Ask the expert
Chemotherapy side effects
Question
Hi I am currently undergoing treatment for breast cancer - chemotherapy at the moment - and have just had my 6th cycle of a probable 8 - I am currently having taxoter - then i wil be having surgery and then probably radiotherapy. I dont eat particularly well after each chemo session due to nausea which I think may be causing to go neutropenic each time - I have had a 5 day stay in hospital at the beginning of treatment due to this and antibiotics after nearly each cycle. I have been tring to boost my immune system by eating a neutropenic diet but my problem now is that after the 4th chemo treatment my gall bladder has flared up so I am now even more limited as to what I can eat. I have cut out dairy and am having soya marg and milk. I have also cut out all fatty foods & oils etc, cakes, biscuits - apart from gingers - I have also cut out tomatoes and some fruits due to their acidity and also cucumber as I have been told its not good to eat. I am not having any sauces due to the vinegar in them but have found a dairy free mayo from the health store. I do eat soups, bits of toast, ginger biscuits , melon for about a week after chemo but thats about iit. Then I gradually introduce some salmon, chicken, other veg and salad and jacket potates and beans. My main concern is that I dont feel as though I am eating a balanced diet at present and there doesnt seem to much information on what things to eat and not to eat - apart from conflicting info - with reagrds to the gall bladder problem. I would appreciate it if you could let me know what foods would be good to eat & in what quantities - ie carbs - how many portions a day and which ones would be best fruits and veg/salad - which ones can I eat, which are best to avoid If you could do this for all the food groups and list foods down and just let me know how many from each food group to choose that would be great and if you have any tips on recipes ar any sauces I can eat to make the food less dry that would also be great as I do have a sore mouth as well which makes eating dry food difficult as well. I hope you can help - sorry its such a long request ! Many thanks
Answer
I would recommend that you ask your Hospital Doctor/Healthcare professional to refer you to see the Dietitian. The Dietitian will work closely with your medical team in order to provide an individual nutritional assessment, taking into account your medical condition and specific dietary concerns.
In terms of advising on the nutritional adequacy of your diet, it is not possible to offer general advice I’m afraid. I do feel that you will benefit from seeing a Dietitian who, on assessment, can offer tailored dietary advice and nutritional support. Dietary advice can some sometimes feel contradictory when balancing complex symptoms, and again, talking things through with the Dietitian will help to put your mind at ease.
Patients that are undergoing treatment for cancer are often advised to keep well nourished by following a diet that is high in protein and calories. This is because diet plays an important part in coping with treatment side effects, recovery, healing and fighting off infection. Neutropenia (becoming neutropenic) is a drop in the number of white cells in the blood. White cells help to protect us from infection, so people that have neutropenia are more at risk of getting an infection than the rest of us. Most chemotherapy drugs can cause neutropenia, and your Doctor will be able to help you understand why this happens in your case.
The risk of a food borne infection is difficult to quantify, and whether or not you actually need to follow any level of dietary restriction may depend on how neutropenic you are (i.e. your white cell count). It may be that you do not need to change your diet at all. Check with your Doctor/Healthcare professional who will be able to advise you on this. As discussed, keeping well nourished will help to boost your immune system.
Your Doctor will be able to examine your mouth and may advise on medications and/or mouth rinses to help ease the soreness. Ultimately, this will help to improve your nutritional intake. The Dietitian may recommend following a soft diet if this is better tolerated. Nourishing fluids e.g. milk and milky drinks can help to provide extra protein and calories. If weight loss is an issue, the Dietitian may recommend trialling nutritional supplement drinks. Supplement drinks contain protein, calories, vitamins and minerals and are available in a variety of styles and flavours. The Dietitian will be able to explain what nutritional products are available and help decide which ones may be most suitable for you if appropriate.
Source: Nutrition in cancer Editorial Board
