Managing side effects
We will go through a number of side effects you may experience
during treatment, and list some helpful resources we have
available.
Dietitians from Royal Surrey NHS Foundation Trust have created a
number of helpful short videos covering the side effects and
frequently asked questions. To watch these videos head to their
website: Diet and
cancer videos | Royal Surrey NHS Foundation Trust
What if eating becomes difficult?
Where possible, try to eat as healthily as you can, however
there may be times when supporting your health and coping with
cancer or treatment-related side-effects means that you need to
adjust the way that you eat. Dealing with some of the side effects
of treatment requires patience and a willingness to experiment with
different meal patterns, flavours and foods.
For information specific to some of the common symptoms and side
effects of cancer and cancer treatments, please
view a series of videos produced by dietitians at Royal Surrey NHS
Foundation Trust.
Coping with a small appetite
Loss of appetite during cancer treatment is very common and can
be related to the physical and emotional effects of cancers, or the
side-effects of your surgery or treatment. Often a loss of appetite
can make it difficult to eat as much as normal and can result in
weight loss.
When your appetite is low or you have lost weight without trying
you may need to make different food choices to what you are used
to. When you are eating less, it is important to make sure what you
do eat is as high in nutrients, calories (energy), and protein as
possible. This can help to avoid weight loss and help you feel as
well as you can.
For ideas of how to make your diet more nourishing click on the
following links:
Coping
with a small appetite
Coping
with a small appetite on a plant based diet
Coping
with a small appetite when you have diabetes
Sore mouth and throat
If eating and drinking is painful speak with your healthcare
team as they may be able to advise and prescribe mouthwashes or
medications to help ease the discomfort. Some of these may be best
taken 20 to 30 minutes before eating but always follow the advice
of your healthcare professional.
For
dietary tips on coping with a sore mouth and throat read our
leaflet.
Dry mouth
Often people find that regularly sipping drinks and choosing
moist foods help them cope with a dry mouth, however, some find
that special lozenges and chewing gums can also be helpful and are
available to buy from a pharmacy. Artificial saliva is also
available on prescription. Talk to your doctor or nurse about
these.
Find
further dietary tips on coping with a dry mouth in our
leaflet
Taste changes
Sometimes as a result of cancer or cancer treatments and
medications, the taste of your food changes. Some people may find
foods taste too salty, too sweet or they may not taste of anything
at all. Some people report a metallic taste, and others will report
that everything tastes like 'cardboard'. For others some things
just might taste 'off'.
Dealing with taste changes requires patience and willingness to
experiment with different flavours and combinations of food and
drinks. Here are
some tips to help with your eating when you have taste
changes.
Nausea
If nausea and vomiting is caused by your treatment, your doctor
may need to prescribe anti-sickness medication. These medicines
work in different ways so it may take time to find the right one
for you. If they are not working for you, speak with your
healthcare team.
There are
some dietary recommendations to help manage your nausea.
Diarrhoea
Diarrhoea is a common side effect of cancer treatments and
medications as well as after bowel surgery. Chemotherapy and pelvic
radiotherapy can affect the lining of the bowel, causing looser
bowel movements. This is usually temporary.
Infections and certain medications such as antibiotics can also
give you diarrhoea. It's important to discover the cause of your
diarrhoea to ensure that it's correctly treated or managed. If you
are having diarrhoea please talk to your healthcare team about
it.
- Drink plenty to replace the liquid you have lost and avoid
dehydration. If the diarrhoea is very frequent consider adding salt
to foods or eating salty foods and drinks e.g. savoury drinks and
crisps.
- Limit or avoid caffeinated and alcoholic drinks as they can act
as stimulants to the bowel and may make diarrhoea worse.
- Limit fatty, greasy and oily foods as these can also make
diarrhoea worse for some people.
- For some, reducing the amount of fibre (roughage) in the diet
in the short term can be helpful. Fibre can be found in the skins,
pips and seeds of fruits vegetables and grains so peeling fruit and
vegetables and choosing white or low fibre cereals and bread e.g.
white bread, corn or rice based cereals will help reduce the fibre
in your diet. You can reintroduce these higher fibre foods once the
diarrhoea has settled as this is an important part of a healthy
diet.
- People who have had bowel surgery may have an altered bowel
habit after surgery which differs to before surgery. The advice
above may still be helpful but you can talk to your healthcare team
about what is to be expected after surgery.
Constipation
Constipation can be caused by medications for example some
chemotherapy, painkillers and anti-sickness medications. Changes in
diet and reduced activity during cancer treatment can also affect
your bowel habits. Sometimes laxatives are needed; you can speak to
your healthcare team about this.
Some of the following tips can also help:
- Caffeine, for example in tea, coffee and some fizzy drinks can
sometimes have a mild laxative effect.
- Increasing the amount of fibre that you eat can also help with
constipation. Foods which are naturally high in fibre are fruits,
vegetables, whole grains and beans and pulses.
- Be mindful that increasing fibre intake can cause abdominal
symptoms of bloating and gas but this should settle with time.
- Be sure to drink plenty of fluids when increasing your fibre
intake and increase fibre gradually to minimise symptoms.
Inform your healthcare team if you remain constipated after
trying these measures.
If you are having treatment that involves the bowel, you should
always seek specialist advice from your healthcare team before
increasing your fibre intake.
Fatigue and tiredness
Fatigue can make food shopping, meal preparation and eating more
difficult. Eating a nutritious and balanced diet can be an
important step towards improving your energy levels.
Practical tips:
- Make the most of times when you have more energy to plan meals,
or batch cook. Freeze individual portions for the days you have
less energy or time.
- Take friends or family up on any offers to help with food
shopping or preparation.
- Using items which can be kept in the kitchen store cupboard or
freezer can help simplify meal and snack preparation. Some foods
are available pre-portioned for ease of preparation.
- Eat when you feel like it, even if this differs from your
normal eating pattern.
- Soft, moist foods require less chewing and therefore can be
easier to eat.
- Most supermarkets offer an online home delivery service.
- Ready-prepared/frozen meals can be delivered by a meal delivery
companies or supermarkets. Or some companies offer recipe boxes
with all the ingredients needed to prepare a meal.
- Some people find it helpful to set alarms or write daily
checklists to prompt them to eat, this can be useful when you have
lost interest in food.
- Local voluntary organisations may also be available in your
area (ask your cancer support worker or the team at the Cancer
Information and Support Centre on level 4, Bristol Haematology and
Oncology Centre or the Macmillan Centre, first floor, Weston
General Hospital).