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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/pdqcis/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" alt="Cover of PDQ Cancer Information Summaries" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>PDQ Cancer Information Summaries [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK66004_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK66004_dtls__"><div>Bethesda (MD): <a href="http://www.cancer.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Cancer Institute (US)</a>; 2002-.</div></div><div class="half_rhythm"></div><div class="bk_noprnt"><form method="get" action="/books/n/pdqcis/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK66004_"><span class="title" itemprop="name">Nutrition in Cancer Care (PDQ®)</span></h1><div class="subtitle whole_rhythm">Patient Version</div><p class="contrib-group"><span itemprop="author">PDQ Supportive and Palliative Care Editorial Board</span>.</p><p class="small">Published online: April 19, 2017.</p><p class="small">Created: <span itemprop="datePublished">March 24, 2003</span>.</p></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><div id="_abs_rndgid_" itemprop="description"><p id="CDR0000286996__632">This PDQ cancer information summary has current information about nutrition before, during, and after cancer treatment. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p><p id="CDR0000286996__633">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Supportive and Palliative Care Editorial Board.</p></div><div id="CDR0000286996__125"><h2 id="_CDR0000286996__125_">Overview of Nutrition in Cancer Care</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000286996__532">Good nutrition is important for cancer patients.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__575">Healthy eating habits are important during cancer treatment.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__139">Cancer can change the way the body uses food.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__126">Cancer and cancer treatments may affect nutrition.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__129">Anorexia and cachexia are common causes of malnutrition in cancer patients.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__132">It is important to treat weight loss caused by cancer and its treatment.</a></div></li></ul></div><div id="CDR0000286996__532"><h3>Good nutrition is important for cancer patients.</h3><p id="CDR0000286996__534"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044698/" class="def">Nutrition</a> is a process in which food is taken in and used by the body for growth, to keep the body healthy, and to replace <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a>. Good nutrition is important for good health. Eating the right kinds of foods before, during, and after <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> treatment can help the patient feel better and stay stronger. A healthy <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044660/" class="def">diet</a> includes eating and drinking enough of the foods and liquids that have the important <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044697/" class="def">nutrients</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044744/" class="def">vitamins</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045787/" class="def">minerals</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046092/" class="def">protein</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000285960/" class="def">carbohydrates</a>, fat, and water) the body needs.</p><p id="CDR0000286996__535">When the body does not get or cannot absorb the nutrients needed for health, it causes a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">condition</a> called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046014/" class="def">malnutrition</a> or malnourishment.</p><p id="CDR0000286996__604">This summary is about nutrition in adults with cancer.</p></div><div id="CDR0000286996__575"><h3>Healthy eating habits are important during cancer treatment.</h3><p id="CDR0000286996__577"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463725/" class="def">Nutrition therapy</a> is used to help cancer patients get the nutrients they need to keep up their body weight and strength, keep body tissue healthy, and fight <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045364/" class="def">infection</a>. Eating habits that are good for cancer patients can be very different from the usual healthy eating guidelines.
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</p><p id="CDR0000286996__578">Healthy eating habits and good nutrition can help patients deal with the effects of cancer and its treatment. Some cancer treatments work better when the patient is well nourished and gets enough <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044651/" class="def">calories</a> and protein in the diet. Patients who are well nourished may have a better <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045849/" class="def">prognosis</a> (chance of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454708/" class="def">recovery</a>) and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>.
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</p></div><div id="CDR0000286996__139"><h3>Cancer can change the way the body uses food.</h3><p id="CDR0000286996__141">Some <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumors</a> make chemicals that change the way the body uses certain nutrients. The body's use of protein, carbohydrates, and fat may be affected, especially by tumors of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046604/" class="def">stomach</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046335/" class="def">intestines</a>. A patient may seem to be eating enough, but the body may not be able to absorb all the nutrients from the food.</p></div><div id="CDR0000286996__126"><h3>Cancer and cancer treatments may affect nutrition.</h3><p id="CDR0000286996__348">For many patients, the effects of cancer and cancer treatments make it hard to eat well. Cancer treatments that affect nutrition include: </p><ul id="CDR0000286996__579"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a>.
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a>.
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a>.
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045729/" class="def">Immunotherapy</a>.</div></li><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046695/" class="def">Stem cell transplant</a>.
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</div></li></ul><p id="CDR0000286996__580">When the head, neck, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046408/" class="def">esophagus</a>, stomach, or intestines are affected by the cancer treatment, it is very hard to take in enough nutrients to stay healthy.</p><p id="CDR0000286996__581">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> of cancer and cancer treatment that can affect eating include:</p><ul id="CDR0000286996__349"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044103/" class="def">Anorexia</a> (loss of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454699/" class="def">appetite</a>).</div></li><li class="half_rhythm"><div>Mouth sores.</div></li><li class="half_rhythm"><div>Dry mouth.</div></li><li class="half_rhythm"><div>Trouble swallowing.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390302/" class="def">Nausea</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390324/" class="def">Vomiting</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000306496/" class="def">Diarrhea</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000407757/" class="def">Constipation</a>.</div></li><li class="half_rhythm"><div>Pain.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000430479/" class="def">Depression</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000430405/" class="def">Anxiety</a>.</div></li></ul><p id="CDR0000286996__350">Cancer and cancer treatments may affect taste, smell, appetite, and the ability to eat enough food or absorb the nutrients from food. This can cause malnutrition (a condition caused by a lack of key nutrients). Malnutrition can cause the patient to be weak, tired, and unable to fight infections or get through cancer treatment. Malnutrition may be made worse if the cancer grows or spreads. Eating too little protein and calories is a very common problem for cancer patients. Having enough protein and calories is important for healing, fighting infection, and having enough energy. </p></div><div id="CDR0000286996__129"><h3>Anorexia and cachexia are common causes of malnutrition in cancer patients.</h3><p id="CDR0000286996__131">Anorexia (the loss of appetite or desire to eat) is a common <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptom</a> in people with cancer. Anorexia may occur early in the disease or later, if the cancer grows or spreads. Some patients already have anorexia when they are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnosed</a> with cancer. Almost all patients who have <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000478743/" class="def">advanced cancer</a> will have anorexia. Anorexia is the most common cause of malnutrition in cancer patients.</p><p id="CDR0000286996__351"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044108/" class="def">Cachexia</a> is a condition marked by a loss of appetite, weight loss, muscle loss, and general weakness. It is common in patients with tumors of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lung</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046254/" class="def">pancreas</a>, and upper <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046189/" class="def">gastrointestinal tract</a>. It is important to watch for and treat cachexia early in cancer treatment because it is hard to correct.</p><p id="CDR0000286996__536"> Cancer patients may have anorexia and cachexia at the same time. Weight loss can be caused by eating fewer calories, using more calories, or both.</p></div><div id="CDR0000286996__132"><h3>It is important to treat weight loss caused by cancer and its treatment.</h3><p id="CDR0000286996__134">It is important that cancer symptoms and side effects that affect eating and cause weight loss are treated early. Both nutrition <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044737/" class="def">therapy</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482419/" class="def">medicine</a> can help the patient stay at a healthy weight. Medicine may be used for the following:</p><ul id="CDR0000286996__582"><li class="half_rhythm"><div>To help increase appetite.
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</div></li><li class="half_rhythm"><div>To help <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463707/" class="def">digest</a> food.
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</div></li><li class="half_rhythm"><div>To help the muscles of the stomach and intestines contract (to keep food moving along).
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</div></li><li class="half_rhythm"><div>To prevent or treat nausea and vomiting.
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</div></li><li class="half_rhythm"><div>To prevent or treat diarrhea.
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</div></li><li class="half_rhythm"><div>To prevent or treat constipation.
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</div></li><li class="half_rhythm"><div>To prevent and treat mouth problems (such as dry mouth, infection, pain, and sores).
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</div></li><li class="half_rhythm"><div>To prevent and treat pain.
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</div></li></ul><p id="CDR0000286996__583">See the <a href="#CDR0000286996__164">Nutrition Therapy in Cancer Care</a> section and the <a href="#CDR0000286996__177">Treatment of Symptoms</a> section for more information. </p></div></div><div id="CDR0000286996__164"><h2 id="_CDR0000286996__164_">Nutrition Therapy in Cancer Care</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000286996__278">Screening and assessment are done before cancer treatment begins, and assessment continues during treatment.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__277">Finding and treating nutrition problems early may improve the patient's prognosis (chance of recovery).</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__281">A healthcare team of nutrition specialists will continue to watch for nutrition problems.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__303">There are three main goals of nutrition therapy for cancer patients in active treatment and recovery.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__306">The goal of nutrition therapy for patients who have advanced cancer is to help with the patient's quality of life.</a></div></li></ul></div><div id="CDR0000286996__278"><h3>Screening and assessment are done before cancer treatment begins, and assessment continues during treatment.</h3><p id="CDR0000286996__369"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046171/" class="def">Screening</a> is used to look for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044698/" class="def">nutrition</a> risks in a patient who has no <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a>. This can help find out if the patient is likely to become <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000659993/" class="def">malnourished</a>, so that steps can be taken to prevent it.</p><p id="CDR0000286996__584"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000430407/" class="def">Assessment</a> checks the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044698/" class="def">nutritional</a> health of the patient and helps to decide if <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463725/" class="def">nutrition therapy</a> is needed to correct a problem.</p><p id="CDR0000286996__585">Screening and assessment may include questions about the following: </p><ul id="CDR0000286996__370"><li class="half_rhythm"><div>Weight changes over the past year.
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</div></li><li class="half_rhythm"><div>Changes in the amount and type of food eaten compared to what is usual for the patient.
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</div></li><li class="half_rhythm"><div>Problems that have affected eating, such as loss of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454699/" class="def">appetite</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390302/" class="def">nausea</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390324/" class="def">vomiting</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000306496/" class="def">diarrhea</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000407757/" class="def">constipation</a>, mouth sores, dry mouth, changes in taste and smell, or pain.
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</div></li><li class="half_rhythm"><div>Ability to walk and do other <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000430401/" class="def">activities of daily living</a> (dressing, getting into or out of a bed or chair, taking a bath or shower, and using the toilet).
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</div></li></ul><p id="CDR0000286996__523"> A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270871/" class="def">physical exam</a> is also done to check the body for general health and signs of disease. The doctor will look for loss of weight, fat, and muscle, and for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044669/" class="def">fluid</a> buildup in the body.</p></div><div id="CDR0000286996__277"><h3>Finding and treating nutrition problems early may improve the patient's prognosis (chance of recovery).</h3><p id="CDR0000286996__167">Early nutrition screening and assessment help find problems that may affect how well the patient's body can deal with the effects of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> treatment. Patients who are underweight or malnourished may not be able to get through treatment as well as a well-nourished patient. Finding and treating nutrition problems early can help the patient gain weight or prevent weight loss, decrease problems with the treatment, and help <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454708/" class="def">recovery</a>.</p></div><div id="CDR0000286996__281"><h3>A healthcare team of nutrition specialists will continue to watch for nutrition problems.</h3><p id="CDR0000286996__283">A nutrition support team will check the patient's nutritional health often during cancer treatment and recovery. The team may include the following <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000478785/" class="def">specialists:</a>
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</p><ul id="CDR0000286996__373"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390246/" class="def">Physician</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269445/" class="def">Nurse</a>.
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454994/" class="def">Registered dietitian</a>.
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044730/" class="def">Social worker</a>.
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044716/" class="def">Psychologist</a>.
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</div></li></ul><p id="CDR0000286996__586">A patient whose <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000489395/" class="def">religion</a> doesn't allow eating certain foods may want to talk with a religious advisor about allowing those foods during cancer treatment and recovery.</p></div><div id="CDR0000286996__303"><h3>There are three main goals of nutrition therapy for cancer patients in active treatment and recovery.</h3><p id="CDR0000286996__305">The main goals of nutrition therapy for patients in active treatment and recovery are to provide nutrients that are missing, maintain nutritional health, and prevent problems. The health care team will use nutrition therapy to do the following:
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</p><ul id="CDR0000286996__374"><li class="half_rhythm"><div>Prevent or treat nutrition problems, including preventing muscle and bone loss.
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</div></li><li class="half_rhythm"><div>Decrease <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> of cancer treatment and problems that affect nutrition.
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</div></li><li class="half_rhythm"><div>Keep up the patient's strength and energy.</div></li><li class="half_rhythm"><div>Help the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046356/" class="def">immune system</a> fight <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045364/" class="def">infection</a>.
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</div></li><li class="half_rhythm"><div>Help the body <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454708/" class="def">recover</a> and heal.</div></li><li class="half_rhythm"><div>Keep up or improve the patient's <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>.
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</div></li></ul><p id="CDR0000286996__375">Good nutrition continues to be important for patients who are in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045867/" class="def">remission</a> or whose cancer has been <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000318813/" class="def">cured</a>.</p></div><div id="CDR0000286996__306"><h3>The goal of nutrition therapy for patients who have advanced cancer is to help with the patient's quality of life.</h3><p id="CDR0000286996__308">The goals of nutrition therapy for patients who have <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000478743/" class="def">advanced cancer</a> include the following:
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</p><ul id="CDR0000286996__377"><li class="half_rhythm"><div>Control side effects.
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</div></li><li class="half_rhythm"><div>Lower the risk of infection.
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</div></li><li class="half_rhythm"><div>Keep up strength and energy.
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</div></li><li class="half_rhythm"><div>Improve or maintain quality of life.
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</div></li></ul><p id="CDR0000286996__600">See the <a href="#CDR0000286996__190">Nutrition in Advanced Cancer</a> section for more information.</p></div></div><div id="CDR0000286996__312"><h2 id="_CDR0000286996__312_">Types of Nutrition Care</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000286996__563">Nutrition support gives nutrition to patients who cannot eat or digest normally.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__587">Nutrition support for patients who cannot eat can be given in different ways.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__320">Enteral Nutrition</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000286996__380">Enteral nutrition is also called tube feeding. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__391">Enteral nutrition may continue after the patient leaves the hospital. </a></div></li></ul></li><li class="half_rhythm"><div><a href="#CDR0000286996__323">Parenteral Nutrition</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000286996__394">Parenteral nutrition carries nutrients directly into the blood stream.
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</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__398">The catheter may be placed into a vein in the chest or in the arm.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__410">Parenteral nutrition support may continue after the patient leaves the hospital.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__413">Ending parenteral nutrition support must be done under medical supervision.</a></div></li></ul></li></ul></div><div id="CDR0000286996__563"><h3>Nutrition support gives nutrition to patients who cannot eat or digest normally.</h3><p id="CDR0000286996__316">It is best to take in food by mouth whenever possible. Some patients may not be able to take in enough food by mouth because of problems from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> or cancer treatment. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482419/" class="def">Medicine</a> to increase <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454699/" class="def">appetite</a> may be used. </p></div><div id="CDR0000286996__587"><h3>Nutrition support for patients who cannot eat can be given in different ways.</h3><p id="CDR0000286996__589">A patient who is not able to take in enough food by mouth may be fed using <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390275/" class="def">enteral nutrition</a> (through a tube inserted into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046604/" class="def">stomach</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046335/" class="def">intestines</a>) or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390306/" class="def">parenteral nutrition</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045738/" class="def">infused</a> into the bloodstream). The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044697/" class="def">nutrients</a> are given in liquid formulas that have water, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046092/" class="def">protein</a>, fats, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000285960/" class="def">carbohydrates</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044744/" class="def">vitamins</a>, and/or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045787/" class="def">minerals</a>.
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</p><p id="CDR0000286996__590"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044698/" class="def">Nutrition</a> support can improve a patient's <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a> during cancer treatment, but there are harms that should be considered before making the decision to use it. The patient and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000650566/" class="def">health care providers</a> should discuss the harms and benefits of each type of nutrition support. (See the <a href="#CDR0000286996__190">Nutrition in Advanced Cancer</a> section below for more information on deciding whether to use nutrition support.)
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</p></div><div id="CDR0000286996__320"><h3>Enteral Nutrition</h3><div id="CDR0000286996__380"><h4>Enteral nutrition is also called tube feeding. </h4><p id="CDR0000286996__382">Enteral nutrition is giving the patient nutrients in liquid form (formula) through a tube that is placed into the stomach or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046582/" class="def">small intestine</a>. The following types of feeding tubes may be used:
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</p><ul id="CDR0000286996__383"><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000644739/" class="def">nasogastric tube</a> is inserted through the nose and down the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439429/" class="def">throat</a> into the stomach or small intestine. This kind of tube is used when enteral nutrition is only needed for a few weeks.
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</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476330/" class="def">gastrostomy tube</a> is inserted into the stomach or a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000686896/" class="def">jejunostomy</a> tube is inserted into the small intestine through an opening made on the outside of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>. This kind of tube is usually used for long-term enteral feeding or for patients who cannot use a tube in the nose and throat.
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</div></li></ul><p id="CDR0000286996__384">The type of formula used is based on the specific needs of the patient. There are formulas for patients who have special health <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">conditions</a>, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044911/" class="def">diabetes</a>. Formula may be given through the tube as a constant drip (continuous feeding) or 1 to 2 cups of formula can be given 3 to 6 times a day (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045620/" class="def">bolus</a> feeding).</p><p id="CDR0000286996__385">Enteral nutrition is sometimes used when the patient is able to eat small amounts by mouth, but cannot eat enough for health. Nutrients given through a tube feeding add the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044651/" class="def">calories</a> and nutrients needed for health. </p></div><div id="CDR0000286996__391"><h4>Enteral nutrition may continue after the patient leaves the hospital. </h4><p id="CDR0000286996__393">If enteral nutrition is to be part of the patient's care after leaving the hospital, the patient and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000648947/" class="def">caregiver</a> will be trained to do the nutrition support care at home.
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</p></div></div><div id="CDR0000286996__323"><h3>Parenteral Nutrition</h3><div id="CDR0000286996__394"><h4>Parenteral nutrition carries nutrients directly into the blood stream.
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</h4><p id="CDR0000286996__396">Parenteral nutrition is used when the patient cannot take food by mouth or by enteral feeding. Parenteral feeding does not use the stomach or intestines to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463707/" class="def">digest</a> food. Nutrients are given to the patient directly into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>, through a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045637/" class="def">catheter</a> (thin tube) inserted into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a>. These nutrients include proteins, fats, vitamins, and minerals. </p><p id="CDR0000286996__524">Parenteral nutrition is used only in patients who need nutrition support for five days or more.</p></div><div id="CDR0000286996__398"><h4>The catheter may be placed into a vein in the chest or in the arm.</h4><p id="CDR0000286996__400">A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045962/" class="def">central venous catheter</a> is placed beneath the skin and into a large vein in the upper chest. The catheter is put in place by a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044306/" class="def">surgeon</a>. This type of catheter is used for long-term parenteral feeding.</p><p id="CDR0000286996__401">A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463728/" class="def">peripheral venous catheter</a> is placed into a vein in the arm. A peripheral venous catheter is put in place by trained medical staff. This type of catheter is usually used for short-term parenteral feeding. </p><p id="CDR0000286996__402">The patient is checked often for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045364/" class="def">infection</a> or bleeding at the place where the catheter enters the body.
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</p></div><div id="CDR0000286996__410"><h4>Parenteral nutrition support may continue after the patient leaves the hospital.</h4><p id="CDR0000286996__412">
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If parenteral nutrition is to be part of the patient's care after leaving the hospital, the patient and caregiver will be trained to do the nutrition support care at home. </p></div><div id="CDR0000286996__413"><h4>Ending parenteral nutrition support must be done under medical supervision.</h4><p id="CDR0000286996__415">Going off parenteral nutrition support needs to be done slowly and is supervised by a medical team. The parenteral feedings are decreased by small amounts over time until they can be stopped, or as the patient is changed over to enteral or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044068/" class="def">oral</a> feeding.</p></div></div></div><div id="CDR0000286996__151"><h2 id="_CDR0000286996__151_">Effects of Cancer Treatment on Nutrition</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000286996__242"> Surgery and Nutrition</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000286996__152">Surgery increases the body's need for nutrients and energy.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__155">Surgery to the head, neck, esophagus, stomach, or intestines may affect nutrition.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__158">Nutrition therapy can help relieve nutrition problems caused by surgery.</a></div></li></ul></li><li class="half_rhythm"><div><a href="#CDR0000286996__243">Chemotherapy and Nutrition</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000286996__244">Chemotherapy affects cells all through the body.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__247">Chemotherapy may affect nutrition.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__250">Nutrition therapy can help relieve nutrition problems caused by chemotherapy.</a></div></li></ul></li><li class="half_rhythm"><div><a href="#CDR0000286996__253">Radiation Therapy and Nutrition</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000286996__254">Radiation therapy can affect cancer cells and healthy cells in the treatment area.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__257">Radiation therapy may affect nutrition.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__260">Nutrition therapy can help relieve the nutrition problems caused by radiation therapy.</a></div></li></ul></li><li class="half_rhythm"><div><a href="#CDR0000286996__263">Biologic Therapy and Nutrition</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000286996__264">Biologic therapy may affect nutrition.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__267">Nutrition therapy can help relieve nutrition problems caused by biologic therapy.</a></div></li></ul></li><li class="half_rhythm"><div><a href="#CDR0000286996__270">Stem Cell Transplant and Nutrition</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000286996__271">Stem cell transplant patients have special nutrition needs.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__274">Nutrition therapy is very important for patients who have a stem cell transplant.</a></div></li></ul></li></ul></div><div id="CDR0000286996__242"><h3> Surgery and Nutrition</h3><div id="CDR0000286996__152"><h4>Surgery increases the body's need for nutrients and energy.</h4><p id="CDR0000286996__154">The body needs extra energy and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044697/" class="def">nutrients</a> to heal <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000441269/" class="def">wounds</a>, fight <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045364/" class="def">infection</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454708/" class="def">recover</a> from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>. If the patient is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000659993/" class="def">malnourished</a> before surgery, it may cause problems during recovery, such as poor healing or infection. For these patients, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463725/" class="def">nutrition care</a> may begin before surgery.</p></div><div id="CDR0000286996__155"><h4>Surgery to the head, neck, esophagus, stomach, or intestines may affect nutrition.</h4><p id="CDR0000286996__157">Most <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> patients are treated with surgery. Surgery that removes all or part of certain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a> can affect a patient's ability to eat and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463707/" class="def">digest</a> food. The following are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044698/" class="def">nutrition</a> problems caused by specific types of surgery: </p><ul id="CDR0000286996__354"><li class="half_rhythm"><div>Surgery to the head and neck may cause problems with:<dl id="CDR0000286996__591" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">Chewing. </p></dd><dt>-</dt><dd><p class="no_top_margin">Swallowing.</p></dd><dt>-</dt><dd><p class="no_top_margin">Tasting or smelling food.</p></dd><dt>-</dt><dd><p class="no_top_margin">Making <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257526/" class="def">saliva</a>.</p></dd><dt>-</dt><dd><p class="no_top_margin">Seeing.
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</p></dd></dl></div></li><li class="half_rhythm"><div>Surgery that affects the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046408/" class="def">esophagus</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046604/" class="def">stomach</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046335/" class="def">intestines</a> may keep these organs from working as they should to digest food and absorb nutrients.</div></li></ul><p id="CDR0000286996__592">All of these can affect the patient's ability to eat normally. Emotional <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000450122/" class="def">stress</a> about the surgery itself also may affect <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454699/" class="def">appetite</a>.</p></div><div id="CDR0000286996__158"><h4>Nutrition therapy can help relieve nutrition problems caused by surgery.</h4><p id="CDR0000286996__160"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463725/" class="def">Nutrition therapy</a> can relieve or decrease the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> of surgery and help cancer patients get the nutrients they need. Nutrition therapy may include the following:</p><ul id="CDR0000286996__356"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463726/" class="def">Nutritional supplement</a> drinks.
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390275/" class="def">Enteral nutrition</a> (feeding liquid through a tube into the stomach or intestines).
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390306/" class="def">Parenteral nutrition</a> (feeding through a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045637/" class="def">catheter</a> into the bloodstream).
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482419/" class="def">Medicines</a> to increase appetite.
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</div></li></ul><p id="CDR0000286996__163">It is common for patients to have pain, tiredness, and/or loss of appetite after surgery. For a short time, some patients may not be able to eat what they usually do because of these <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a>. Following certain tips about food may help. These include: </p><ul id="CDR0000286996__357"><li class="half_rhythm"><div>Stay away from carbonated drinks (such as sodas) and foods that cause gas, such as:<dl id="CDR0000286996__548" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">Beans.</p></dd><dt>-</dt><dd><p class="no_top_margin">Peas.</p></dd><dt>-</dt><dd><p class="no_top_margin">Broccoli.</p></dd><dt>-</dt><dd><p class="no_top_margin">Cabbage.</p></dd><dt>-</dt><dd><p class="no_top_margin">Brussels sprouts.</p></dd><dt>-</dt><dd><p class="no_top_margin">Green peppers.</p></dd><dt>-</dt><dd><p class="no_top_margin">Radishes.</p></dd><dt>-</dt><dd><p class="no_top_margin">Cucumbers.</p></dd></dl></div></li><li class="half_rhythm"><div>Increase <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044651/" class="def">calories</a> by frying foods and using gravies, mayonnaise, and salad dressings. Supplements high in calories and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046092/" class="def">protein</a> can also be used.</div></li><li class="half_rhythm"><div>Choose high-protein and high-calorie foods to increase energy and help wounds heal. Good choices include:<dl id="CDR0000286996__550" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">Eggs.</p></dd><dt>-</dt><dd><p class="no_top_margin">Cheese.</p></dd><dt>-</dt><dd><p class="no_top_margin">Whole milk.</p></dd><dt>-</dt><dd><p class="no_top_margin">Ice cream.</p></dd><dt>-</dt><dd><p class="no_top_margin">Nuts.</p></dd><dt>-</dt><dd><p class="no_top_margin">Peanut butter.</p></dd><dt>-</dt><dd><p class="no_top_margin">Meat.</p></dd><dt>-</dt><dd><p class="no_top_margin">Poultry.</p></dd><dt>-</dt><dd><p class="no_top_margin">Fish.</p></dd></dl></div></li><li class="half_rhythm"><div>If <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000407757/" class="def">constipation</a> is a problem, increase <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046401/" class="def">fiber</a> by small amounts and drink lots of water. Good sources of fiber include:<dl id="CDR0000286996__549" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">Whole-grain cereals (such as oatmeal and bran).</p></dd><dt>-</dt><dd><p class="no_top_margin">Beans.</p></dd><dt>-</dt><dd><p class="no_top_margin">Vegetables.</p></dd><dt>-</dt><dd><p class="no_top_margin">Fruit.</p></dd><dt>-</dt><dd><p class="no_top_margin">Whole-grain breads.</p></dd></dl> See the <a href="#CDR0000286996__341">Constipation</a> section for more information.</div></li></ul></div></div><div id="CDR0000286996__243"><h3>Chemotherapy and Nutrition</h3><div id="CDR0000286996__244"><h4>Chemotherapy affects cells all through the body.</h4><p id="CDR0000286996__246"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a> affects fast-growing <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> and is used to treat cancer because cancer cells grow and divide quickly. Healthy cells that normally grow and divide quickly may also be killed. These include cells in the mouth, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046447/" class="def">digestive tract</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046379/" class="def">hair follicles</a>.</p></div><div id="CDR0000286996__247"><h4>Chemotherapy may affect nutrition.</h4><p id="CDR0000286996__249">Chemotherapy may cause side effects that cause problems with eating and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463707/" class="def">digestion</a>. When more than one anticancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drug</a> is given, more side effects may occur or they may be more severe. The following side effects are common:</p><ul id="CDR0000286996__358"><li class="half_rhythm"><div>Loss of appetite.
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044042/" class="def">Inflammation</a> and sores in the mouth.</div></li><li class="half_rhythm"><div>Changes in the way food tastes.
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</div></li><li class="half_rhythm"><div>Feeling full after only a small amount of food.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390302/" class="def">Nausea</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390324/" class="def">Vomiting</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000306496/" class="def">Diarrhea</a>.</div></li><li class="half_rhythm"><div>Constipation. (See the <a href="#CDR0000286996__341">Constipation</a> section for more information.)</div></li></ul></div><div id="CDR0000286996__250"><h4>Nutrition therapy can help relieve nutrition problems caused by chemotherapy.</h4><p id="CDR0000286996__252">Patients who have side effects from chemotherapy may not be able to eat normally and get all the nutrients they need to restore healthy <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044648/" class="def">blood counts</a> between treatments. Nutrition therapy can help relieve these side effects, help patients recover from chemotherapy, prevent delays in treatment, prevent weight loss, and maintain general health. Nutrition therapy may include the following: </p><ul id="CDR0000286996__359"><li class="half_rhythm"><div>Nutrition supplement drinks between meals.
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</div></li><li class="half_rhythm"><div>Enteral nutrition (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390298/" class="def">tube feedings</a>).
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</div></li><li class="half_rhythm"><div>Changes in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044660/" class="def">diet</a>, such as eating small meals throughout the day.</div></li></ul></div></div><div id="CDR0000286996__253"><h3>Radiation Therapy and Nutrition</h3><div id="CDR0000286996__254"><h4>Radiation therapy can affect cancer cells and healthy cells in the treatment area.</h4><p id="CDR0000286996__256"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> can kill cancer cells and healthy cells in the treatment area. The amount of damage depends on the following:</p><ul id="CDR0000286996__516"><li class="half_rhythm"><div>The part of the body that is treated.</div></li><li class="half_rhythm"><div>The total <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044664/" class="def">dose</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045072/" class="def">radiation</a> and how it is given.</div></li></ul></div><div id="CDR0000286996__257"><h4>Radiation therapy may affect nutrition.</h4><p id="CDR0000286996__259">Radiation therapy to any part of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046446/" class="def">digestive system</a> often has side effects that cause nutrition problems. Most of the side effects begin a few weeks after radiation therapy begins and go away a few weeks after it is finished. Some side effects can continue for months or years after treatment ends. </p><p id="CDR0000286996__593">The following are some of the more common side effects:</p><ul id="CDR0000286996__361"><li class="half_rhythm"><div>For radiation therapy to the head and neck
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<dl id="CDR0000286996__518" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">Loss of appetite.</p></dd><dt>-</dt><dd><p class="no_top_margin">Changes in the way food tastes.</p></dd><dt>-</dt><dd><p class="no_top_margin">Pain when swallowing.</p></dd><dt>-</dt><dd><p class="no_top_margin">Dry mouth or thick saliva.</p></dd><dt>-</dt><dd><p class="no_top_margin">Sore mouth and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000481753/" class="def">gums</a>.</p></dd><dt>-</dt><dd><p class="no_top_margin">Narrowing of the upper esophagus, which can cause choking, breathing, and swallowing problems.</p></dd></dl></div></li><li class="half_rhythm"><div>For radiation therapy to the chest<dl id="CDR0000286996__519" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">Infection of the esophagus.</p></dd><dt>-</dt><dd><p class="no_top_margin">Trouble swallowing.</p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390277/" class="def">Esophageal reflux</a> (a backward flow of the stomach contents into the esophagus).</p></dd></dl>
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</div></li><li class="half_rhythm"><div>For radiation therapy to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046246/" class="def">pelvis</a><dl id="CDR0000286996__520" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">Diarrhea.</p></dd><dt>-</dt><dd><p class="no_top_margin">Nausea.</p></dd><dt>-</dt><dd><p class="no_top_margin">Vomiting.</p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044042/" class="def">Inflamed</a> intestines or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046555/" class="def">rectum</a>.</p></dd><dt>-</dt><dd><p class="no_top_margin">A decrease in the amount of nutrients absorbed by the intestines.</p></dd></dl>
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</div></li></ul><p id="CDR0000286996__517">Radiation therapy may also cause tiredness, which can lead to a decrease in appetite.
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</p></div><div id="CDR0000286996__260"><h4>Nutrition therapy can help relieve the nutrition problems caused by radiation therapy.</h4><p id="CDR0000286996__262">Nutrition therapy during radiation treatment can help the patient get enough protein and calories to get through treatment, prevent weight loss, help <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000441269/" class="def">wound</a> and skin healing, and maintain general health. Nutrition therapy may include the following:
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</p><ul id="CDR0000286996__362"><li class="half_rhythm"><div>Nutritional supplement drinks between meals.
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</div></li><li class="half_rhythm"><div>Enteral nutrition (tube feedings).
|
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</div></li><li class="half_rhythm"><div>Changes in the diet, such as eating small meals throughout the day.
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</div></li></ul><p id="CDR0000286996__527">Patients who receive <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000440106/" class="def">high-dose radiation</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044737/" class="def">therapy</a> to prepare for a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045263/" class="def">bone marrow transplant</a> may have many nutrition problems and should see a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044661/" class="def">dietitian</a> for nutrition support.</p><p id="CDR0000286996__521">See the <a href="#CDR0000286996__270">Stem Cell Transplant and Nutrition</a> section for more information.</p></div></div><div id="CDR0000286996__263"><h3>Biologic Therapy and Nutrition</h3><div id="CDR0000286996__264"><h4>Biologic therapy may affect nutrition.</h4><p id="CDR0000286996__363">The side effects of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045617/" class="def">biologic therapy</a> are different for each patient and each type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000415238/" class="def">biologic agent</a>. The following nutrition problems are common:</p><ul id="CDR0000286996__364"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000450108/" class="def">Fever</a>.</div></li><li class="half_rhythm"><div>Nausea.
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</div></li><li class="half_rhythm"><div>Vomiting.
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</div></li><li class="half_rhythm"><div>Diarrhea.
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</div></li><li class="half_rhythm"><div>Loss of appetite.
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</div></li><li class="half_rhythm"><div>Tiredness. </div></li><li class="half_rhythm"><div>Weight gain. </div></li></ul></div><div id="CDR0000286996__267"><h4>Nutrition therapy can help relieve nutrition problems caused by biologic therapy.</h4><p id="CDR0000286996__269">The side effects of biologic therapy can cause weight loss and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046014/" class="def">malnutrition</a> if they are not treated. Nutrition therapy can help patients receiving biologic therapy get the nutrients they need to get through treatment, prevent weight loss, and maintain general health.
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</p></div></div><div id="CDR0000286996__270"><h3>Stem Cell Transplant and Nutrition</h3><div id="CDR0000286996__271"><h4>Stem cell transplant patients have special nutrition needs.</h4><p id="CDR0000286996__365">Chemotherapy, radiation therapy, and medicines used for a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046695/" class="def">stem cell transplant</a> may cause side effects that keep a patient from eating and digesting food as usual. Common side effects include the following:
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</p><ul id="CDR0000286996__366"><li class="half_rhythm"><div>Changes in the way food tastes.</div></li><li class="half_rhythm"><div>Dry mouth or thick saliva.
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</div></li><li class="half_rhythm"><div>Mouth and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439429/" class="def">throat</a> sores.
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</div></li><li class="half_rhythm"><div>Nausea.</div></li><li class="half_rhythm"><div>Vomiting.
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</div></li><li class="half_rhythm"><div>Diarrhea.
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</div></li><li class="half_rhythm"><div>Constipation.
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</div></li><li class="half_rhythm"><div>Weight loss and loss of appetite.
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</div></li><li class="half_rhythm"><div>Weight gain.
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</div></li></ul></div><div id="CDR0000286996__274"><h4>Nutrition therapy is very important for patients who have a stem cell transplant.</h4><p id="CDR0000286996__546">Transplant patients have a very high risk of infection. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000346522/" class="def">High doses of chemotherapy</a> or radiation therapy decrease the number of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045993/" class="def">white blood cells</a>, which fight infection. It is especially important that transplant patients avoid getting <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045364/" class="def">infections</a>.</p><p id="CDR0000286996__276">Patients who have a transplant need plenty of protein and calories to get through and recover from the treatment, prevent weight loss, fight infection, and maintain general health. It is also important to avoid infection from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044123/" class="def">bacteria</a> in food. Nutrition therapy during transplant treatment may include the following:
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</p><ul id="CDR0000286996__368"><li class="half_rhythm"><div>A diet of cooked and processed foods only, because raw vegetables and fresh fruit may carry harmful bacteria.
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</div></li><li class="half_rhythm"><div>Guidelines on safe food handling.
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</div></li><li class="half_rhythm"><div>A specific diet based on the type of transplant and the part of the body affected by cancer.
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</div></li><li class="half_rhythm"><div>Parenteral nutrition (feeding through the bloodstream) during the first few weeks after the transplant, to give the patient the calories, protein, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044744/" class="def">vitamins</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045787/" class="def">minerals</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044669/" class="def">fluids</a> they need to recover.
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</div></li></ul><p id="CDR0000286996__598">See the <a href="#CDR0000286996__332">Low White Blood Cell Counts and Infections</a> section for more information.</p></div></div></div><div id="CDR0000286996__177"><h2 id="_CDR0000286996__177_">Treatment of Symptoms</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000286996__178">Anorexia</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__181">Taste Changes</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__184">Dry Mouth</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__187">Mouth Sores and Infections</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__326">Nausea</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__329">Diarrhea</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__332">Low White Blood Cell Counts and Infections</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__338">Dehydration (Lack of Fluid)</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__341">Constipation</a></div></li></ul></div><p id="CDR0000286996__416">When <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> or cancer treatment affect normal eating, changes can be made to help the patient get the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044697/" class="def">nutrients</a> needed. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000482419/" class="def">Medicines</a> may be given to increase <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454699/" class="def">appetite</a>. Eating foods that are high in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044651/" class="def">calories</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046092/" class="def">protein</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044744/" class="def">vitamins</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045787/" class="def">minerals</a> is usually best. Meals should be planned to meet the patient's <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044698/" class="def">nutrition</a> needs and tastes in food. The following are some of the more common <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> caused by cancer and cancer treatment and ways to treat or control them. </p><div id="CDR0000286996__178"><h3>Anorexia</h3><p id="CDR0000286996__180"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044103/" class="def">Anorexia</a> (the loss of appetite or desire to eat) is one of the most common problems for cancer patients. Eating in a calm, comfortable place and getting regular exercise may improve appetite. The following may help cancer patients who have a loss of appetite:</p><ul id="CDR0000286996__417"><li class="half_rhythm"><div>Eat small high-protein and high-calorie meals every 1-2 hours instead of three large meals. The following are high-calorie, high-protein food choices:
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<dl id="CDR0000286996__419" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">Cheese and crackers.
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</p></dd><dt>-</dt><dd><p class="no_top_margin">Muffins.
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</p></dd><dt>-</dt><dd><p class="no_top_margin">Puddings.
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</p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463726/" class="def">Nutritional supplements</a>.
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</p></dd><dt>-</dt><dd><p class="no_top_margin">Milkshakes.
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</p></dd><dt>-</dt><dd><p class="no_top_margin">Yogurt.
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</p></dd><dt>-</dt><dd><p class="no_top_margin">Ice cream.
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</p></dd><dt>-</dt><dd><p class="no_top_margin">Powdered milk added to foods such as pudding, milkshakes, or any recipe using milk.
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</p></dd><dt>-</dt><dd><p class="no_top_margin">Finger foods (handy for snacking) such as deviled eggs, deviled ham on crackers, or cream cheese or peanut butter on crackers or celery.</p></dd><dt>-</dt><dd><p class="no_top_margin">Chocolate.</p></dd></dl></div></li><li class="half_rhythm"><div>Add extra calories and protein to food by using butter, skim milk powder, honey, or brown sugar.
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</div></li><li class="half_rhythm"><div>Drink liquid supplements (special drinks that have nutrients), soups, milk, juices, shakes, and smoothies, if eating solid food is a problem.
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</div></li><li class="half_rhythm"><div>Eat breakfasts that have one third of the calories and protein needed for the day.</div></li><li class="half_rhythm"><div>Eat snacks that have plenty of calories and protein.
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</div></li><li class="half_rhythm"><div>Eat foods that smell good. Strong odors can be avoided in the following ways:<dl id="CDR0000286996__547" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">Use boiling bags or microwave steaming bags.</p></dd><dt>-</dt><dd><p class="no_top_margin">Cook outdoors on the grill.</p></dd><dt>-</dt><dd><p class="no_top_margin">Use a kitchen fan when cooking.</p></dd><dt>-</dt><dd><p class="no_top_margin">Serve cold food instead of hot (since odors are in the rising steam).</p></dd><dt>-</dt><dd><p class="no_top_margin">Take off any food covers to release the odors before going into a patient's room.</p></dd><dt>-</dt><dd><p class="no_top_margin">Use a small fan to blow food odors away from patients.</p></dd><dt>-</dt><dd><p class="no_top_margin">Order take-out food.</p></dd></dl>
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</div></li><li class="half_rhythm"><div>Try new foods and new recipes, flavorings, spices, and foods with a different texture or thickness. Food likes and dislikes may change from day to day.</div></li><li class="half_rhythm"><div>Plan menus ahead of time and get help preparing meals.</div></li><li class="half_rhythm"><div>Make and store small amounts of favorite foods so they are ready to eat when hungry.</div></li></ul><p id="CDR0000286996__420">See the <a href="https://www.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a> for <a href="https://www.cancer.gov/publications/patient-education/eating-hints" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Eating Hints: Before, During, and After Cancer Treatment</a>, which has recipes such as Lactose-Free Double Chocolate Pudding, Banana Milkshake, and Fruit and Cream. For a free copy of this booklet, call the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044264/" class="def">Cancer Information Service</a> at 1-800-4-CANCER (1-800-422-6237).
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</p></div><div id="CDR0000286996__181"><h3>Taste Changes</h3><p id="CDR0000286996__183">Changes in how foods taste may be caused by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation treatment</a>, dental problems, mouth sores and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045364/" class="def">infections</a>, or some medicines. Many cancer patients who receive <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a> notice a bitter taste or other changes in their sense of taste. A sudden dislike for certain foods may occur. This can cause a loss of appetite, weight loss, and a decreased <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>. Some or all of a normal sense of taste may return, but it may take up to a year after treatment ends. The following may help cancer patients who have taste changes:</p><ul id="CDR0000286996__422"><li class="half_rhythm"><div>Eat small meals and healthy snacks several times a day.
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</div></li><li class="half_rhythm"><div>Eat meals when hungry rather than at set mealtimes.
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</div></li><li class="half_rhythm"><div>Eat favorite foods and try new foods when feeling best.
|
|
</div></li><li class="half_rhythm"><div>Eat poultry, fish, eggs, and cheese instead of red meat.
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</div></li><li class="half_rhythm"><div>Eat citrus fruits (oranges, tangerines, lemons, grapefruit) unless mouth sores are present.</div></li><li class="half_rhythm"><div>Add spices and sauces to foods.
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</div></li><li class="half_rhythm"><div>Eat meat with something sweet, such as cranberry sauce, jelly, or applesauce. </div></li><li class="half_rhythm"><div>Find nonmeat, high-protein recipes in a vegetarian or Chinese cookbook.
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</div></li><li class="half_rhythm"><div>Use sugar-free <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000537557/" class="def">lemon</a> drops, gum, or mints if there is a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463718/" class="def">metallic</a> or bitter taste in the mouth.
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</div></li><li class="half_rhythm"><div>Rinse mouth with water before eating.
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</div></li><li class="half_rhythm"><div>Eat with family and friends.
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</div></li><li class="half_rhythm"><div>Have others prepare the meal.
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</div></li><li class="half_rhythm"><div>Use plastic utensils if foods have a metal taste.</div></li></ul><p id="CDR0000286996__423">Taking <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000256545/" class="def">zinc sulfate</a> tablets during <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a> to the head and neck may help a normal sense of taste come back faster after treatment.</p></div><div id="CDR0000286996__184"><h3>Dry Mouth</h3><p id="CDR0000286996__186">Dry mouth is often caused by radiation therapy to the head and neck and by certain medicines. Dry mouth may affect speech, taste, and the ability to swallow or to use dentures or braces. There is also an increased risk of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463703/" class="def">cavities</a> and gum disease because less <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257526/" class="def">saliva</a> is made to wash the teeth and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000481753/" class="def">gums</a>.</p><p id="CDR0000286996__424">The main treatment for dry mouth is drinking plenty of liquids. Other ways to help relieve dry mouth include the following: </p><ul id="CDR0000286996__425"><li class="half_rhythm"><div>Keep water handy at all times to moisten the mouth.
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</div></li><li class="half_rhythm"><div>Eat moist foods with extra sauces, gravies, butter, or margarine.
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</div></li><li class="half_rhythm"><div>Eat foods and drinks that are very sweet or tart (to increase saliva).</div></li><li class="half_rhythm"><div>Eat ice chips or frozen desserts (such as frozen grapes and ice pops).
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</div></li><li class="half_rhythm"><div>Drink fruit nectar instead of juice.
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</div></li><li class="half_rhythm"><div>Suck on hard candy or chew gum.
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</div></li><li class="half_rhythm"><div>Use a straw to drink liquids. </div></li><li class="half_rhythm"><div>Clean teeth (including dentures) and rinse mouth at least four times a day (after eating and at bedtime).
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|
Don't use mouth rinses that contain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463134/" class="def">alcohol</a>.
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</div></li></ul><p id="CDR0000286996__426">See the <a href="/books/n/pdqcis/CDR0000062871/#CDR0000062871__35">Dry Mouth</a> section of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044271/" class="def">PDQ</a> summary on <a href="/books/n/pdqcis/CDR0000062871/">Oral Complications of Chemotherapy and Head/Neck Radiation</a> for more information.</p></div><div id="CDR0000286996__187"><h3>Mouth Sores and Infections</h3><p id="CDR0000286996__189">Mouth sores can be caused by chemotherapy and radiation therapy. These treatments affect fast-growing <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a>, such as cancer cells. Normal cells inside the mouth also grow quickly and may be damaged by these cancer treatments. Mouth sores can be painful and become <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045364/" class="def">infected</a> or bleed and make it hard to eat. By choosing certain foods and taking good care of their mouths, patients can usually make eating easier. The following can help patients who have mouth sores and infections:</p><ul id="CDR0000286996__537"><li class="half_rhythm"><div>Eat soft foods that are easy to chew and swallow, such as the following: <dl id="CDR0000286996__428" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">Soft fruits, including bananas, applesauce, and watermelon.
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</p></dd><dt>-</dt><dd><p class="no_top_margin">Peach, pear, and apricot nectars.
|
|
</p></dd><dt>-</dt><dd><p class="no_top_margin">Cottage cheese.
|
|
</p></dd><dt>-</dt><dd><p class="no_top_margin">Mashed potatoes.
|
|
</p></dd><dt>-</dt><dd><p class="no_top_margin">Macaroni and cheese.
|
|
</p></dd><dt>-</dt><dd><p class="no_top_margin">Custards and puddings.
|
|
</p></dd><dt>-</dt><dd><p class="no_top_margin">Gelatin.
|
|
</p></dd><dt>-</dt><dd><p class="no_top_margin">Milkshakes.
|
|
</p></dd><dt>-</dt><dd><p class="no_top_margin">Scrambled eggs.
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</p></dd><dt>-</dt><dd><p class="no_top_margin">Oatmeal or other cooked cereals.</p></dd></dl></div></li><li class="half_rhythm"><div>Stay away from the following:<dl id="CDR0000286996__427" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">Citrus fruits and juices, (such as oranges, tangerines, lemons, and grapefruit).
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</p></dd><dt>-</dt><dd><p class="no_top_margin">Spicy or salty foods.</p></dd><dt>-</dt><dd><p class="no_top_margin">Rough, coarse, or dry foods, including raw vegetables, granola, toast, and crackers.
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</p></dd></dl></div></li><li class="half_rhythm"><div>Use a blender to make vegetables (such as potatoes, peas, and carrots) and meats smooth.
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|
</div></li><li class="half_rhythm"><div>Add gravy, broth, or sauces to food.
|
|
</div></li><li class="half_rhythm"><div>Drink high-calorie, high-protein drinks in addition to meals.</div></li><li class="half_rhythm"><div>Cook foods until soft and tender.
|
|
</div></li><li class="half_rhythm"><div>Eat foods cold or at room temperature. Hot and warm foods can irritate a tender mouth.
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</div></li><li class="half_rhythm"><div>Cut foods into small pieces.
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</div></li><li class="half_rhythm"><div>Use a straw to drink liquids.
|
|
</div></li><li class="half_rhythm"><div>
|
|
Numb the mouth with ice chips or flavored ice pops before eating. </div></li><li class="half_rhythm"><div>Clean teeth (including dentures) and rinse mouth at least four times a day (after eating and at bedtime).
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</div></li></ul><p id="CDR0000286996__430">See the <a href="/books/n/pdqcis/CDR0000062871/#CDR0000062871__32">Oral Mucositis</a> and <a href="/books/n/pdqcis/CDR0000062871/#CDR0000062871__33">Infection</a> sections of the PDQ summary on <a href="/books/n/pdqcis/CDR0000062871/">Oral Complications of Chemotherapy and Head/Neck Radiation</a> for more information on mouth sores and infections.
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</p></div><div id="CDR0000286996__326"><h3>Nausea</h3><p id="CDR0000286996__328"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390302/" class="def">Nausea</a> caused by cancer treatment can affect the amount and kinds of food eaten. The following may help cancer patients control nausea:
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</p><ul id="CDR0000286996__431"><li class="half_rhythm"><div>Eat before cancer treatments.
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</div></li><li class="half_rhythm"><div>Rinse out the mouth before and after eating.
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</div></li><li class="half_rhythm"><div>Eat foods that are bland, soft, and easy-to-<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463707/" class="def">digest</a>, rather than heavy meals.
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Eat small meals several times a day.</div></li><li class="half_rhythm"><div>Eat dry foods such as crackers, bread sticks, or toast throughout the day.
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</div></li><li class="half_rhythm"><div>Slowly sip <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044669/" class="def">fluids</a> throughout the day.
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</div></li><li class="half_rhythm"><div>Suck on hard candies such as peppermints or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000537557/" class="def">lemon</a> drops if the mouth has a bad taste.</div></li><li class="half_rhythm"><div>Stay away from foods that are likely to cause nausea. For some patients, this includes spicy foods, greasy foods, and foods that have strong odors.
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</div></li><li class="half_rhythm"><div>Sit up or lie with the upper body raised for one hour after eating.
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</div></li><li class="half_rhythm"><div>Don't eat in a room that has cooking odors or that is very warm. Keep the living space at a comfortable temperature with plenty of fresh air.
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</div></li></ul><p id="CDR0000286996__432">See the PDQ summary on <a href="/books/n/pdqcis/CDR0000062804/">Nausea and Vomiting</a> for more information. </p></div><div id="CDR0000286996__329"><h3>Diarrhea</h3><p id="CDR0000286996__331"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000306496/" class="def">Diarrhea</a> may be caused by cancer treatments, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a> on the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046604/" class="def">stomach</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046335/" class="def">intestines</a>, or by emotional <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000450122/" class="def">stress</a>. Long-term diarrhea may lead to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044659/" class="def">dehydration</a> (lack of water in the body) or low levels of salt and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044344/" class="def">potassium</a>, which are important minerals needed by the body.</p><p id="CDR0000286996__433">The following may help cancer patients control diarrhea:
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</p><ul id="CDR0000286996__434"><li class="half_rhythm"><div>Eat broth, soups, bananas, and canned fruits to help replace salt and potassium lost by diarrhea.
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Sports drinks can also help.</div></li><li class="half_rhythm"><div>Drink plenty of fluids during the day. Liquids at room temperature may cause fewer problems than hot or cold liquids.
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</div></li><li class="half_rhythm"><div>Drink at least one cup of liquid after each loose <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651179/" class="def">bowel movement</a>.
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</div></li><li class="half_rhythm"><div>Stay away from the following:<dl id="CDR0000286996__538" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">Greasy foods, hot or cold liquids, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454809/" class="def">caffeine</a>.</p></dd><dt>-</dt><dd><p class="no_top_margin">High-<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046401/" class="def">fiber</a> foods—especially dried beans and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044963/" class="def">cruciferous vegetables</a> (such as broccoli, cauliflower, and cabbage).
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</p></dd><dt>-</dt><dd><p class="no_top_margin">Milk and milk products, until the cause of the diarrhea is known.
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</p></dd><dt>-</dt><dd><p class="no_top_margin">Foods and beverages that cause gas (such as peas, lentils, cruciferous vegetables, chewing gum, and soda).
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</p></dd><dt>-</dt><dd><p class="no_top_margin">Sugar-free candies or gum made with sorbitol (sugar alcohol).
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</p></dd></dl></div></li></ul><p id="CDR0000286996__599">See the <a href="#CDR0000286996__338">Dehydration (Lack of Fluid)</a> section for more information.</p></div><div id="CDR0000286996__332"><h3>Low White Blood Cell Counts and Infections</h3><p id="CDR0000286996__334">A low <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045993/" class="def">white blood cell</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044648/" class="def">count</a> may be caused by radiation therapy, chemotherapy, or the cancer itself. Patients who have a low white blood cell count have an increased risk of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045364/" class="def">infection</a>. The following may help cancer patients prevent infections when white blood cell counts are low:</p><ul id="CDR0000286996__437"><li class="half_rhythm"><div>Stay away from:<dl id="CDR0000286996__539" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">Raw eggs or raw fish.</p></dd><dt>-</dt><dd><p class="no_top_margin">Old, moldy, or damaged fruits and vegetables.
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</p></dd><dt>-</dt><dd><p class="no_top_margin">Food sold in open bins or containers.
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</p></dd><dt>-</dt><dd><p class="no_top_margin">Salad bars and buffets when eating out.
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</p></dd></dl></div></li><li class="half_rhythm"><div>Wash hands often to prevent the spread of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044123/" class="def">bacteria</a>.
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</div></li><li class="half_rhythm"><div>Thaw foods in the refrigerator or microwave. Never thaw foods at room temperature. Cook foods immediately after thawing.
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</div></li><li class="half_rhythm"><div>Keep hot foods hot and cold foods cold.
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</div></li><li class="half_rhythm"><div>Cook all meat, poultry, and fish until well done.</div></li><li class="half_rhythm"><div>Refrigerate all leftovers within 2 hours of cooking and eat them within 24 hours.
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</div></li><li class="half_rhythm"><div>Buy foods packed as single servings, to avoid leftovers.
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</div></li><li class="half_rhythm"><div>Do not buy or eat food that is out of date.
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</div></li><li class="half_rhythm"><div>Do not buy or eat food in cans that are swollen, dented, or damaged.</div></li></ul></div><div id="CDR0000286996__338"><h3>Dehydration (Lack of Fluid)</h3><p id="CDR0000286996__340">The body needs plenty of water to replace the fluids lost every day. Nausea, vomiting, and pain may keep the patient from drinking and eating enough to get the amount of water the body needs. Long-term diarrhea causes a loss of fluid from the body. One of the first signs of dehydration (lack of water in the body) is feeling very tired. The following may help cancer patients prevent dehydration: </p><ul id="CDR0000286996__438"><li class="half_rhythm"><div>Drink 8 to 12 cups of liquids a day. This can be water, juice, milk, or foods that have a lot of liquid in them, such as ice pops, flavored ices, and gelatins.
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</div></li><li class="half_rhythm"><div>Stay away from drinks that have caffeine in them, such as sodas, coffee, and tea (both hot and cold).
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</div></li><li class="half_rhythm"><div>Take a water bottle whenever leaving home. It is important to drink even if not thirsty. </div></li><li class="half_rhythm"><div>Drink most liquids between meals.
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</div></li><li class="half_rhythm"><div>Use medicines that help prevent and treat nausea and vomiting.
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</div></li></ul></div><div id="CDR0000286996__341"><h3>Constipation</h3><p id="CDR0000286996__343">It is very common for cancer patients to have <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000407757/" class="def">constipation</a> (fewer than three bowel movements a week). Constipation may be caused by the following: </p><ul id="CDR0000286996__601"><li class="half_rhythm"><div>Too little water or fiber in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044660/" class="def">diet</a>.</div></li><li class="half_rhythm"><div>Not being active.</div></li><li class="half_rhythm"><div>Cancer treatment, such as chemotherapy.</div></li><li class="half_rhythm"><div>Certain medicines used to treat the side effects of chemotherapy, such as nausea and pain.</div></li></ul><p id="CDR0000286996__602">Preventing and treating constipation is a part of cancer care. </p><p id="CDR0000286996__439">To prevent constipation:</p><ul id="CDR0000286996__440"><li class="half_rhythm"><div>Eat more fiber-containing foods. Twenty-five to 35 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000373014/" class="def">grams</a> of fiber a day is best. Food labels show the amount of fiber in a serving. (Some sources of fiber are listed below.) Add a little more fiber each day and drink plenty of fluids at the same time to keep the fiber moving through the intestines.</div></li><li class="half_rhythm"><div>Drink 8 to 12 cups of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044669/" class="def">fluid</a> each day. Water, prune juice, warm juices, lemonade, and teas without caffeine can be very helpful.
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</div></li><li class="half_rhythm"><div>Take walks and exercise regularly. Wear shoes made for exercise.
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</div></li></ul><p id="CDR0000286996__441">To treat constipation:
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</p><ul id="CDR0000286996__442"><li class="half_rhythm"><div>Continue to eat high-fiber foods and drink plenty of fluids. Try adding wheat bran to the diet; begin with 2 heaping tablespoons each day for 3 days, then increase by 1 tablespoon each day until constipation is relieved. <b>Do not take more than 6 tablespoons a day.</b>
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</div></li><li class="half_rhythm"><div>Stay physically active.
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</div></li><li class="half_rhythm"><div>Use <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044696/" class="def">over-the-counter</a> constipation treatments, if needed. These include:<dl id="CDR0000286996__551" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">Bulk-forming products (such as Citrucel, Metamucil, Fiberall, and Fiber-Lax).</p></dd><dt>-</dt><dd><p class="no_top_margin">Stimulants (such as Dulcolax and Senokot).</p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046605/" class="def">Stool</a> softeners (such as Colace and Surfak).</p></dd><dt>-</dt><dd><p class="no_top_margin">Osmotics (such as milk of magnesia).</p></dd></dl>
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</div></li><li class="half_rhythm"><div>Cottonseed and aerosol <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044204/" class="def">enemas</a> can also help. Do not use lubricants such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000486450/" class="def">mineral oil</a> because they may keep the body from using important nutrients the way it should.</div></li></ul><p id="CDR0000286996__443">Good food sources of fiber include the following:</p><ul id="CDR0000286996__444"><li class="half_rhythm"><div>Legumes (beans and lentils).</div></li><li class="half_rhythm"><div>Vegetables. </div></li><li class="half_rhythm"><div>Cold cereals (whole grain or bran).</div></li><li class="half_rhythm"><div>Hot cereals. </div></li><li class="half_rhythm"><div>Fruit. </div></li><li class="half_rhythm"><div>Whole-grain breads.</div></li></ul><p id="CDR0000286996__603">See the <a href="/books/n/pdqcis/CDR0000062834/#CDR0000062834__8">Constipation</a> section of the PDQ summary on <a href="/books/n/pdqcis/CDR0000062834/">Gastrointestinal Complications</a> for more information.</p></div></div><div id="CDR0000286996__190"><h2 id="_CDR0000286996__190_">Nutrition in Advanced Cancer </h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000286996__455">Palliative care helps relieve symptoms that bother the patient and helps improve the patient's quality of life.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__552">Nutrition needs are different for patients with advanced cancer.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__461">The benefits and harms of nutrition support are different for each patient. </a></div></li></ul></div><div id="CDR0000286996__455"><h3>Palliative care helps relieve symptoms that bother the patient and helps improve the patient's quality of life.</h3><p id="CDR0000286996__528">The goal of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269448/" class="def">palliative care</a> is to improve the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a> of patients who have a serious or life-threatening disease. Palliative care is meant to prevent or treat <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454766/" class="def">psychological</a>, social, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000441265/" class="def">spiritual</a> problems caused by a disease or its treatment.</p><p id="CDR0000286996__457">Palliative care for patients with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000478743/" class="def">advanced cancer</a> includes <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463725/" class="def">nutrition therapy</a> (see the <a href="#CDR0000286996__177">Treatment of Symptoms</a> section) and/or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651195/" class="def">drug therapy</a>. </p></div><div id="CDR0000286996__552"><h3>Nutrition needs are different for patients with advanced cancer.</h3><p id="CDR0000286996__554">It is common for patients with advanced <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> to want less food. Patients usually prefer soft foods and clear liquids. Those who have problems swallowing may do better with thick liquids than with thin liquids. Patients often do not feel much hunger at all and may need very little food.</p><p id="CDR0000286996__555">In patients with advanced cancer, most foods are allowed. During this time, eating can be focused on pleasure rather than getting enough <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044697/" class="def">nutrients</a>. Patients usually cannot eat enough of any food that might cause a problem. However, some patients may need to stay on a special <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044660/" class="def">diet</a>. For example, patients with cancer that affects the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a> may need a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044732/" class="def">soft diet</a> to keep the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046500/" class="def">bowel</a> from getting blocked.</p></div><div id="CDR0000286996__461"><h3>The benefits and harms of nutrition support are different for each patient. </h3><p id="CDR0000286996__463">Answering the following questions may help to make decisions about using <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044698/" class="def">nutrition</a> support:
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</p><ul id="CDR0000286996__464"><li class="half_rhythm"><div>What are the wishes and needs of the patient and family?
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</div></li><li class="half_rhythm"><div>Will the patient's quality of life be improved?
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</div></li><li class="half_rhythm"><div>Do the possible benefits outweigh the risks and costs?
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</div></li><li class="half_rhythm"><div>Is there an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000430404/" class="def">advance directive</a>? An advance directive is a legal document that states the treatment or care a person wishes to receive or not receive if he or she becomes unable to make medical decisions. One type of advance directive is a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000441252/" class="def">living will</a>.</div></li></ul><p id="CDR0000286996__465">Cancer patients and their <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000648947/" class="def">caregivers</a> have the right to make informed decisions. The healthcare team and a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454994/" class="def">registered dietitian</a> can explain the benefits and risks of using nutrition support for patients with advanced cancer. In most cases, there are more harms than benefits, especially with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390306/" class="def">parenteral nutrition</a> support. However, for someone who still has good quality of life but is unable to get enough food and water by mouth, enteral feedings may be best. The benefits and risks of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390275/" class="def">enteral nutrition</a> during advanced cancer include the following: </p><h4><span class="title">Benefits</span></h4><ul id="CDR0000286996__466"><li class="half_rhythm"><div>May make the patient more alert.</div></li><li class="half_rhythm"><div>May be a comfort to the family.</div></li><li class="half_rhythm"><div>May relieve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390302/" class="def">nausea</a>.</div></li><li class="half_rhythm"><div>May make the patient feel more hopeful.</div></li></ul><h4><span class="title">Harms</span></h4><ul id="CDR0000286996__467"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> may be needed to place a tube through the abdomen.
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</div></li><li class="half_rhythm"><div>May increase the amount of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257526/" class="def">saliva</a> in the mouth and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439429/" class="def">throat</a>. This may cause choking or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045476/" class="def">pneumonia</a>.</div></li><li class="half_rhythm"><div>May cause <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000306496/" class="def">diarrhea</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000407757/" class="def">constipation</a>.</div></li><li class="half_rhythm"><div>May cause nausea.</div></li><li class="half_rhythm"><div>May cause <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045364/" class="def">infection</a>.</div></li><li class="half_rhythm"><div>Makes patient care harder for caregiver.</div></li></ul></div></div><div id="CDR0000286996__594"><h2 id="_CDR0000286996__594_">Food and Drug Interactions </h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000286996__595">Some foods do not mix safely with certain drugs.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__471">Some herbal supplements do not mix safely with certain drugs or foods.</a></div></li></ul></div><div id="CDR0000286996__595"><h3>Some foods do not mix safely with certain drugs.</h3><p id="CDR0000286996__597"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">Cancer</a> patients may be treated with a number of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a>. Taking certain foods and drugs together may decrease or change how well the drugs work or cause life-threatening <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a>. The following table lists some of the food and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454754/" class="def">drug interactions</a> that may occur with certain anticancer drugs:</p><div id="CDR0000286996__470" class="table"><h3><span class="title"> Drug-Food Interactions</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK66004.3/table/CDR0000286996__470/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__CDR0000286996__470_lrgtbl__"><table class="no_top_margin"><thead><tr><th colspan="1" rowspan="1" style="vertical-align:top;">Brand Name</th><th colspan="1" rowspan="1" style="vertical-align:top;">Generic Name</th><th colspan="1" rowspan="1" style="vertical-align:top;">Food Interactions</th></tr></thead><tbody><tr><td colspan="1" rowspan="1" style="vertical-align:top;"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000523453/" class="def">Targretin</a></td><td colspan="1" rowspan="1" style="vertical-align:top;"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045423/" class="def">Bexarotene</a></td><td colspan="1" rowspan="1" style="vertical-align:top;">Grapefruit juice may increase the drug's effects. </td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;">Folex</td><td colspan="1" rowspan="2" style="vertical-align:top;"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045393/" class="def">Methotrexate</a></td><td colspan="1" rowspan="2" style="vertical-align:top;"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463134/" class="def">Alcohol</a> may cause <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046312/" class="def">liver</a> damage.</td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000413957/" class="def">Rheumatrex</a></td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000484118/" class="def">Mithracin</a></td><td colspan="1" rowspan="1" style="vertical-align:top;"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463729/" class="def">Plicamycin</a></td><td colspan="1" rowspan="1" style="vertical-align:top;"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000373932/" class="def">Supplements</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045632/" class="def">calcium</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000427253/" class="def">vitamin D</a> may decrease the drug's effect.</td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000635747/" class="def">Matulane</a></td><td colspan="1" rowspan="1" style="vertical-align:top;"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045378/" class="def">Procarbazine</a></td><td colspan="1" rowspan="1" style="vertical-align:top;">Alcohol may cause headache, trouble breathing, flushed skin, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390302/" class="def">nausea</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390324/" class="def">vomiting</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454809/" class="def">Caffeine</a> may raise <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000462668/" class="def">blood pressure</a>. </td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000507640/" class="def">Temodar</a></td><td colspan="1" rowspan="1" style="vertical-align:top;"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045387/" class="def">Temozolomide</a></td><td colspan="1" rowspan="1" style="vertical-align:top;">Food may slow or decrease the drug's effect. </td></tr></tbody></table></div></div><p id="CDR0000286996__631">Talk with your doctor about possible food and drug interactions.</p></div><div id="CDR0000286996__471"><h3>Some herbal supplements do not mix safely with certain drugs or foods.</h3><p id="CDR0000286996__473">Taking some <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000560646/" class="def">herbal supplements</a> with certain foods and drugs may change how well cancer treatment works or cause life-threatening side effects. Talk with your doctor about how herbal supplements may affect your cancer treatment.</p></div></div><div id="CDR0000286996__606"><h2 id="_CDR0000286996__606_">Nutrition and Lifestyle in Cancer Survivors</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000286996__620">Cancer survivors have special nutrition needs. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__622">Healthy diet and lifestyle habits can improve the quality of life for cancer survivors.
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</a></div></li></ul></div><div id="CDR0000286996__620"><h3>Cancer survivors have special nutrition needs. </h3><p id="CDR0000286996__607">Everyone needs a healthy <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044660/" class="def">diet</a> and exercise for good health and to help prevent disease. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">Cancer</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000450125/" class="def">survivors</a> have special health needs, especially because of the risks of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390292/" class="def">late effects</a> and the cancer coming back. Studies have shown that a healthy diet helps to prevent late effects such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000527371/" class="def">obesity</a>, heart disease, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000643126/" class="def">metabolic syndrome</a>. Researchers are also studying whether certain diet and exercise habits in cancer survivors can keep cancer from coming back or keep new cancers from forming. </p></div><div id="CDR0000286996__622"><h3>Healthy diet and lifestyle habits can improve the quality of life for cancer survivors.
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</h3><p id="CDR0000286996__608"> Surveys show that many cancer survivors do not follow cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439419/" class="def">prevention</a> guidelines and have lifestyle behaviors that may increase their risk for late effects or make late effects worse. Education programs can help cancer survivors learn how to make behavior changes that keep them healthier. Programs that cover diet, exercise, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000450122/" class="def">stress</a> management are more likely to help cancer survivors make lasting changes.</p><p id="CDR0000286996__624">
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The effects of diet and lifestyle on cancer continue to be studied.</p></div></div><div id="CDR0000286996__613"><h2 id="_CDR0000286996__613_">Nutrition in Cancer Prevention</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000286996__627">Following certain dietary guidelines may help prevent cancer.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000286996__629">The effect of soy on breast cancer and breast cancer prevention is being studied. </a></div></li></ul></div><div id="CDR0000286996__627"><h3>Following certain dietary guidelines may help prevent cancer.</h3><p id="CDR0000286996__615">The American Cancer Society and the American Institute for Cancer Research both have dietary guidelines that may help prevent <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>. Their guidelines are a lot alike and include the following:</p><ul id="CDR0000286996__616"><li class="half_rhythm"><div>Eat a plant-based <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044660/" class="def">diet</a> with a large variety of fruits and vegetables.</div></li><li class="half_rhythm"><div>Eat foods low in fat.
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</div></li><li class="half_rhythm"><div>Eat foods low in salt.
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</div></li><li class="half_rhythm"><div>Get to and stay at a healthy weight.
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</div></li><li class="half_rhythm"><div>Be active for 30 minutes on most days of the week.
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</div></li><li class="half_rhythm"><div>Drink few <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463134/" class="def">alcoholic</a> drinks or don't drink at all.
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</div></li><li class="half_rhythm"><div>Prepare and store food safely.
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</div></li><li class="half_rhythm"><div>Do not use <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439432/" class="def">tobacco</a> in any form.
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</div></li></ul></div><div id="CDR0000286996__629"><h3>The effect of soy on breast cancer and breast cancer prevention is being studied. </h3><p id="CDR0000286996__618">Study results include the following:</p><ul id="CDR0000286996__625"><li class="half_rhythm"><div>Some studies show that eating <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000407766/" class="def">soy</a> may decrease the risk of having <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000444971/" class="def">breast cancer</a>. </div></li><li class="half_rhythm"><div>Taking soy <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000373932/" class="def">supplements</a> in the form of powders or pills has not been shown to prevent breast cancer. </div></li><li class="half_rhythm"><div>Adding soy foods to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044660/" class="def">diet</a> after being <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnosed</a> with breast cancer has not been shown to keep the breast cancer from coming back.</div></li></ul><p id="CDR0000286996__619">Soy has substances in it that act like <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046076/" class="def">estrogen</a> in the body. Studies were done to find out how soy affects breast cancer in patients who have <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumors</a> that need estrogen to grow. Some studies have shown that soy foods are safe for women with breast cancer when eaten in moderate amounts as part of a healthy diet. </p><p id="CDR0000286996__626">If you are a breast cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000450125/" class="def">survivor</a> be sure to check the most up-to-date information when deciding whether to include soy in your diet. </p></div></div><div id="CDR0000286996__541"><h2 id="_CDR0000286996__541_">To Learn More About Nutrition and Cancer Care</h2><div id="CDR0000286996__556"><h3>National Cancer Institute</h3><p id="CDR0000286996__557">For information from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044266/" class="def">National Cancer Institute</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044267/" class="def">(NCI)</a> about <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044698/" class="def">nutrition</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> treatment, see <a href="https://www.cancer.gov/about-cancer/treatment/side-effects" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Side Effects</a>.</p><p id="CDR0000286996__558">For information from NCI about nutrition and cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439419/" class="def">prevention</a>, see the following <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044271/" class="def">PDQ</a> summaries:</p><ul id="CDR0000286996__559"><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000454520/">Cancer Prevention Overview</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000257994/">Breast Cancer Prevention</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000258007/">Colorectal Cancer Prevention</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000062888/">Esophageal Cancer Prevention</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000062825/">Lung Cancer Prevention</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000062850/">Stomach (Gastric) Cancer Prevention</a></div></li></ul></div><div id="CDR0000286996__560"><h3>Organizations</h3><p id="CDR0000286996__561">For general nutrition information and other resources, see the following:</p><ul id="CDR0000286996__562"><li class="half_rhythm"><div>United States Department of Agriculture<ul id="CDR0000286996__573" class="simple-list"><li class="half_rhythm"><div><a href="https://www.choosemyplate.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">www.choosemyplate.gov</a></div></li><li class="half_rhythm"><div><a href="https://health.gov/dietaryguidelines/2015/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">2015–2020 Dietary Guidelines for Americans</a></div></li></ul></div></li></ul><ul id="CDR0000286996__347"><li class="half_rhythm"><div>Academy of Nutrition and Dietetics
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<ul id="CDR0000286996__506" class="simple-list"><li class="half_rhythm"><div>800-877-1600
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</div></li><li class="half_rhythm"><div><a href="http://www.eatright.org/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">www.eatright.org</a></div></li></ul>
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</div></li><li class="half_rhythm"><div>American Botanical Council
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<ul id="CDR0000286996__504" class="simple-list"><li class="half_rhythm"><div>800-373-7105
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</div></li><li class="half_rhythm"><div><a href="http://abc.herbalgram.org/site/PageServer?pagename=Homepage" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">abc.herbalgram.org</a></div></li></ul>
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</div></li><li class="half_rhythm"><div>American Cancer Society
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<ul id="CDR0000286996__505" class="simple-list"><li class="half_rhythm"><div>800-227-2345
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</div></li><li class="half_rhythm"><div><a href="https://www.cancer.org/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">www.cancer.org</a></div></li></ul>
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</div></li><li class="half_rhythm"><div>American Institute for Cancer Research
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<ul id="CDR0000286996__507" class="simple-list"><li class="half_rhythm"><div>800-843-8114</div></li><li class="half_rhythm"><div>
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<a href="http://www.aicr.org/site/PageServer?pagename=homepage" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">www.aicr.org</a></div></li></ul></div></li><li class="half_rhythm"><div>American Society for Parenteral and Enteral Nutrition
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<ul id="CDR0000286996__508" class="simple-list"><li class="half_rhythm"><div>301-587-6315</div></li><li class="half_rhythm"><div>
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<a href="http://www.nutritioncare.org/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">www.nutritioncare.org</a></div></li></ul>
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</div></li><li class="half_rhythm"><div>National Center for Complementary and Integrative Health (NCCIH)
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<ul id="CDR0000286996__510" class="simple-list"><li class="half_rhythm"><div>
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888-644-6226 (NCCIH Clearinghouse)
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</div></li><li class="half_rhythm"><div>866-464-3615 (toll free TTY)</div></li><li class="half_rhythm"><div><a href="https://nccih.nih.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">nccih.nih.gov</a>
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</div></li></ul></div></li><li class="half_rhythm"><div>
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Office of Dietary Supplements
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<ul id="CDR0000286996__511" class="simple-list"><li class="half_rhythm"><div>301-435-2920</div></li><li class="half_rhythm"><div>
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<a href="https://ods.od.nih.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">ods.od.nih.gov</a></div></li></ul></div></li></ul></div><div id="CDR0000286996__204"><h3>Books</h3><ul id="CDR0000286996__346"><li class="half_rhythm"><div><b>American Cancer Society’s Healthy Eating Cookbook: a Celebration of Food, Friends, and Healthy Living</b>. 3rd ed. Atlanta, GA: The American Cancer Society, 2005.
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</div></li><li class="half_rhythm"><div>Bloch A, Cassileth BR, Holmes MD, Thomson CA, eds.: <b>Eating Well, Staying Well During and After Cancer</b>. Atlanta, GA: American Cancer Society, 2004.
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</div></li><li class="half_rhythm"><div>Ghosh K, Carson L, and Cohen E: <b>Betty Crocker’s Living With Cancer Cookbook: Easy Recipes and Tips Through Treatment and Beyond</b>. New York, NY: Hungry Minds, 2002.
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</div></li><li class="half_rhythm"><div>Weihofen DL, Robbins J, Sullivan PA: <b>Easy-to-Swallow, Easy-to-Chew Cookbook: over 150 Tasty and Nutritious Recipes for People Who Have Difficulty Swallowing</b>. New York, NY: John Wiley & Sons, Inc., 2002.
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</div></li><li class="half_rhythm"><div>Wilson JR: <b>I-Can’t-Chew Cookbook: Delicious Soft-Diet Recipes for People With Chewing, Swallowing, or Dry-Mouth Disorders</b>. Alameda, Calif: Hunter House Inc., 2003.
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</div></li></ul></div></div><div id="CDR0000286996__605"><h2 id="_CDR0000286996__605_">Current Clinical Trials</h2><p id="CDR0000286996__TrialSearch_605_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000286996__AboutThis_1"><h2 id="_CDR0000286996__AboutThis_1_">About This PDQ Summary</h2><div id="CDR0000286996__AboutThis_2"><h3>About PDQ</h3><p id="CDR0000286996__AboutThis_3">Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in <a href="https://www.cancer.gov/espanol/publicaciones/pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Spanish</a>.</p><p id="CDR0000286996__AboutThis_4">PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.</p></div><div id="CDR0000286996__AboutThis_5"><h3>Purpose of This Summary</h3><p id="CDR0000286996__AboutThis_6">This PDQ cancer information summary has current information about nutrition before, during, and after cancer treatment. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p></div><div id="CDR0000286996__AboutThis_7"><h3>Reviewers and Updates</h3><p id="CDR0000286996__AboutThis_8">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change.
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</p><p id="CDR0000286996__AboutThis_9">The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the <a href="http://www.cancer.gov/publications/pdq/editorial-boards/supportive-care" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ Supportive and Palliative Care Editorial Board</a>.
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</p></div><div id="CDR0000286996__AboutThis_10"><h3>Clinical Trial Information</h3><p id="CDR0000286996__AboutThis_11">A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
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</p><p id="CDR0000286996__AboutThis_12">Clinical trials are listed in PDQ and can be found online at <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI's website</a>. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).
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</p></div><div id="CDR0000286996__AboutThis_13"><h3>Permission to Use This Summary</h3><p id="CDR0000286996__AboutThis_14">PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”
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</p><p id="CDR0000286996__AboutThis_15">The best way to cite this PDQ summary is:</p><p id="CDR0000286996__AboutThis_21">PDQ® Supportive and Palliative Care Editorial Board. PDQ Nutrition in Cancer Care. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: <a href="https://www.cancer.gov/about-cancer/treatment/side-effects/appetite-loss/nutrition-pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www.cancer.gov/about-cancer/treatment/side-effects/appetite-loss/nutrition-pdq</a>. Accessed <MM/DD/YYYY>. [PMID: 26389440]</p><p id="CDR0000286996__AboutThis_16">Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in <a href="https://visualsonline.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Visuals Online</a>. Visuals Online is a collection of more than 2,000 scientific images.
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