Nutrition Before During and After Cancer

Information on nutritional needs for cancer patients

Common Challenges for Survivors

Loss of Weight and Lean Body Mass
Those who have survived cancers of the head, neck, gastrointestinal and lung are among those more likely to be malnourished and underweight. For these cancer survivors, nutrition care should aim for positive energy balance and adequate protein to preserve or rebuild lean body mass.

Low lean body mass, especially as part of sarcopenic obesity, is associated with poor health outcomes. Loss of lean body mass often is also seen in survivors of colon, breast, and childhood cancers.


Physical activity also is important to increase strength and endurance and, when tailored to individual needs, may help improve eating by enhancing appetite.

Physical activity, including resistance training, may help protect against the loss of lean body mass. Adequate protein and calories are essential, and research is under way regarding the potential for omega-3 fatty acids to help reduce muscle catabolism and the appropriate choices among protein sources to support muscle growth.

Among the most common and debilitating problems cancer survivors face, cancer-related fatigue is a persistent tiredness not proportional to recent activity that interferes with usual functioning and isn’t alleviated with rest. Some survivors experience fatigue even years after treatment is completed. Although it may appear without a clear cause, cancer-related fatigue can occur because of new or ongoing and potentially treatable medical problems such as thyroid, pulmonary, cardiac or liver disorders; anemia; depression; poor appetite; and medications. Survivors are urged to discuss fatigue with their physicians.

Family members and friends often urge survivors with cancer-related fatigue to rest more. While adequate sleep and rest are important, research strongly supports engaging in physical activity to reduce cancer-related fatigue, and it’s one of the few evidence-based treatments currently available. Other research shows that additional, potentially helpful non pharmaceutical interventions include yoga, cognitive behavioral therapy, counseling, and relaxation techniques.

Nutrition consultation also is included in National Comprehensive Cancer Network clinical practice guidelines for assessing and addressing cancer-related fatigue. The guidelines highlight the management of nutritional deficiencies that developed during cancer treatment, adequate hydration, and electrolyte balance to prevent and treat fatigue.

mediterranean diet pyramid

Although research is lacking, anecdotal data from dietitians working with cancer survivors suggest that high-fiber, whole-food carbohydrate choices distributed throughout the day can help survivors maintain their energy level and avoid fatigue related to blood sugar swings.

Other Post treatment Challenges
Cancer survivors typically recover from the acute effects of their treatment within weeks or months after treatment ends. In some cases, however, side effects of treatment persist, such as taste changes, odynophagia (painful swallowing), dysphagia (difficulty swallowing), xerostomia (dry mouth caused by a lack of saliva), enteritis, diarrhea, constipation, and other concerns that can challenge nutritional status. The websites of the National Cancer Institute (, the ACS (, the AICR (, the American Society of Clinical Oncology (, and the Oncology Nutrition Dietetic Practice Group of the Academy of Nutrition and Dietetics ( provide practical tips for handling such problems. In addition, dietitians who are board-certified oncology nutrition specialists (those with the CSO credential) have special expertise in this area and are excellent resources.


The Chocolate

The health benefits of chocolate depend upon the type of chocolates you choose – and how many.

The Healthy Insides

Dark Chocolate

Most of the health benefits with dark chocolate relate to cardiovascular disease. Dark chocolate is packed with flavonoids, a group of phytochemicals that act as antioxidants. Research shows that consuming chocolate increases the antioxidants in our blood. Cocoa powder ranks as having the highest antioxidants of the chocolate products, followed by dark chocolate and milk chocolate. Studies link eating chocolate in moderation with heart health, including improving blood vessel function and lowering blood pressure. The flavonoids can slow the oxidation of LDL cholesterol (the “bad” type). When LDL cholesterol becomes oxidized it can clog blood vessels.

Cocoa Powder

Given chocolate’s rich supply of flavonoids, researchers have also investigated whether it may play a role in cancer prevention. The studies in cancer prevention are still emerging. A recent review of studies on the cancer protective properties of cocoa concluded that the evidence is limited but suggestive.

Cacao Beans

From Cacao to Cocoa

Whatever the chocolate, it all begins with the cacao bean. First, the cacao bean is roasted and ground into thick chocolate liquor (non-alcoholic). This liquor, hardened, is unsweetened chocolate. When pressure is added to the liquor, it pushes out the bean’s fat, called cocoa butter. Cocoa powder is made by drying and sifting the remaining material from the liquor. Mix up some chocolate liquor, cocoa butter, sugar and milk, and the commercial chocolate treat emerges. In general, higher the percentage of cacao, the darker the chocolate, more intense the flavor and less room for sugar.

White chocolate contains cocoa butter but not any chocolate liquor; technically it is not chocolate. (It gets its name because it contains cocoa butter.)

Pick Your Pleasure

There are plenty of ways to get the same healthful plant compounds contained in chocolate, such as by eating fruits and vegetables. For chocolate lovers, you can enjoy it all. Whether it’s dark or milk, aim for the plain chocolates without sugar.

Weakened Immune Systems III

Cancer and its treatment can weaken your body’s immune system. As a result, your body cannot fight infection well. While your immune system is recovering, you are advised to avoid being exposed to possible infection-causing germs. This is the third blog in this series.

Cook foods well

cooking thermometer

Put a meat thermometer into the middle of the thickest part of the food to test for doneness. Test a thermometer’s accuracy by putting it into boiling water. It should read 212° F.

Cook meat until it is no longer pink and the juices run clear. The only way to know for sure that the meat has been cooked to the right temperature is to use a food thermometer. Meats should be cooked to 160° F and poultry to 180° F.

Microwave cooking

Rotate the dish a quarter turn once or twice during cooking if there is no turntable in the microwave oven. This helps prevent cold spots in food where bacteria can survive.

Use a lid or vented plastic wrap to thoroughly heat leftovers. Stir often during reheating.

Grocery shopping

sell by date

Check “sell-by” and “use-by” dates. Pick only the freshest products.

Check the packaging date on fresh meats, poultry, and seafood. Do not buy products that are out of date.

Do not use damaged, swollen, rusted, or deeply dented cans. Be sure that packaged and boxed foods are properly sealed.

Choose unblemished fruits and vegetables.

Do not eat deli foods. In the bakery, avoid unrefrigerated cream- and custard-containing desserts and pastries.

Do not eat foods from self-serve or bulk containers.

Do not eat yogurt and ice cream products from soft-serve machines.

Do not eat free food samples.

Get your frozen and refrigerated foods just before you check out at the grocery store, especially during the summer months.

Refrigerate groceries right away. Never leave food in a hot car.

Small Snacks when Eating is next to impossible

Crackers with Chocolate-Hazelnut spread and banana

Spread 2 bread crackers with 1 tablespoon chocolate-hazel nut spread, top with 1 sliced small banana.

Calories: 214, Protein: 4g, Fiber: 6g, Fat: 7g


Rice cake with peanut butter, Coconut and dried cherries


Spread 1 rice cake with 1 tablespoon creamy peanut butter, sprinkle 2 teaspoons toasted unsweetened shredded coconut and 2 teaspoons of dried cherries.

Calories: 177, Protein: 5g, Fiber: 2g, Fat 11g

Tropical fruit Parfait


Top ½ cup plain low fat Greek yoghurt with 1 sliced Kiwi and ¼ diced mango sprinkle with 1 tablespoon chopped walnuts,

Calories: 204, Protein: 12g, Fiber: 3g, Fat: 7g

Pea and Mint Dip with Pretzel chips


Mash ½ cup frozen peas with 1tablespoon of fresh mint and 2 teaspoons of lime juice, enjoy with 15 pretzel chips

Calories: 209, protein 8g, Fiber: 5g, Fat: 0g

Dark Chocolate and Nut Clusters


Mix together ¼ cup of unsalted roasted nuts and 1 ounce of melted dark chocolate (70-80% cocoa). Drop into wax paper and cool

Calories: 195, Protein: 4g, Fiber: 3g, Fat: 14g

Spicy Watermelon and Pistachios


Toss 2cups cubed watermelon with 1 tablespoon fresh lime juice and ½ teaspoon grated lime zest. Sprinkle with a pinch of cayenne pepper or black pepper and 2 teaspoons of chopped unsalted pistachios

Calories: 126, Protein: 3g, Fiber: 2g, Fat: 3g

Nutrition and Pancreatic Cancer


Pancreatic cancer is the fourth leading cause of cancer death in men and women. Prognosis is poor with a 5-year survival rate of less than 5%. As there is no effective screening modality, the best way to reduce morbidity and mortality due to pancreatic cancer is by effective primary prevention.

A recent study in International Journal of Cancer Research and Treatment suggests that:
  • Fruits (particularly citrus) and vegetable consumption may be beneficial.
  • The consumption of whole grains has been shown to reduce pancreatic cancer risk.
  • Fortification of whole grains with folate may confer further protection.
  • Red meat, cooked at high temperatures, should be avoided, and replaced with poultry or fish.
  • Total fat should be reduced.
  • The use of curcumin and other flavonoids should be encouraged in the diet.
  • There is no evidence for benefit from vitamin D supplementation.
  • There may be benefit for dietary folate.
  • Smoking and high Body Mass Index, have been associated with pancreatic cancer risk.

March is National Nutrition Month


National Nutrition Month® is a nutrition education and information campaign created annually in March by the Academy of Nutrition and Dietetics, formerly the American Dietetic Association. The campaign focuses attention on the importance of making informed food choices and developing sound eating and physical activity habits.

Eating Right means eating with color and portion control, the more colorful your shopping basket and your dinner plate, the better the nutrition.  Make one night an international meal night. This makes it easier to expand those taste buds. An easy way to have a colorful plate is by adding variety.

Every time you shop, buy a new fruit or a vegetable that you have never had before and learn to cook/eat it. This not only adds to the excitement of food preparation it automatically adds variety to your diet and provides you with essentials vitamins and minerals and other trace elements that a monotonous and repetitive meal may lack.