Tips for Patients on Maintaining Weight During Cancer Therapy

NEW YORK--Getting good nutrition can be hard for patients undergoingcancer treatment. But taking in as much nourishment as possiblewhile they still have an appetite can help, advises Memorial Sloan-Ketteringdietitian Maria Biasucci.

"Take advantage of the uptimes," she urged patientsattending a Cancer Care nutrition seminar in Manhattan. "Areyou going to be getting therapy in 2 weeks? Eat as much as youcan because you may not feel like it later, and you may lose someweight."

Before and during therapy, patients should supplement their dietwith high-calorie foods, adding enriching butter or margarine,cream and dressings. If they can tolerate it, Ms. Biasucci recommendsthat patients drink "double-strength milk.".

Patients should also think about preparing meals and freezingthem for use during therapy when they may not feel like cooking.They should have protein snacks and high-calorie protein drinkson hand in case other foods become unappealing to them, she said.

A patient at the Cancer Care meeting told Ms. Biasucci that foodtasted bad and asked what could be done. "You might wantto avoid red meat because that can cause a bitter taste,"she said. "Substitute the lighter cuts like turkey, chicken,or fish. Use more eggs and more dairy products to supplement proteinintake. Put meat in casseroles or soups to mask the flavor. Tryusing other seasonings like lemon juice, basil, rosemary, or oregano."

People with chewing or swallowing problems, she said, should gettender or chopped cuts of meat and put gravy or sauce on the meatto make chewing easier. Canned or cooked foods, pureed meats orvegetables, and even baby foods are helpful.

Those with dry mouth should also use soft food. They should drinkplenty of liquids; puree their foods; add gravy, margarine, orbutter; and avoid acidic or salty foods or coarse foods like toast,cookies, or cakes unless dipped in liquid.

"Can I eat vegetables? Do they have too much vitamin K?"a women taking blood thinner asked. Yes, she could have a consistentmoderate intake of vegetables, Ms. Biasucci said, but she advisedagainst dark green leafy vegetables.

Small, frequent meals, six to eight a day, are best for thosewith GI problems. Patients should eat slowly to avoid ingestionof air, avoid highly seasoned or greasy foods, and stay away fromgassy foods like onions, green peppers, and cauliflower, Ms. Biasuccisaid.

Patients who have diarrhea during and after therapy should uselow-fiber foods, try canned vegetables and fruits, and avoid fattyfoods. Those that need to avoid milk and milk products can useEnsure or other high-protein, high-calorie drinks that do nothave lactose, but drink it in small sips, Ms. Biasucci advised.

People who are constipated during or after treatment should eathigh-fiber foods (raw vegetables, salads, fruits) and add oneor two tablespoons of Millers wheat bran to cereals, casseroles,or other foods, she said. They should also snack on high-fiberfoods, such as oatmeal cookies or granola bars, and drink prunejuice or hot lemon water in the morning.

Patients should not worry about their food intake on the dayswhen they are feeling a little bit sick or queasy, she said. Theycan eat small frequent meals or snack on crackers or toast. Sippingliquids slowly through a straw can help the queasiness, she suggested.

"When you're done with treatment, follow the food pyramid,"Ms. Biasucci urged the patients. "Choose foods lower downon the pyramid, the high-fiber and nonfat or low-fat options,"she said, pointing out that a diet high in fat has been associatedin some studies with development of gastric, breast, and coloncancer and with recurrences.

Double -Strength Milk

Double-strength milk is made by adding a cup of nonfat dry milkpowder to a quart of whole milk. "It's something I like touse with cancer patients who can tolerate milk products becauseit increases the calories and protein in milk," Ms. Biasuccisaid. She advises cancer patients undergoing therapy to use itwith hot or cold cereal or whenever milk is used.

For additional calories, Ms. Biasucci suggested using double-strengthmilk with supplements available in grocery stores such as CarnationInstant Breakfast. "If you make it with the double-strengthmilk, it has as many calories as Ensure or other protein supplements,"she said.