthwise and scoop the potato flesh into a mixing bowl, leaving a ¼-inch-thick shell and using care not to break the skins.

4. In the bowl with the potato flesh, add the butter and mash to combine. Add 2 tablespoons each of the milk, sour cream, and Cheddar cheese and mash until creamy and combined. Season with salt and pepper. Taste and add more milk, sour cream, or Cheddar cheese if necessary. Divide the mixture evenly among the potato shells. Arrange stuffed potatoes on a baking sheet and sprinkle with Parmesan cheese.

5. Bake for 15 to 20 minutes, or until cheese has melted and potatoes are lightly golden.

Brie and Apple Grilled Cheese

Sometimes a slight twist, like a special bread or an unexpected cheese, makes an ordinary sandwich suddenly appealing. In this heated sandwich, Brie, a creamy, soft cheese, melts into a yummy puddle of comfort on raisin bread.

You can substitute Cheddar or another hard cheese for Brie if your doctor has advised you to avoid soft cheeses.

1 serving
Prep Time: 15 minutes or less
Total Time: 15 minutes or less

Nutritional Information Per Serving

Calories 310
Total Fat 17 g
Total Carbohydrate 30 g
Dietary Fiber 2 g
Sugars 9 g
Protein 10 g
Sodiumv 540 mg

Don’t like raisins? You can substitute cinnamon swirl or any soft bread for the raisin bread in this sandwich.

1 ½ ounces Brie cheese, white rind trimmed, or other cheese, at room temperature
2 slices raisin bread
2 to 3 thin slices peeled Granny Smith or other apple
1 teaspoon butter, softened

1. Spread the Brie on one side of each piece of bread. Place apple on top of one slice and top with the other slice, cheese side down. Spread the butter on the other sides of the bread.

2. Place in a skillet over medium heat. Cook until the bottom is golden and the cheese begins to melt. Carefully turn the sandwich and cook until golden and the cheese has melted completely.

Cheese and Spinach Strata

Strata, a savory breakfast bread pudding, can be prepared the night before so the egg mixture has time to absorb into the bread, making a soft, custardy, comforting dish. Even though some people may be turned off by eggs, in this mild strata the egg flavor is not assertive.

This version includes chopped spinach for added nutrients, but you can leave it out if spinach isn’t appealing. You can make the flavors stronger by adding sautéed mushrooms, tomatoes, or other ingredients if your stomach is up to it.

Use any type of leftover bread. For better texture, leave the bread out for several hours to go stale so the eggs will better soak into the bread.

6 to 8 servings
Prep Time: 30 minutes or less
Total Time: 1 hour and 30 minutes plus 8 hours or more
refrigeration

Nutritional Information Per Serving

Calories 250
Total Fat 12 g
Total Carbohydrate 20 g
Dietary Fiber 2 g
Sugars 5 g
Protein 16 g
Sodium 400 mg

Spinach is full of vitamins C, E, and K, as well as beta carotene, folate, and riboflavin. Eggs are not only high in protein, but also provide biotin, a structural component in bone and hair.

Reserve ¼ cup of the spinach to make the Cheese and Spinach
Portobello Pizzas (page 127).

5 eggs
1 ½ cups low-fat milk
5 cups cubed stale bread (about 1-inch cubes)
1 cup regular or reduced-fat shredded Cheddar cheese
1 (10-ounce) box frozen chopped spinach, thawed, squeezed
of excess liquid, and patted dry
Salt and freshly ground black pepper

(Continues…)Excerpted from What to Eat During Cancer Treatment by Jeanne Besser, Kristina Ratley, Sheri Knecht, Michele Szafranski. Copyright © 2009 American Cancer Society. Excerpted by permission of American Cancer Society / Health Promotions.
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