Questions About Cancer? 1-800-4-CANCER

Nutrition in Cancer Care (PDQ®)

Patient Version
Last Modified: 12/28/2011

Effects of Cancer Treatment on Nutrition

Key Points for This Section


Surgery and Nutrition

Surgery increases the body's need for nutrients and energy.

The body needs extra energy and nutrients to heal wounds, fight infection, and recover from surgery. If the patient is malnourished before surgery, it may cause problems during recovery, such as poor healing or infection. For these patients, nutrition care may begin before surgery.

Surgery to the head, neck, esophagus, stomach, or intestines may affect nutrition.

More than half of cancer patients are treated with surgery. Surgery that removes all or part of certain organs can affect a patient's ability to eat and digest food. The following are nutrition problems caused by specific types of surgery:

  • Surgery to the head and neck may cause problems with:
    • Chewing.
    • Swallowing.
    • Tasting or smelling food.
    • Making saliva.
    • Seeing.

  • Surgery that affects the esophagus, stomach, or intestines may keep these organs from working as they should to digest food and absorb nutrients.

All of these can affect the patient's ability to eat normally. Emotional stress about the surgery itself also may affect appetite.

Nutrition therapy can help relieve nutrition problems caused by surgery.

Nutrition therapy can relieve or decrease the side effects of surgery and help cancer patients get the nutrients they need. Nutrition therapy may include the following:

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 symptoms. Following certain tips about food may help. These include:

  • Stay away from carbonated drinks (such as sodas) and foods that cause gas, such as:
    • Beans.
    • Peas.
    • Broccoli.
    • Cabbage.
    • Brussels sprouts.
    • Green peppers.
    • Radishes.
    • Cucumbers.
  • Increase calories by frying foods and using gravies, mayonnaise, and salad dressings. Supplements high in calories and protein can also be used.
  • Choose high-protein and high-calorie foods to increase energy and help wounds heal. Good choices include:
    • Eggs.
    • Cheese.
    • Whole milk.
    • Ice cream.
    • Nuts.
    • Peanut butter.
    • Meat.
    • Poultry.
    • Fish.
  • If constipation is a problem, increase fiber by small amounts and drink lots of water. Good sources of fiber include:
    • Whole-grain cereals (such as oatmeal and bran).
    • Beans.
    • Vegetables.
    • Fruit.
    • Whole-grain breads.
    See the Constipation 1 section for more information.

Chemotherapy and Nutrition

Chemotherapy affects cells all through the body.

Chemotherapy affects fast-growing cells 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, digestive tract, and hair follicles.

Chemotherapy may affect nutrition.

Chemotherapy may cause side effects that cause problems with eating and digestion. When more than one anticancer drug is given, more side effects may occur or they may be more severe. The following side effects are common:

Nutrition therapy can help relieve nutrition problems caused by chemotherapy.

Patients who have side effects from chemotherapy may not be able to eat normally and get all the nutrients they need to restore healthy blood counts 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:

  • Nutrition supplement drinks between meals.
  • Enteral nutrition (tube feedings).
  • Changes in the diet, such as eating small meals throughout the day.

Radiation Therapy and Nutrition

Radiation therapy can affect cancer cells and healthy cells in the treatment area.

Radiation therapy can kill cancer cells and healthy cells in the treatment area. The amount of damage depends on the following:

  • The part of the body that is treated.
  • The total dose of radiation and how it is given.

Radiation therapy may affect nutrition.

Radiation therapy to any part of the digestive system 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.

The following are some of the more common side effects:

  • For radiation therapy to the head and neck
    • Loss of appetite.
    • Changes in the way food tastes.
    • Pain when swallowing.
    • Dry mouth or thick saliva.
    • Sore mouth and gums.
    • Narrowing of the upper esophagus, which can cause choking, breathing, and swallowing problems.
  • For radiation therapy to the chest
    • Infection of the esophagus.
    • Trouble swallowing.
    • Esophageal reflux (a backward flow of the stomach contents into the esophagus).
  • For radiation therapy to the abdomen or pelvis
    • Diarrhea.
    • Nausea.
    • Vomiting.
    • Inflamed intestines or rectum.
    • A decrease in the amount of nutrients absorbed by the intestines.

Radiation therapy may also cause tiredness, which can lead to a decrease in appetite.

Nutrition therapy can help relieve the nutrition problems caused by radiation therapy.

Nutrition therapy during radiation treatment can help the patient get enough protein and calories to get through treatment, prevent weight loss, help wound and skin healing, and maintain general health. Nutrition therapy may include the following:

  • Nutritional supplement drinks between meals.
  • Enteral nutrition (tube feedings).
  • Changes in the diet, such as eating small meals throughout the day.

Patients who receive high-dose radiation therapy to prepare for a bone marrow transplant may have many nutrition problems and should see a dietitian for nutrition support.

See the Stem Cell Transplant and Nutrition 2 section for more information.

Biologic Therapy and Nutrition

Biologic therapy may affect nutrition.

The side effects of biologic therapy are different for each patient and each type of biologic agent. The following nutrition problems are common:

  • Fever.
  • Nausea.
  • Vomiting.
  • Diarrhea.
  • Loss of appetite.
  • Tiredness.
  • Weight gain.

Nutrition therapy can help relieve nutrition problems caused by biologic therapy.

The side effects of biologic therapy can cause weight loss and malnutrition 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.

Stem Cell Transplant and Nutrition

Stem cell transplant patients have special nutrition needs.

Chemotherapy, radiation therapy, and medicines used for a stem cell transplant may cause side effects that keep a patient from eating and digesting food as usual. Common side effects include the following:

  • Changes in the way food tastes.
  • Dry mouth or thick saliva.
  • Mouth and throat sores.
  • Nausea.
  • Vomiting.
  • Diarrhea.
  • Constipation.
  • Weight loss and loss of appetite.
  • Weight gain.

Nutrition therapy is very important for patients who have a stem cell transplant.

Transplant patients have a very high risk of infection. High doses of chemotherapy or radiation therapy decrease the number of white blood cells, which fight infection. It is especially important that transplant patients avoid getting infections.

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 bacteria in food. Nutrition therapy during transplant treatment may include the following:

  • A diet of cooked and processed foods only, because raw vegetables and fresh fruit may carry harmful bacteria.
  • Guidelines on safe food handling.
  • A specific diet based on the type of transplant and the part of the body affected by cancer.
  • Parenteral nutrition (feeding through the bloodstream) during the first few weeks after the transplant, to give the patient the calories, protein, vitamins, minerals, and fluids they need to recover.

See the Low White Blood Cell Counts and Infections 3 section for more information.



Glossary Terms

abdomen (AB-doh-men)
The area of the body that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.
appetite (A-peh-tite)
A desire to satisfy a physical or mental need, such as for food, sex, or adventure.
bacteria (bak-TEER-ee-uh)
A large group of single-cell microorganisms. Some cause infections and disease in animals and humans. The singular of bacteria is bacterium.
biologic agent (BY-oh-LAH-jik AY-jent)
A substance that is made from a living organism or its products and is used in the prevention, diagnosis, or treatment of cancer and other diseases. Biologic agents include antibodies, interleukins, and vaccines. Also called biological agent and biological drug.
biological therapy (BY-oh-LAH-jih-kul THAYR-uh-pee)
Treatment to boost or restore the ability of the immune system to fight cancer, infections, and other diseases. Also used to lessen certain side effects that may be caused by some cancer treatments. Agents used in biological therapy include monoclonal antibodies, growth factors, and vaccines. These agents may also have a direct antitumor effect. Also called biological response modifier therapy, biotherapy, BRM therapy, and immunotherapy.
blood cell count (blud sel kownt)
A test to check the number of red blood cells, white blood cells, and platelets in a sample of blood. Also called CBC and complete blood count.
bone marrow transplantation (bone MAYR-oh tranz-plan-TAY-shun)
A procedure to replace bone marrow that has been destroyed by treatment with high doses of anticancer drugs or radiation. Transplantation may be autologous (an individual's own marrow saved before treatment), allogeneic (marrow donated by someone else), or syngeneic (marrow donated by an identical twin).
calorie (KA-luh-ree)
A measurement of the energy content of food. The body needs calories as to perform its functions, such as breathing, circulating the blood, and physical activity. When a person is sick, their body may need extra calories to fight fever or other problems.
cancer (KAN-ser)
A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.
catheter (KA-theh-ter)
A flexible tube used to deliver fluids into or withdraw fluids from the body.
cell (sel)
The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.
chemotherapy (KEE-moh-THAYR-uh-pee)
Treatment with drugs that kill cancer cells.
constipation (KON-stih-PAY-shun)
A condition in which stool becomes hard, dry, and difficult to pass, and bowel movements don’t happen very often. Other symptoms may include painful bowel movements, and feeling bloated, uncomfortable, and sluggish.
diarrhea (dy-uh-REE-uh)
Frequent and watery bowel movements.
diet (DY-et)
The things a person eats and drinks.
dietitian (dy-eh-TIH-shun)
A health professional with special training in nutrition who can help with dietary choices. Also called nutritionist.
digestion (dy-JES-chun)
The process of breaking down food into substances the body can use for energy, tissue growth, and repair.
digestive system (dy-JES-tiv SIS-tem)
The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum.
digestive tract (dy-JES-tiv trakt)
The organs through which food and liquids pass when they are swallowed, digested, and eliminated. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum and anus.
dose (dose)
The amount of medicine taken, or radiation given, at one time.
drug (drug)
Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.
enteral nutrition (EN-teh-rul noo-TRIH-shun)
A form of nutrition that is delivered into the digestive system as a liquid. Drinking nutrition beverages or formulas and tubefeeding are forms of enteral nutrition. People who are unable to meet their needs with food and beverages alone, and who do not have vomiting or uncontrollable diarrhea may be given tubefeedings. Tubefeeding can be used to add to what a person is able to eat or can be the only source of nutrition. A small feeding tube may be placed through the nose into the stomach or the small intestine, or it may be surgically placed into the stomach or the intestinal tract through an opening made on the outside of the abdomen, depending on how long it will be used.
esophageal reflux (ee-SAH-fuh-JEE-ul REE-flux)
The backward flow of stomach acid contents into the esophagus (the tube that connects the mouth to the stomach). Also called gastric reflux and gastroesophageal reflux.
esophagus (ee-SAH-fuh-gus)
The muscular tube through which food passes from the throat to the stomach.
fever (FEE-ver)
An increase in body temperature above normal (98.6 degrees F), usually caused by disease.
fiber (FY-ber)
In food, fiber is the part of fruits, vegetables, legumes, and whole grains that cannot be digested. The fiber in food may help prevent cancer. In the body, fiber refers to tissue made of long threadlike cells, such as muscle fiber or nerve fiber.
fluid (FLOO-id)
A substance that flows smoothly and takes the shape of its container. Liquids and gases are fluids.
gums (gumz)
The tissue of the upper and lower jaws that surrounds the base of the teeth. Also called gingiva.
hair follicle (… FAH-lih-kul)
A shaft or opening on the surface of the skin through which hair grows.
high-dose chemotherapy (hy-dose kee-moh-THAYR-uh-pee)
An intensive drug treatment to kill cancer cells, but that also destroys the bone marrow and can cause other severe side effects. High-dose chemotherapy is usually followed by bone marrow or stem cell transplantation to rebuild the bone marrow.
high-dose radiation (hy-dose RAY-dee-AY-shun)
An amount of radiation that is greater than that given in typical radiation therapy. High-dose radiation is precisely directed at the tumor to avoid damaging healthy tissue, and may kill more cancer cells in fewer treatments. Also called HDR.
infection (in-FEK-shun)
Invasion and multiplication of germs in the body. Infections can occur in any part of the body and can spread throughout the body. The germs may be bacteria, viruses, yeast, or fungi. They can cause a fever and other problems, depending on where the infection occurs. When the body’s natural defense system is strong, it can often fight the germs and prevent infection. Some cancer treatments can weaken the natural defense system.
inflammation (IN-fluh-MAY-shun)
Redness, swelling, pain, and/or a feeling of heat in an area of the body. This is a protective reaction to injury, disease, or irritation of the tissues.
intestine (in-TES-tin)
The long, tube-shaped organ in the abdomen that completes the process of digestion. The intestine has two parts, the small intestine and the large intestine. Also called bowel.
malnourished (mal-NER-isht)
Describes a condition caused by not getting enough calories or the right amount of key nutrients needed for health. Key nutrients include vitamins and minerals.
malnutrition (mal-noo-TRIH-shun)
A condition caused by not getting enough calories or the right amount of key nutrients, such as vitamins and minerals, that are needed for health. Malnutrition may occur when there is a lack of nutrients in the diet or when the body cannot absorb nutrients from food. Cancer and cancer treatment may cause malnutrition.
medicine (MEH-dih-sin)
Refers to the practices and procedures used for the prevention, treatment, or relief of symptoms of a diseases or abnormal conditions. This term may also refer to a legal drug used for the same purpose.
mineral (MIH-neh-rul)
In medicine, a mineral is a nutrient that is needed in small amounts to keep the body healthy. Mineral nutrients include the elements calcium, magnesium, and iron.
nausea (NAW-zee-uh)
A feeling of sickness or discomfort in the stomach that may come with an urge to vomit. Nausea is a side effect of some types of cancer therapy.
nutrient (NOO-tree-ent)
A chemical compound (such as protein, fat, carbohydrate, vitamin, or mineral) contained in foods. These compounds are used by the body to function and grow.
nutrition (noo-TRIH-shun)
The taking in and use of food and other nourishing material by the body. Nutrition is a 3-part process. First, food or drink is consumed. Second, the body breaks down the food or drink into nutrients. Third, the nutrients travel through the bloodstream to different parts of the body where they are used as "fuel" and for many other purposes. To give the body proper nutrition, a person has to eat and drink enough of the foods that contain key nutrients.
nutrition therapy (noo-TRIH-shun THAYR-uh-pee)
Treatment based on nutrition. It includes checking a person’s nutrition status, and giving the right foods or nutrients to treat conditions such as those caused by diabetes, heart disease, and cancer. It may involve simple changes in a person’s diet, or intravenous or tube feeding. Nutrition therapy may help patients recover more quickly and spend less time in the hospital. Also called medical nutrition therapy.
nutritional supplement (noo-TRIH-shuh-nul SUH-pleh-ment)
A product that is added to the diet. A nutritional supplement is taken by mouth, and usually contains one or more dietary ingredient (such as vitamin, mineral, herb, amino acid, and enzyme). Also called dietary supplement.
organ (OR-gun)
A part of the body that performs a specific function. For example, the heart is an organ.
parenteral nutrition (puh-REN-teh-rul noo-TRIH-shun)
A form of nutrition that is delivered into a vein. Parenteral nutrition does not use the digestive system. It may be given to people who are unable to absorb nutrients through the intestinal tract because of vomiting that won't stop, severe diarrhea, or intestinal disease. It may also be given to those undergoing high-dose chemotherapy or radiation and bone marrow transplantation. It is possible to give all of the protein, calories, vitamins and minerals a person needs using parenteral nutrition. Also called hyperalimentation, total parenteral nutrition, and TPN.
pelvis (PEL-vus)
The lower part of the abdomen, located between the hip bones.
protein (PROH-teen)
A molecule made up of amino acids that are needed for the body to function properly. Proteins are the basis of body structures such as skin and hair and of substances such as enzymes, cytokines, and antibodies.
radiation (RAY-dee-AY-shun)
Energy released in the form of particle or electromagnetic waves. Common sources of radiation include radon gas, cosmic rays from outer space, medical x-rays, and energy given off by a radioisotope (unstable form of a chemical element that releases radiation as it breaks down and becomes more stable).
radiation therapy (RAY-dee-AY-shun THAYR-uh-pee)
The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.
recover (ree-KUH-ver)
To become well and healthy again.
rectum (REK-tum)
The last several inches of the large intestine closest to the anus.
saliva (suh-LY-vuh)
The watery fluid in the mouth made by the salivary glands. Saliva moistens food to help digestion and it helps protect the mouth against infections.
side effect (side eh-FEKT)
A problem that occurs when treatment affects healthy tissues or organs. Some common side effects of cancer treatment are fatigue, pain, nausea, vomiting, decreased blood cell counts, hair loss, and mouth sores.
stem cell transplant (stem sel tranz-plant)
A method of replacing immature blood-forming cells in the bone marrow that have been destroyed by drugs, radiation, or disease. Stem cells are injected into the patient and make healthy blood cells. A stem cell transplant may be autologous (using a patient’s own stem cells that were saved before treatment), allogeneic (using stem cells donated by someone who is not an identical twin), or syngeneic (using stem cells donated by an identical twin).
stomach (STUH-muk)
An organ that is part of the digestive system. The stomach helps digest food by mixing it with digestive juices and churning it into a thin liquid.
stress (stres)
The response of the body to physical, mental, or emotional pressure. This may make a person feel frustrated, angry, or anxious, and may cause unhealthy chemical changes in the body. Untreated, long-term stress may lead to many types of mental and physical health problems.
surgery (SER-juh-ree)
A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.
symptom (SIMP-tum)
An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.
therapy (THAYR-uh-pee)
Treatment.
throat (throte)
The hollow tube inside the neck that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). The throat is about 5 inches long, depending on body size. Also called pharynx.
tubefeeding (toob-FEE-ding)
A type of enteral nutrition (nutrition that is delivered into the digestive system in a liquid form). For tubefeeding, a small tube may be placed through the nose into the stomach or the small intestine. Sometimes it is surgically placed into the stomach or the intestinal tract through an opening made on the outside of the abdomen, depending on how long it will be used. People who are unable to meet their needs with food and beverages alone, and who do not have vomiting or uncontrollable diarrhea may be given tubefeedings. Tubefeeding can be used to add to what a person is able to eat or can be the only source of nutrition.
vitamin (VY-tuh-min)
A nutrient that the body needs in small amounts to function and stay healthy. Sources of vitamins are plant and animal food products and dietary supplements. Some vitamins are made in the human body from food products. Vitamins are either fat-soluble (can dissolve in fats and oils) or water-soluble (can dissolve in water). Excess fat-soluble vitamins are stored in the body’s fatty tissue, but excess water-soluble vitamins are removed in the urine. Examples are vitamin A, vitamin C, and vitamin E.
vomit (VAH-mit)
To eject some or all of the contents of the stomach through the mouth.
white blood cell (hwite blud sel)
A type of immune cell. Most white blood cells are made in the bone marrow and are found in the blood and lymph tissue. White blood cells help the body fight infections and other diseases. Granulocytes, monocytes, and lymphocytes are white blood cells. Also called leukocyte and WBC.
wound (woond)
A break in the skin or other body tissues caused by injury or surgical incision (cut).

Table of Links

1http://www.cancer.gov/cancertopics/pdq/supportivecare/nutrition/Patient/Page5#S
ection_341
2http://www.cancer.gov/cancertopics/pdq/supportivecare/nutrition/Patient/Page4#S
ection_270
3http://www.cancer.gov/cancertopics/pdq/supportivecare/nutrition/Patient/Page5#S
ection_332