Cancer Nutrition Expert Outlines Dietary Strategies to Combat Treatment Side Effects and Support Long-Term Survivorship

Cancer patients face numerous nutritional challenges throughout their treatment journey, from appetite loss and unintentional weight loss to taste alterations and swallowing difficulties. Denise B. Reynolds, a registered dietitian at Atrium Health Levine Cancer (search)Search term, provides evidence-based strategies to address these complications while supporting long-term survivorship health.

Treatment-Related Nutritional Challenges

Unintentional weight loss often serves as the initial symptom that prompts patients to seek medical attention. "Many times, the cancer itself will cause issues with appetite, gastrointestinal upset, things like that: it is different for everyone," Reynolds explains. "Cancer treatment can make those situations worse, but some of the issues that they have start with weight loss, which is one of the reasons why they go to their doctor."

The cancer treatment process itself introduces additional nutritional complications. Chemotherapy and radiation can cause anemia by breaking down red blood cells, potentially requiring iron supplementation or infusions. However, Reynolds cautions against broad supplementation approaches, particularly immune-boosting products that may interfere with treatment efficacy.

"Certain supplements can be high in, say, antioxidants, and that can interfere with the chemotherapy or radiation," she notes. "We do not want that. That can interfere with some of the treatment that we offer our patients."

Managing Nausea and Appetite Issues

For patients experiencing nausea and vomiting, Reynolds recommends a strategic approach centered on small, frequent meals. Unlike typical illness-related nausea, chemotherapy-induced nausea may actually improve with food intake.

"Having something in your stomach during the nausea and vomiting from chemotherapy can help quell some of that nausea," Reynolds explains, comparing it to pregnancy-related nausea. She suggests keeping crackers bedside and consuming them first thing in the morning.

Electrolyte-enriched beverages like Gatorade or Pedialyte can help replace lost fluids when plain water becomes nauseating. Bland, low-odor foods such as crackers, dry toast, and chicken noodle soup provide comfort without triggering additional nausea.

Addressing Taste and Smell Alterations

Chemotherapy-induced taste changes require specific dietary modifications. For the common metallic taste associated with certain chemotherapy agents, Reynolds recommends using plastic utensils or chopsticks and choosing frozen over canned foods. "Drinking out of a plastic bottle or with a straw so that you are not touching that metal, may help," she advises.

When foods taste abnormally bitter, adding sweetness through citrusy flavors can help balance the taste. For bland-tasting foods, particularly common in radiation patients, strong spices like oregano or controlled amounts of hot sauce can enhance flavor without relying on excess salt.

"All that being said, we try balancing whatever taste that you have with the opposite," Reynolds explains. "If things are too sweet, balance it with something bitter. If something is too bitter, balance it with something sweet."

Managing Mucositis and Swallowing Difficulties

Patients with mucositis or dysphagia require modified food textures and temperatures. Soft, moist foods like scrambled eggs or chicken salad prove easier to swallow than solid proteins. Cold foods can provide soothing relief for inflamed mouth tissues.

"Things that are cold soothe the mouth. Many times, we have patients who will hold ice in their mouth to help freeze that area a little bit, make it feel a bit more soothing," Reynolds notes.

Maintaining oral hygiene becomes crucial during this period, using alcohol-free mouth rinses to prevent bacterial infections. Cooking methods that add moisture, such as slow-cooking meats or adding gravies and sauces, can facilitate easier swallowing.

Long-Term Survivorship Nutrition

For cancer survivors, Reynolds advocates following the American Institute for Cancer Research guidelines through the New American plate approach. This Mediterranean-style diet emphasizes reducing red meat consumption while maintaining smaller portions of fish and chicken.

"We are trying not to overload them with animal proteins and bring back those fruits and vegetables, nuts, seeds, whole grains, increasing the amount of fiber that someone is getting," she explains. The goal involves helping patients reach and maintain a healthy weight, whether they are underweight or overweight following treatment.

Beyond dietary modifications, Reynolds emphasizes the importance of physical activity and hydration in combating post-treatment fatigue. "Eating a good, healthy diet, rich in fruits and vegetables and whole grains, and getting in some exercise can help with that fatigue," she states.

Collaborative Care Approach

Atrium Health employs 18 registered dietitians who work closely with oncology teams to address nutrition-related treatment complications. Reynolds encourages patients to request dietitian referrals through their healthcare providers to receive personalized nutritional support.

"We are always here to answer questions for you, whether it is about supplements or a particular food or something you have heard or to correct misinformation," Reynolds emphasizes. "Always ask questions, always be your best advocate, and we are all here to help you through this journey."