When you are healthy, eating enough food to get the nutrients you need is usually not a problem. In fact, most nutrition guidelines stress eating lots of vegetables, fruits, and whole grain products such as whole wheat breads or pasta; limiting the amount of red meat that you eat, especially those that are processed or high in fat; cutting back on fat, sugar, alcohol, and salt; and staying at a healthy weight.

When you are being treated for cancer, however, this may be hard to do, especially if you have side effects or just don't feel well. As a result, you may need to change your diet to help build up your strength and withstand the effects of your cancer and its treatment.

When your cancer was first diagnosed, your doctor talked with you about a treatment plan. This may have involved surgery, radiation therapy, chemotherapy, hormone therapy, biologic therapy (immunotherapy), or some combination of treatments. All of these treatments kill cancer cells. But in the process some healthy cells also become damaged. That is what causes the cancer treatment side effects. The following side effects can affect your ability to eat:

• loss of appetite (anorexia)
• weight loss or gain
• sore mouth or throat
• dry mouth
• dental and gum problems
• changes in taste or smell
• nausea
• vomiting
• diarrhea
• constipation
• fatigue (tiredness)
• depression

You may or may not have any of these side effects. Many factors determine if you will have any side effects and how severe they will be. These factors include the type of cancer you have, the part of the body affected, the type and length of your treatment, and the dose of treatment.

Many side effects can be controlled and most go away after treatment ends. Talk with your doctor or nurse about your chances of having side effects and what can be done to help control them. After your treatment starts, tell your cancer care team about any side effects that are not controlled. Let them know if the medicines they have given you to control the side effects do not work, so that others can be used.

Ways to get the nutrients you need

If you have cancer, you need to take in enough nutrients to meet the following goals:

• prevent or reverse nutritional deficiencies
• decrease side effects of cancer and its treatment
• maximize your quality of life

Your health care team has several methods to help you get the nutrients you need. The most common ways are:

By mouth

If you can, try to meet your nutritional needs by eating and drinking nutritious foods and drinks. You may be able to get enough nutrients by eating high-calorie, high-protein meals supplemented with snacks, canned liquid nutrition products, and homemade drinks and shakes. If that proves to be too hard, or if your calorie and nutrient needs have greatly increased, you may need to use a feeding tube.

By feeding tube

Tube feedings are used most often to maintain good nutrition or to boost weight in people who have a poor appetite. Tube feedings can be given at home, if needed, with the help of family, friends, or caregivers. Once tube feedings begin, you will usually feel better because your nutritional needs are being met.

For tube feeding, a thin, flexible tube is placed through the nose and into the stomach. Once the tube is in place, liquid formulas can be given. If needed, such formulas can provide all of your needs for calories, protein, vitamins, and minerals. People who have feeding tubes can usually continue to eat by mouth since the tube is small and does not keep you from swallowing.

If you need a feeding tube, every effort will be made to help you eat by mouth, too. For example, you may be tube fed at night while you sleep toallow you to eat during the day. Most people get used to tube feedings within a few days. Some people may need longer to adjust. It often helps to talk with someone who has also had a feeding tube.

A more permanent type of tube can be placed directly into the stomach(gastrostomy) or the intestines (jejunostomy). These surgical procedures can usually be done in an outpatient setting.

By vein (total parenteral nutrition)

Tube feedings may not always provide all the needed fluids and nutrients in people with serious digestive problems. In these cases, nutrient solutions can be given directly through a vein. This type of therapy is called intravenous hyperalimentation or total parenteral nutrition (TPN). TPN is most often used when someone has had surgery of the digestive system; when there is a complete blockage of the bowel; when the person has severe vomiting or diarrhea; or when complications from cancer or treatment prevent eating or using a feeding tube. Like tube feedings, TPN can be given at home.