When Amudha Vadivelu from Bengaluru was diagnosed with stage-3 breast cancer in February 2019, she didn’t expect the struggle to hit her platter too. Amudha, an operations manager at an e-commerce company, was advised by her doctors to follow a strict diet during chemotherapy.
Speaking to Happiest Health, the breast cancer survivor recalls the challenges she faced while adhering to a rigorous diet during the course of treatment. “I’m a single mother with three kids, so I don’t often find the time to prepare meals at home. After I began my therapy, my doctor specified that I should eat home-cooked meals. I also had to consume my liquids in tetra packs to prevent infections,” she says.
Food matters: Diet during chemotherapy
Each person will have different nutritional needs during treatment. But to avoid bacteria found in raw food (especially meat), all meals consumed during chemotherapy should be fully cooked, says Pitchiah Kasinathan, a clinical dietitian at Fortis Malar Hospital, Chennai.
“Raw eggs should be avoided during chemotherapy because they can disrupt the medication, affect the immune system and may even cause cardiovascular problems. Hence, fully cooked eggs should be taken,” he explains. “We also advise people to avoid homemade curd as it may have lactic acid bacteria.”
According to Dr C N Patil, HOD and lead consultant, medical oncology and hemato-oncology, Aster RV Bangalore (Aster International Institute of Oncology), people on chemotherapy should avoid eating out. “When undergoing chemotherapy, the white blood cell count reduces drastically, lowering immunity and making people prone to contracting infections. Hence, one must avoid food from outside as they may be undercooked.”
Amudha was also advised to refrain from eating certain foods by her doctor. “I was instructed not to consume homemade curd and to consume pasteurised curd instead,” she shares. “Dal and sambar were allowed as well. For salads, I always had to make sure the vegetables were thoroughly washed to prevent bacteria. Instead of egg yolks, I was asked to have properly cooked egg whites,” she recalls.
What must a chemotherapy diet include?
Chemotherapy is an effective cancer treatment where cancer cells are killed through medicines. However, it comes with many side effects such as muscle loss, fatigue, hair loss, and loss of appetite. Dr Patil explains why this occurs.
“The chemo affects the dividing cells in the intestinal mucosa (inner lining of the intestinal tract). So, the gut is also affected by the chemotherapy. It causes mucositis (sour mouth and gut) and diarrhea,” he says. “Chemotherapy also acts on the salivary glands and the taste buds, hence altering the taste.”
Therefore, doctors recommend that those undergoing chemotherapy must have bland food. “Consuming spicy food will irritate the already damaged mucosa, leading to gastrointestinal issues,” Dr Patil stresses. However, he advises that the food must be rich in nutrients, calories and proteins during cancer treatment.
Kasinathan highlights that people undergoing cancer treatment must consume a balanced diet that can help them gain immunity and withstand chemotherapy. Thus, following a diet specified by the doctor is essential.
The diet should ideally contain proteins, fruits, vegetables, complex carbohydrates and vitamins.
- Proteins: “A protein-rich and high-calorie diet is required for people undergoing chemotherapy so that they can regain their muscle strength,” explains Kasinathan. “Consuming high proteins like pulses, milk, egg, fish, chicken and lean meat is recommended. Lean meat can either be steamed or prepared as a curry, but it cannot be fried.”
- Fruits and vegetables: Fruits and vegetables can be consumed in the form of soups and smoothies. “This is for easy swallowing and digestion, especially people with oesophageal cancer,” says Kasinathan. The diet should incorporate multi-coloured fruits and vegetables as they are rich in phytochemicals that give nourishment. “We suggest papayas, watermelons, berries, grapes, oranges and purple-coloured cabbages, along with carrots, mangoes, pumpkins and sweet potatoes.
- Complex carbohydrates: Choose complex carbohydrates over simple carbs. “Complex carbohydrate foods like multi-grains, nuts, rice, fibre-rich food like ragi and flax seeds help build strength,” says Kasinathan.
- Vitamins: Kasinathan points out that vitamin C has antioxidant properties and so, it is essential to incorporate this into the diet through fruits like lemon, orange, grapes and mosambi.
Dr Patil says that depending on the type of cancer, the diet can vary. “Those who are under intense chemotherapy for liquid cancer/tumor (cancer that can affect bodily fluids and the bone marrow) like leukemia and lymphoma, should avoid the intake of raw food to prevent infection. However, for solid cancers like lung cancer or breast cancer, raw fruits and vegetables can be taken. However, they must be washed and properly scraped.”
Diet post-chemotherapy
A chemotherapy diet usually lasts up to six months. Two months after the treatment, people can gradually get back to their regular diet, says Dr Patil. But he points out that non-vegetarians must exert caution while doing this because red meat cannot be easily digested. “People can have properly cooked lean meat in small proportions.”
In the case of people with underlying conditions, Dr Patil also advises following an individualised diet plan curated to their needs. “If they are diabetic, they must follow a diet curated by their diabetologist, dietician and oncologist.”
Kasinathan stresses the importance of physical activity after cancer treatment. “People must devote some time to physical activity as it can help them build their appetite. It does not necessarily have to be rigorous activities. People can perform whatever exercises they are capable of,” he says.
Takeaways
- Diet during chemotherapy must be rich in proteins, complex carbohydrates, fruits and vegetables.
- People should follow a diet recommended by their doctor.
- During chemotherapy, consuming home-cooked meals is essential.
