Cancer Nutrition Guide

Issue

Vol. 2 No. 3 (2025)

Date Log

Submitted
April 26, 2025
Accepted
June 30, 2025
Published
July 11, 2025

Cancer Nutrition Guide - Optimal Eating, Treatment Side‑Effects & Safety Tips

https://doi.org/10.69512/ajphi.v2i3.113
Rajeep Guragain
Birat Medical College and Teaching Hospital, Biratnagar, Nepal
https://orcid.org/0009-0005-0889-4402
Rochana Acharya, MD
Department of Internal Medicine, Cleveland Clinic Foundation, OH, USA
https://orcid.org/0000-0001-7293-8207

Corresponding Author(s) : Rajeep Guragain

rjvrjay@gmail.com

The American Journal of Patient Health Info, Vol. 2 No. 3 (2025)

Abstract


  1. About 1 out of every 5 people with cancer don’t die from the cancer itself, but because their bodies don’t get enough food and nutrients.

  2. People with cancer need a diet that’s different from a typical healthy diet; it should include more high-protein and high-calorie foods like lean meats, eggs, nuts, beans, and dairy.

  3. Cancer treatments can weaken the immune system, so it is very important to handle food carefully and keep everything clean to avoid infections from bad food.

  4. Feeling nauseous or sick to your stomach is common during cancer treatment. Eating small, simple meals can help reduce this feeling.

  5. If eating by mouth becomes too difficult, some patients might need to get their food through a tube that goes into their stomach or through an IV (a needle in their vein) to ensure they get enough energy and nutrients.

Keywords

Anorexia Cancer Chemotherapy Malnutrition Nutrition
Guragain, R., & Acharya, MD, R. (2025). Cancer Nutrition Guide - Optimal Eating, Treatment Side‑Effects & Safety Tips . The American Journal of Patient Health Info, 2(3). https://doi.org/10.69512/ajphi.v2i3.113
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References
  1. Beirer A. Malnutrition and cancer, diagnosis and treatment. Memo. 2021;14:168–73. Available from: https://www.researchgate.net/publication/350566637_Malnutrition_and_cancer_diagnosis_and_treatment
  2. Teunissen SCCM, Wesker W, Kruitwagen C, de Haes HCJM, Voest EE, de Graeff A. Symptom Prevalence in Patients with Incurable Cancer: A Systematic Review. Journal of Pain and Symptom Management. 2007 Jul;34(1):94–104.Available from: https://pubmed.ncbi.nlm.nih.gov/17509812/
  3. Bulmuş Tüccar T, Acar Tek N. Determining the factors affecting energy metabolism and energy requirement in cancer patients. J Res Med Sci. 2021;26(1):124. Available from: https://pubmed.ncbi.nlm.nih.gov/35126587/
  4. Clinton SK, Giovannucci EL, Hursting SD. The World Cancer Research Fund/American Institute for Cancer Research Third Expert Report on Diet, Nutrition, Physical Activity, and Cancer: Impact and Future Directions. J Nutr. 2020;150(4):663–71. Available from: https://pubmed.ncbi.nlm.nih.gov/31758189/
  5. Hesketh PJ. Chemotherapy-induced nausea and vomiting. N Engl J Med. 2008;358(23):2482–94. Available from: https://pubmed.ncbi.nlm.nih.gov/18525044/
  6. Memorial Sloan Kettering Cancer Center. Diet and nutrition during head and neck cancer treatment [Internet]. New York: Memorial Sloan Kettering Cancer Center; [cited 2025 Apr 17]. Available from: https://www.mskcc.org/cancer-care/patient-education/diet-and-nutrition-during-head-and-neck-cancer-treatment
  7. Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F, et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr. 2017;36(1):11–48. Available from: https://pubmed.ncbi.nlm.nih.gov/27637832/
  8. National Cancer Institute. Nutrition during cancer treatment [Internet]. Bethesda (MD): National Cancer Institute; [updated 2024 Sep 20; cited 2025 Apr 25]. Available from: https://www.cancer.gov/about-cancer/treatment/side-effects/nutrition
  9. National Cancer Institute. Eating hints: Before, during, and after cancer treatment [Internet]. Bethesda (MD): National Cancer Institute; [cited 2025 Apr 25]. Available from: https://www.cancer.gov/publications/patient-education/eatinghints.pdf
  10. American Cancer Society. Managing nausea and vomiting [Internet]. Atlanta (GA): American Cancer Society; [cited 2025 Apr 25]. Available from: https://www.cancer.org/cancer/managing-cancer/side-effects/eating-problems/nausea-and-vomiting/managing.html
  11. Cancer Council Australia. Nutrition and cancer [Internet]. Sydney (AU): Cancer Council Australia; [cited 2025 Apr 25]. Available from: https://www.cancer.org.au/assets/pdf/nutrition-and-cancer-booklet
  12. National Cancer Institute. Eating hints: Before, during, and after cancer treatment [Internet]. Bethesda (MD): National Cancer Institute; [cited 2025 Apr 25]. Available from: https://www.cancer.gov/publications/patient-education/eatinghints.pdf
  13. Cancer Research UK. Diet, fluid, and exercise for constipation [Internet]. London: Cancer Research UK; [cited 2025 Apr 25]. Available from: https://www.cancerresearchuk.org/about-cancer/coping/physically/bowel-problems/types/constipation/diet-fluid-exercise
  14. Cancer Research UK. Tips for coping with diarrhoea [Internet]. London: Cancer Research UK; [cited 2025 Apr 25]. Available from: https://www.cancerresearchuk.org/about-cancer/coping/physically/bowel-problems/types/diarrhoea/tips-coping-diarrhoea
  15. American Cancer Society. Nutrition and a weak immune system [Internet]. Atlanta (GA): American Cancer Society; [cited 2025 Apr 25]. Available from: https://www.cancer.org/cancer/survivorship/coping/nutrition/weak-immune-system.html
  16. Laviano A, Koverech A, Zanetti M. Nutrition support and clinical outcome in advanced cancer patients. Nutrients. 2022;14(11):2180. Available from: https://pubmed.ncbi.nlm.nih.gov/30001763/
  17. Klement RJ. The influence of ketogenic diets on the quality of life in cancer patients: A review. Nutr Cancer. 2024;76(2):217–28. Available from: https://pubmed.ncbi.nlm.nih.gov/33813635/
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Rajeep Guragaina, Rochana Acharyab

a Birat Medical College and Teaching Hospital, Biratnagar, Nepal

b Department of Internal Medicine, Cleveland Clinic Foundation, OH, USA

Re-Submitted on: 18th April 2025

Final Submission

Background

Malnutrition is a common but often overlooked problem in people with cancer. The word comes from "mal," meaning bad, and "nutrition," which refers to the food and nutrients your body needs to stay healthy. Malnutrition occurs in 20% to over 70% of patients with cancer. Alarmingly, 1 to 2 deaths out of 10 cancer-related deaths are due to malnutrition rather than the cancer itself. [1]

There are many reasons why people with cancer might not get enough nutrition. Sometimes, the cancer releases chemicals that make them lose their appetite, which is called cancer-related anorexia. Cancers in the head and neck can make swallowing hard, while cancers in the stomach or intestines can cause belly pain. Blood cancers might make people feel full quickly. Some people with cancer have slow digestion, which makes things worse. Cancer treatments like chemotherapy also can change how food tastes or smells, so eating isn’t as enjoyable. Other problems like pain, tiredness, dry mouth, diarrhea, or constipation can also make it hard for people with cancer to eat enough. [2]

Why is Good Nutrition Even More Important During Cancer?

When someone has cancer, their body is under a lot of stress and has to work harder than usual. Both cancer and treatments like chemotherapy and radiation can make the body much weaker.

Figure 1.

Eating the right foods is really important during this time. Good nutrition gives the body energy to fight cancer and helps with side effects like tiredness and weakness. It keeps muscles strong, stops too much weight loss, supports the immune system to fight infections, and even helps reduce emotional stress. Eating well also helps the body heal faster after surgery or other treatments. Because the body uses more energy to fight the illness, people with cancer often need more protein and calories than healthy people. [1,3]

What Should People With Cancer Eat?

People with cancer need to eat healthy foods to stay strong, feel better during treatment and help their bodies heal. Because cancer treatments can change how food tastes and make you less hungry, it will be helpful to eat small meals more often and drink plenty of fluids. Avoiding too much sugar, red meat, and processed foods is also a good idea. Since everyone’s body is different, people with cancer should talk to a registered dietitian who can help them pick the best foods to feel their best. [4]

Eating During Cancer Care: Challenges and Simple Solutions

Cancer treatments are important for fighting the disease, but they can sometimes cause problems that make eating challenging. Different treatments affect the body differently, and knowing what to expect can help you prepare and find solutions that work for you.

Figure 2.

How Chemotherapy Affects Eating: What to Expect and How to Cope?

Chemotherapy works by attacking fast-growing cancer cells, but it can also affect other normal fast-growing cells in your body, like those in your mouth and digestive system, which leads to several common issues:

Chemotherapy is a treatment that fights cancer by attacking fast-growing cells, but it can also affect healthy cells in your mouth and stomach. This can cause common problems like losing your appetite, food smelling or tasting different, and feeling sick after eating. Some people get mouth sores that make chewing painful, while others notice that food tastes metallic or bland. Digestive issues like diarrhea or constipation can be troublesome during treatment. These changes can make eating tough, but knowing what to expect can help you manage these side effects better. [5]

  • Eat smaller meals more often instead of having three large ones.
  • Try cold or room-temperature foods like yogurt or pudding if hot foods hurt your mouth.
  • Rinse your mouth with warm salt water to help sores heal faster.
  • Avoid spicy, sour, or crunchy foods if they cause pain.
  • Use plastic utensils if metal ones make your food taste weird.

How Radiation Therapy Affects Eating and Easy Ways to Feel Better

Radiation treatment can affect different parts of your body depending on where the radiation was given. If the radiation was given near your head or neck, you might have a dry mouth, trouble swallowing, or a sore throat. Radiation to your chest can make swallowing hard and cause heartburn. If it was aimed at your stomach or pelvic area, you might feel sick to your stomach or have diarrhea.

To help with these problems:

  • Drink plenty of water throughout the day to stay hydrated.
  • Eat soft, moist foods that are easier to swallow—smoothies are a great choice.
  • Add sauces or gravy to your meals to help the food go down more smoothly.
  • Avoid foods that can irritate your throat, such as citrus fruits, spicy dishes, and hard, crunchy snacks. [6]

Eating After Cancer Surgery

Surgery for cancer can sometimes change how you eat, especially if it affects your mouth, throat, or digestive system. You might find it hard to chew or swallow, or feel full faster than before.

After surgery, it helps to:

  • Begin with liquids and very soft foods that are easy to digest
  • Take small bites and chew slowly and carefully.
  • Avoid fizzy drinks that can make you feel bloated. [5,7]

How do Immunotherapy and Hormone Therapy Affect Eating?

New cancer treatments like immunotherapy and hormone therapy can cause different problems with eating. Many people feel very tired, which makes cooking hard. Some might feel sick to their stomach, while others could gain weight.

To manage these issues, try eating smaller meals more often to keep your energy up. Keep healthy, high-protein snacks nearby for when you need a quick boost. Also, try staying active by doing light activities like short walks to help your body feel better. [8]

Common Eating Problems in People with Cancer and Easy Solutions to Try

Knowing about the eating problems that come with cancer treatment and how to handle them can help people with cancer stay well-nourished during their treatment. Below is a closer look at common challenges with eating and easy ways to deal with them.

1. Loss of Appetite and Weight Loss

Many people with cancer have less hunger than usual, which can cause serious weight loss and muscle weakening. This happens because cancer changes how the body uses energy, and treatments like chemotherapy often make you feel less hungry. When the body doesn’t get enough calories and protein, it becomes weaker and has a harder time handling the side effects of treatment.

Figure 3.

To fight this, it helps to eat foods with lots of calories and nutrients in small amounts. Foods like peanut butter, cheese, and whole milk yogurt give your body protein and healthy fats. For many people, drinking smoothies is often easier than eating solid food. Another good idea is to eat your biggest meal when you feel the most hungry, which might be breakfast instead of dinner. Keeping your favorite snacks nearby for when you feel hungry can also help. Some people find that light exercise, like short walks, can make them hungrier. [9]

2. Nausea and Vomiting

Feeling sick to your stomach (nausea) is a very common and upsetting side effect of cancer treatment. Chemotherapy and radiation can irritate your stomach and make your brain want to make you throw up. Because of this, many people find it hard to even think about eating.

Figure 4.

To manage nausea, it helps to choose certain foods. Dry and plain foods like saltine crackers, plain toast, or rice are usually easier to keep down. These foods can calm your stomach by soaking up stomach acid. Eating small amounts more often is better than eating big meals when you feel sick. Some drinks can help, too, like ginger and peppermint tea, which naturally reduce nausea. Lemon water or sucking on lemon candies might also help. Remember to drink fluids slowly throughout the day so you don’t get dehydrated, as that can make nausea worse. Strong food smells can make nausea worse, so it’s good to avoid them. Cold or room-temperature foods usually don’t smell as much as hot foods. Cooking in a place with fresh air or asking someone else to cook for you can make eating easier. [10]

3. Mouth Sores and Dry Mouth

Chemotherapy and radiation can hurt the cells in your mouth, causing painful sores and less saliva (spit). This can make chewing and swallowing really uncomfortable, and some people might even stop eating because of the pain.

Figure 5.

If you have mouth sores, it’s important to pay attention to what you eat. Soft, moist foods like scrambled eggs, mashed potatoes, or yogurt are usually easier to eat. Cold foods like ice cream or pudding can also help soothe your mouth. Cutting food into small pieces or blending it makes chewing easier. Keeping your mouth moist is also important. Drinking water often or sucking on ice chips can help. Sugar-free gum or hard candy might also help your mouth produce more saliva. Special mouth rinses made with baking soda and salt can help heal sores and reduce pain. Some foods can make your mouth feel worse, so avoid acidic foods like citrus fruits and tomatoes, spicy foods, and anything sharp like chips or toast. Mouthwashes with alcohol can also irritate your mouth, so it’s better not to use them. [11]

4. Changes in Taste and Smell

Many people with cancer notice that food tastes and smells very different during treatment. Chemotherapy can change your taste buds, making foods taste metallic, bitter, or just “off.” This can make foods you once loved seem yucky. Here are some ways to make eating easier:

  • If food tastes metallic, use plastic forks and spoons instead of metal ones.
  • Marinate meats in sweet or tangy sauces to hide bad flavors.
  • Cold or room-temperature foods often taste better than hot foods because they don’t smell as strong.
  • Try adding stronger seasonings like garlic, onion, or herbs to make food more flavorful. Tart flavors like lemon or vinegar can also help cover metallic tastes. A little honey or sugar might also make food taste better.
  • If strong smells bother you, eat in a place with fresh air. To reduce bad smells, cover drinks with lids and use straws.
  • Simple foods without cooking, like sandwiches or cereal, can be easier to eat than foods with strong smells. [12]

5. Diarrhea and Constipation

Cancer treatments can upset your digestion, causing either diarrhea or constipation. Chemotherapy can irritate your digestive system and lead to diarrhea, while pain medicines often cause constipation.

If you have diarrhea, eating bland foods like bananas, rice, applesauce, and toast (called the BRAT diet) can help firm your stools. Drinking plenty of fluids like broth, sports drinks, or special rehydration solutions is also very important to replace lost water and salts. Eating small meals often is easier on your stomach than big meals.

If you’re constipated, the first step is to drink more fluids. Warm drinks like herbal tea or prune juice can help get your bowels moving. Slowly adding fiber from foods like oatmeal, cooked veggies, or fruit with skin can help, too, but it’s best to add fiber little by little to avoid gas or bloating. Light exercise, like walking around your house, can also help your digestion work better. [13,14]

How a Dietitian Can Help You Eat Better During Cancer Treatment?

A registered dietitian is a food and health expert who helps people with cancer eat the right way. They create meal plans that match your body’s needs and your treatment. [5] This plan can help you feel stronger and deal with problems like nausea or loss of appetite. Dietitians might also recommend vitamins or special foods and drinks to help you.

When you visit a dietitian, it’s good to be prepared. Write down any foods or drinks that have been hard for you to eat or drink. Also, jot down questions you want to ask so you don’t forget. A family member or friend can help you remember what the dietitian says. You can even ask if recording the meeting is okay, so you can listen later. If your dietitian isn’t working with your cancer doctor, ask your doctor to share your health info with them. This way, everyone can work together to care for you best.

7 Food Safety Tips for People with Cancer

Cancer treatments can weaken your immune system, making it easier to get sick from bad food. That’s why handling food safely is crucial to avoid infections that could slow your treatment or cause serious problems.

Figure 6.

  • Patients and caregivers should always wash their hands well before cooking or eating. [6]
  • Wash all fruits and vegetables thoroughly—even those with skins you peel off.
  • Cook meats, chicken, and eggs thoroughly to kill germs.
  • Avoid risky foods like raw or undercooked meat and eggs, unpasteurized dairy products, and raw sprouts.
  • Only eat deli meats and soft cheeses made from unpasteurized milk if they are heated until steaming hot.
  • When eating out, choose freshly prepared foods and avoid buffets where food sits out for too long.
  • Refrigerate leftovers quickly and heat them thoroughly before eating. [15]

Nutrition Support When Eating is Hard During Cancer Treatment

Sometimes, cancer treatments make eating very difficult. When this happens, doctors may suggest other ways to ensure patients get the nutrition they need. Tube feeding (enteral nutrition) delivers liquid food straight to the stomach or small intestine through a soft, flexible tube. This is used when patients have trouble swallowing but their digestion still works. The tube can be temporary, going through the nose, or more permanent, placed directly into the stomach through the belly.

Sometimes, if the digestive system isn’t working properly, you may need nutrition through veins, called parenteral nutrition. This delivers nutrients directly into the bloodstream. Although it’s not as natural as eating or tube feeding, it helps stay strong when other options aren’t possible. Both tube feeding and Intravenous (IV) nutrition need close medical care but can be very helpful for people with cancer to stay healthy and finish their cancer treatment. [16] These ways of getting nutrition need close care from doctors, nurses, and nutritionists, but they are very important for helping people stay strong and finish their cancer treatment.

Conclusion

Eating during cancer treatment can be tough, and what works one day might not work the next because side effects can change. It’s okay to try different eating methods or change your habits for a while. Don’t get discouraged! Working with a registered dietitian who understands cancer can help. They can make meal plans for you, suggest helpful supplements, and develop creative ideas to make eating easier.

Remember, most of these eating problems are only temporary. As your treatment progresses and your body gets stronger, the side effects will improve, and you can return to eating more normally. The most important thing is to get enough calories and protein, even if you have to eat differently. This helps your body stay strong and fight cancer. [17]

Question to Ask Your Doctor

  1. Should I take vitamins or probiotic supplements while getting treatment? Will they help me?
  2. Is it safe to drink alcohol during cancer treatment?
  3. Are there real health benefits from eating things like turmeric, green tea, or special mushrooms when I have cancer?
  4. Can fasting (like skipping meals for a while) help or hurt me during cancer treatment?
  5. Is it better for someone with cancer to eat vegetarian food or include meat in their diet?

Conflict of Interest

RG is a creative designer at AJPHI. RA and RG have no other conflicts of interest to declare.

Peer-Reviewed By

Vivek Ghosh, MD

Birat Medical College and Teaching Hospital, Biratnagar, Nepal

References

  1. Beirer A. Malnutrition and cancer, diagnosis and treatment. Memo. 2021;14:168–73. Available from: https://www.researchgate.net/publication/350566637_Malnutrition_and_cancer_diagnosis_and_treatment
  2. Teunissen SCCM, Wesker W, Kruitwagen C, de Haes HCJM, Voest EE, de Graeff A. Symptom Prevalence in Patients with Incurable Cancer: A Systematic Review. Journal of Pain and Symptom Management. 2007 Jul;34(1):94–104.Available from: https://pubmed.ncbi.nlm.nih.gov/17509812/
  3. Bulmuş Tüccar T, Acar Tek N. Determining the factors affecting energy metabolism and energy requirement in cancer patients. J Res Med Sci. 2021;26(1):124. Available from: https://pubmed.ncbi.nlm.nih.gov/35126587/
  4. Clinton SK, Giovannucci EL, Hursting SD. The World Cancer Research Fund/American Institute for Cancer Research Third Expert Report on Diet, Nutrition, Physical Activity, and Cancer: Impact and Future Directions. J Nutr. 2020;150(4):663–71. Available from: https://pubmed.ncbi.nlm.nih.gov/31758189/
  5. Hesketh PJ. Chemotherapy-induced nausea and vomiting. N Engl J Med. 2008;358(23):2482–94. Available from: https://pubmed.ncbi.nlm.nih.gov/18525044/
  6. Memorial Sloan Kettering Cancer Center. Diet and nutrition during head and neck cancer treatment [Internet]. New York: Memorial Sloan Kettering Cancer Center; [cited 2025 Apr 17]. Available from: https://www.mskcc.org/cancer-care/patient-education/diet-and-nutrition-during-head-and-neck-cancer-treatment
  7. Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F, et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr. 2017;36(1):11–48. Available from: https://pubmed.ncbi.nlm.nih.gov/27637832/
  8. National Cancer Institute. Nutrition during cancer treatment [Internet]. Bethesda (MD): National Cancer Institute; [updated 2024 Sep 20; cited 2025 Apr 25]. Available from: https://www.cancer.gov/about-cancer/treatment/side-effects/nutrition
  9. National Cancer Institute. Eating hints: Before, during, and after cancer treatment [Internet]. Bethesda (MD): National Cancer Institute; [cited 2025 Apr 25]. Available from: https://www.cancer.gov/publications/patient-education/eatinghints.pdf
  10. American Cancer Society. Managing nausea and vomiting [Internet]. Atlanta (GA): American Cancer Society; [cited 2025 Apr 25]. Available from: https://www.cancer.org/cancer/managing-cancer/side-effects/eating-problems/nausea-and-vomiting/managing.html
  11. Cancer Council Australia. Nutrition and cancer [Internet]. Sydney (AU): Cancer Council Australia; [cited 2025 Apr 25]. Available from: https://www.cancer.org.au/assets/pdf/nutrition-and-cancer-booklet
  12. National Cancer Institute. Eating hints: Before, during, and after cancer treatment [Internet]. Bethesda (MD): National Cancer Institute; [cited 2025 Apr 25]. Available from: https://www.cancer.gov/publications/patient-education/eatinghints.pdf
  13. Cancer Research UK. Diet, fluid, and exercise for constipation [Internet]. London: Cancer Research UK; [cited 2025 Apr 25]. Available from: https://www.cancerresearchuk.org/about-cancer/coping/physically/bowel-problems/types/constipation/diet-fluid-exercise
  14. Cancer Research UK. Tips for coping with diarrhoea [Internet]. London: Cancer Research UK; [cited 2025 Apr 25]. Available from: https://www.cancerresearchuk.org/about-cancer/coping/physically/bowel-problems/types/diarrhoea/tips-coping-diarrhoea
  15. American Cancer Society. Nutrition and a weak immune system [Internet]. Atlanta (GA): American Cancer Society; [cited 2025 Apr 25]. Available from: https://www.cancer.org/cancer/survivorship/coping/nutrition/weak-immune-system.html
  16. Laviano A, Koverech A, Zanetti M. Nutrition support and clinical outcome in advanced cancer patients. Nutrients. 2022;14(11):2180. Available from: https://pubmed.ncbi.nlm.nih.gov/30001763/
  17. Klement RJ. The influence of ketogenic diets on the quality of life in cancer patients: A review. Nutr Cancer. 2024;76(2):217–28. Available from: https://pubmed.ncbi.nlm.nih.gov/33813635/

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