Managing Eating Problems During Cancer Treatment, Part 3

by National Cancer Institute

(Page 4 of 7)

Dental and Gum Problems

Cancer and cancer treatment can cause tooth decay and other problems for your teeth and gums. For example, radiation to the mouth can affect your salivary glands, making your mouth dry and increasing your risk of cavities. Changes in eating habits also may add to the problem. Your doctor and dentist should work closely together to fix any problems with your teeth before you start treatment. If you eat often or eat a lot of sweets, you may need to brush your teeth more often. Brushing after each meal or snack is a good idea. Here are some other ideas for preventing dental problems:

• Be sure to let your doctor know about any dental problems you are having.

• Be sure to see your dentist regularly. Patients who are receiving treatment that affects the mouth - for example, radiation to the head and neck - may need to see the dentist more often than usual.

• Use a soft toothbrush. Ask your doctor, nurse, or dentist to suggest a special kind of toothbrush and/or toothpaste if your gums are very sensitive.

• Rinse your mouth with warm water when your gums and mouth are sore.

• If you are eating foods high in sugar or foods that stick to your teeth, be sure to brush or rinse your mouth afterward so that the sugar won't damage your teeth, or use sugar-free varieties. (Sorbitol, a sugar substitute that is contained in many sugar-free foods, can cause diarrhea in many people. If diarrhea is a problem for you, check the labels of sugar-free foods before you buy them and limit your use of them.)

Changed Sense of Taste or Smell

Your sense of taste or smell may change during your illness or treatment. Foods, especially meat or other high-protein foods, can begin to have a bitter or metallic taste. Many foods will have less taste. Chemotherapy, radiation therapy, or the cancer itself may cause these problems. Dental problems also can change the way foods taste. For most people, changes in taste and smell go away when their treatment is finished.

There is no foolproof way to prevent changes to your sense of taste or smell because each person is affected differently by illness and treatments. However, the tips below should help if you have this problem. (If you also have a sore mouth, sore gums, or a sore throat, talk to your doctor, nurse, or registered dietitian. They can suggest ways to help you without hurting the sore areas.)

• Choose and prepare foods that look and smell good to you.

• If red meat, such as beef, tastes or smells strange, try chicken, turkey, eggs, dairy products, or mild-tasting fish instead.

• Help the flavor of meat, chicken, or fish by marinating it in sweet fruit juices, sweet wine, Italian dressing, or sweet-and-sour sauce.

• Try using small amounts of flavorful seasonings, such as basil, oregano, or rosemary.

• Try tart foods, such as oranges or lemonade, that may have more taste. A tart lemon custard might taste good and will also provide needed protein and calories. (If you have a sore mouth or throat, tart or citrus foods might cause pain or discomfort.)

• If smells bother you, try serving foods at room temperature, turning on a kitchen fan, covering foods when cooking, and cooking outdoors in good weather.

• Try using bacon, ham, or onion to add flavor to vegetables.

• Visit your dentist to rule out dental problems that may affect the taste or smell of food.

• Ask your dentist or doctor about special mouthwashes and good mouth care.

Nausea

Nausea, with or without vomiting, is a common side effect of surgery, chemotherapy, radiation therapy, and biological therapy. The disease itself, or other conditions unrelated to your cancer or treatment, may also cause nausea. Some people have nausea or vomiting right after treatment; others don't have it until two or three days after a treatment. Many people never experience nausea. For those who do, nausea often goes away once the treatment is completed. Also, there are now drugs that can effectively control this side effect. These medications, called antiemetics, are often given at the beginning of a chemo-therapy session to prevent nausea.

Whatever the cause, nausea can keep you from getting enough food and needed nutrients. Here are some ideas that can help:

• Ask your doctor about antiemetics that might help you control nausea and vomiting.
• Try foods that are easy on your stomach, such as:
  • toast, crackers, and pretzels
  • yogurt
  • sherbet
  • angel food cake
  • cream of wheat, rice, or oatmeal
  • boiled potatoes, rice, or noodles
  • skinned chicken that is baked or broiled, not fried
  • canned peaches or other soft, bland fruits and vegetables
  • clear liquids
  • ice chips
  • carbonated drinks
• Avoid foods that:
  • are fatty, greasy, or fried
  • are very sweet, such as candy, cookies, or cake
  • are spicy or hot
  • have strong odors
• Eat small amounts, often and slowly. Eat before you get hungry, because hunger can make feelings of nausea stronger.
• If nausea makes certain foods unappealing, then eat more of the foods you find easier to handle.
• Avoid eating in a room that's stuffy, too warm, or has cooking odors that might disagree with you.
• Drink fewer liquids with meals. Drinking liquids can cause a full, bloated feeling.
• Slowly drink or sip liquids throughout the day. A straw may help.
• Have foods and drinks at room temperature or cooler; hot foods may add to nausea.
• Don't force yourself to eat favorite foods when you feel nauseated. This may cause a permanent dislike for those foods.
• Rest after meals, because activity may slow digestion. It's best to rest sitting up for about an hour after meals.
• If nausea is a problem in the morning, try eating dry toast or crackers before getting up.
• Wear loose-fitting clothes.
• If nausea occurs during radiation therapy or chemotherapy, avoid eating for 1 to 2 hours before treatment.
• Try to keep track of when your nausea occurs and what causes it (specific foods, events, surroundings). If possible and if it helps, change your diet or schedule. Share the information with your doctor or nurse.

Vomiting

Vomiting may follow nausea and may be brought on by treatment, food odors, gas in the stomach or bowel, or motion. In some people, certain associations or surroundings, such as the hospital, may cause vomiting. As with nausea, some people have vomiting right after treatment, while others don't have it until a day or more after treatment.

If vomiting is severe or lasts for more than a day or two, contact your doctor. He or she may give you an antiemetic medication to control nausea and vomiting.

Very often, if you can control nausea, you can prevent vomiting. At times, though, you may not be able to prevent either. Relaxation exercises or meditation may help you. These usually involve deep rhythmic breathing and quiet concentration, and can be done almost anywhere. If vomiting does occur, try these suggestions to help prevent further episodes:

• Do not eat or drink anything until you have the vomiting under control.

• Once the vomiting is under control, try small amounts of clear liquids, such as water or bouillon. Begin with 1 teaspoonful every 10 minutes, gradually increasing the amount to 1 tablespoon every 20 minutes. Finally, try 2 tablespoons every 30 minutes.

• When you are able to keep down clear liquids, try a full-liquid diet or a soft diet. Continue taking small amounts as often as you can keep them down. If you feel okay, gradually work up to your regular diet. If you have a hard time digesting milk, you may want to try a soft diet instead of a full-liquid diet, because a full-liquid diet includes a lot of milk products. Ask a registered dietitian for information about a soft diet.

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