Preparing yourself for cancer treatment

Until you begin treatment, you won't know exactly what, if any, side effects you may have or how they feel. One way to prepare for them is to think of your treatment as a time to focus on yourself and on getting well. Some other ways to get ready include the following:

The power of positive thinking

You can reduce your anxiety about treatment side effects by having a positive attitude, talking about your feelings, and learning as much as you can about your cancer and treatment. Planning how you will cope with possible side effects can make you feel more in control and help you keep your appetite.

Many people have few or no side effects that keep them from eating. Even if you have side effects, they may be mild, and you may be able to control side effects with drugs that are available. Most of these effects go away after cancer treatment ends.

For more information on coping, call the American Cancer Society at 1-800-ACS-2345 and ask about our booklets A Message of Hope: Coping With Cancer in Everyday Life; Understanding Chemotherapy: A Guide for Patients and Families; and Understanding Radiation Therapy: A Guide for Patients and Families.

Eating well

Your body needs a healthy diet to function at its best. It is even more important if you have cancer. With a healthy diet, you'll go into treatment with reserves to help keep up your strength, prevent body tissue from breaking down, rebuild tissue, and maintain your defenses against infection. People who eat well are better able to cope with side effects of treatment. And you may even be able to handle higher doses of certain drugs. In fact, some cancer treatments are more effective in people who are well-nourished and are getting enough calories and protein.

• Don't be afraid to try new foods. Some things you may never have liked before may taste good to you during treatment.

• Choose a diet with many types of plant-based food. Try substituting dried beans and peas for meat at a few meals each week.

• Try to eat at least 5 colorful servings a day of fruits and vegetables, including citrus fruits and dark-green and deep-yellow vegetables. Colorful vegetables and fruits and plant-based foods contain natural health-promoting substances called phytochemicals.

• Limit high-fat foods, especially those from animal sources. Choose lower-fat milk and dairy products. Reduce the amount of fat in your meals by choosing a lower-fat cooking method such as baking or broiling.

• Limit the amount of salt-cured, smoked, and pickled foods that you eat.

• Drink alcohol in moderation, if at all.

• Try to maintain a healthy weight and be physically active.

• If you are not able to do any of the above during this time, do not worry about it.

Plan ahead

• Stock your pantry and freezer with your favorite foods so you won't need to shop as often. Include foods you know you can eat even when you are sick.

• Cook in advance and freeze foods in meal-sized portions.

• Talk to your friends or family members about ways they can help with shopping and cooking, or ask a friend or family member to take over those jobs for you.

• You can also talk to your doctor, nurse, or a registered dietitian about any concerns you have about eating well. She or he can help you plan meals and develop a grocery list in case you have side effects such as constipation or nausea.

Include nutritious snacks

During cancer treatment your body often needs extra calories and protein to help you maintain your weight and recover and heal as quickly as possible. Nutritious snacks can help you meet those needs, keep up your strength and energy level, and enhance your feeling of well-being. To make it easier to add snacks to your daily routine, try the following:

• Eat small, nutritious snacks throughout the day.

• Keep a variety of protein-rich snacks on hand that are easy to prepare and eat. These include yogurt, cereal and milk, half a sandwich, a bowl of hearty soup, and cheese and crackers.

• Avoid snacks that may make any treatment-related side effects worse. If you suffer from diarrhea, for example, avoid popcorn and raw fruits and vegetables. If you have a sore throat, avoid dry, coarse snacks and acidic foods.

• If you are able to eat normally and maintain your weight without snacks, then do not include them.

Suggestions for increasing calories and protein

Eat several small, frequent meals and snacks a day rather than 3 large ones.

Eat favorite foods at any time of the day. For example, eat breakfast foods for dinner if they appeal to you.

Eat every few hours. Don't wait until you feel hungry.

Eat your biggest meal when you feel hungriest. For example, if you are hungriest in the morning, make breakfast your biggest meal.

Try to eat high-calorie, high-protein foods at each meal and snack.

Exercise lightly or take a walk before meals to increase your appetite.

Drink high-calorie, high-protein beverages such as milkshakes and canned liquid supplements. Cold drinks are usually tolerated well.

Drink most of your fluids between meals instead of with meals. Drinking fluid with meals can make you feel too full.

Try homemade or commercially prepared nutrition bars and puddings.

*Adapted from Eldridge B, and Hamilton KK, Editors, Management ofNutrition Impact Symptoms in Cancer and Educational Handouts. Chicago,IL: American Dietetic Association; 2004.

High-Calorie, High-Protein Shake and Drink Recipes

If you need more calories or have trouble swallowing, you might try the following recipes. They might not be right for everyone. If you want to increase calories but not fat, try using reduced-fat dairy products.

For the recipes below, follow these basic instructions:

Place all ingredients in a blender container or prepare in a large container with a hand-held blender.
Cover and blend on high speed until well mixed.
Chill drinks before serving.
Store unused drinks in the refrigerator or freezer.
Add 1 to 2 tablespoons of powdered milk to each recipe to increase protein.

Note: If you cannot tolerate milk or milk products or if you have diabetes, ask your nurse or dietitian for other recipe ideas.

Fortified milk
Drink or use in cooking to add protein

1 quart whole or low-fat milk and 1 cup powdered non-fat dry milk

Blend and chill at least 6 hours. Can also be made with buttermilk or dry buttermilk.

(211 calories and 14 grams of protein per cup)

Sherbet shake
A refreshing shake

1 cup sherbet
1/2 cup whole milk or low-fat milk
1/2 teaspoon vanilla extract

(422 calories and 6 grams of protein per serving)

Cottage cheese smoothie
A thick, protein-packed drink

1/3 cup cottage cheese
1/2 cup vanilla ice cream
1/4 cup prepared fruit flavored gelatin

(310 calories and 11 grams of protein per serving)

Classic instant breakfast milkshake
A protein-packed favorite

1/2 cup whole milk
1 envelope instant breakfast mix
1 cup vanilla ice cream (add flavorings or different flavor ice creams forvariety)

(474 calories and 20 grams of protein per serving)

Peach yogurt frost
A frosty, tangy drink

1 envelope vanilla instant breakfast mix
1 cup whole milk
1/2 cup peach yogurt
6 to 10 crushed ice cubes

(400 calories and 19 grams of protein per serving)

Chocolate cocoa drink
A cool, creamy chocolate drink

1 ¼ cup vanilla ice cream
1/2 cup whole milk
1 package of hot chocolate mix
2 teaspoons sugar

(600 calories and 24 grams of protein per serving)

Homemade soup recipes

Winter soup

2 tablespoons canola oil
1 medium onion, chopped
2 (14 ½-oz) cans fat-free chicken broth, or same amount of homemade broth
3/4 cup tomato sauce
1/2 cup macaroni, uncooked
1 (15-oz) can white beans (cannelloni or Great Northern beans), drained
Pepper to taste

Heat oil in a large soup pot over medium low heat. Add onion and cook for3 minutes. Add broth and tomato sauce, bring to a boil, then stir in macaroni. Reduce heat, cover and simmer for 10 minutes. Add pepper to taste, then stir in white beans. Heat mixture thoroughly. Serve in soup bowls with croutons, cornbread, crackers, or a sprinkle of Parmesan cheese. Makes 4 to 6 servings.

Approximate nutrients per serving: 295 calories, 8 grams of fat

Turkey vegetable soup

1 teaspoon canola oil
1 lb 93%-lean ground turkey
1 cup onion, diced
1 large clove garlic, minced
2 cups water
1 ½ cups potato, peeled and diced
1/2 cup carrots, peeled and chopped
2 (15-oz) cans tomatoes (no salt added)
1 (10-oz) package frozen mixed vegetables
1 teaspoon chili powder
1/2 teaspoon each oregano and marjoram

In a large pot over low heat, sauté the turkey, onion, and garlic in oil. Drain fat. Add water and potatoes and bring to a boil. Cook 10 minutes.Add carrots and tomatoes and cook 10 minutes more. Add mixed vegetables and spices, cover, and simmer for 15 minutes. Makes 8 servings, 1½ cups each.

Approximate nutrients per serving: 190 calories, 21 grams of protein

Gazpacho

2 cans tomato soup
2 cans water
1 tablespoon olive oil
1 teaspoon salt
Dash hot sauce
Dash garlic powder
1 small onion, chopped
1 cucumber, peeled, seeded, and chopped
1 green pepper, seeded and chopped
1 large can or 2 fresh tomatoes, peeled, seeded, and chopped

Mix together the first 6 ingredients, then add remaining 4. Chill and serve with chips or crackers. Puree in blender or food processor if desired. Makes 8 one-cup servings.

Approximate nutrients per serving: 90 calories, 2 grams protein, 3 grams fiber

Cream of broccoli soup

3 cups broccoli florets and peeled stems, finely chopped
1 ½ cups water
1 tablespoon canola or olive oil
1/2 cup onion, chopped
1 tablespoon all-purpose flour
3 cups 1%-fat milk
1/2 teaspoon salt (optional)
1/2 teaspoon pepper
1/4 teaspoon paprika
1/4 teaspoon celery seed
1/8 teaspoon cayenne pepper

Combine broccoli and water in a 3-quart saucepan and bring to a boil. Lower heat; cover and simmer for 10 minutes. Drain, saving liquid. Put oil in a larger saucepan over low heat and add onion and sauté until soft. Add flour and continue to cook for several seconds, stirring constantly. Stir in reserved liquid and cook until thickened. Add milk, broccoli, salt, black pepper, paprika, celery seed, and cayenne pepper, mixing well. Heat to serving temperature over low heat. Makes 6 servings.

Approximate nutrients per serving: 101 calories, 3 grams of fat

Potato soup

3 medium potatoes, peeled and cubed
2 cups reduced-sodium chicken broth
2 stalks chopped celery
1/2 small onion, peeled
1 tablespoon olive oil
1 tablespoon flour
2 cups milk
2 eggs, hard cooked, peeled, and chopped
Salt and pepper to taste

Cook the potatoes in chicken broth with celery and onion until the potatoes are tender. Blend the mixture in a blender or processor. In a heavy saucepan over low heat, stir flour into the oil to make a paste. Slowly add the milk, stirring or whisking continuously until the mixture is thoroughly blended and heated through. Add the pureed potato mixture. Add chopped eggs that have been pushed through a sieve. Mix well and season with salt and pepper as desired. Serve hot or cold. (This soup thickens when chilled and may need to be thinned with more chicken broth or milk.) Makes 4 servings.

Approximate nutrients per serving: 240 calories, 12 grams protein when prepared with reduced-fat milk

Don’t forget about physical activity!

Physical activity provides many benefits such as helping to maintain muscle mass, strength, and stamina, and bone strength. It can help reduce depression, stress, and constipation. So, if you don’t already exercise, talk to your doctor about including at least 30 minutes or more of moderate activity, like walking, on 5 or more days of the week as you are able. If your doctor approves, start where you are (perhaps 5 to 10 minutes each day) and work up to the goal of 30 minutes -- as you are able.

Revised: 02/04/2008