“You have to think of the food as medicine.”
When you think of treatment for blood cancer, your doctors and care team, and the medications you’re taking may come to mind. Treating blood cancer, however, involves more than just what happens in the hospital. Maintaining a healthy lifestyle and caring for your physical and mental health are important aspects of a good blood cancer treatment regimen—and that includes making nutrition a priority.
“Getting the proper nutrition through treatment with blood cancers is crucial,” says Ruthee-Lu Bayer, MD, the director of stem cell transplantation at Monter Cancer Center, Northwell Health. “I often tell my patients that you have to think of the food as medicine.”
The Importance of Proper Nutrition During Blood Cancer Treatment
Good nutrition can help you feel better and stay stronger during and after cancer treatment. Getting enough nutrients also helps the body replace blood cells and tissues broken down by treatment.
“Proper nutrition can help patients manage side effects, improve healing, and prevent complications down the line,” says Dr. Bayer.
During blood cancer treatment, patients may experience side effects that affect their appetite and nutrition, such as:
- Mouth ulcers
- Nausea and vomiting
- Or fatigue.
“Even if they may not experience any other side effects, appetite is always the first to be affected or compromised,” says Antonella Apicella, MS, RD, CDN, a registered dietician at Northwell Health.
When the appetite is suppressed, this can cause patients to lose weight, which may increase the risk of additional side effects, compromise nutrition, and decrease the tolerance to treatment, says Apicella.
What’s more, during cancer treatment patients’ bodies are in a hypermetabolic state. Their body is burning more calories than they would normally, which means they require more calories to sustain their weight, says Dr. Bayer.
“The goal would be to prevent weight loss during treatment,” says Apicella.
Eating Well During Blood Cancer Treatment
Most nutritionists agree that eating a wide variety of foods is the best way to make sure you’re getting all the nutrients your body needs. Here’s an ideal diet for all Americans, including cancer patients and survivors:
- Focus on fruits and vegetables.
- Make half of your grains come from whole grains (e.g. whole-wheat bread).
- Choose fat-free, low-fat, or soy dairy products.
- Choose low-fat proteins such as poultry, seafood, or beans.
- Use healthy oils like olive oil, and limit saturated fats and trans fats.
- Limit added sugars to less than 10 percent of daily calories.
- Limit sodium to less than 2,300 milligrams daily.
- And hydrate with water, tea, and coffee, and limit sweetened soda.
“If a patient feels that they’re not wanting to eat, we do work with the patient closely to see what would be a realistic goal,” says Apicella. If eating is difficult during cancer treatment, try these tips to get the calories and nutrients you need:
- Eat small, frequent meals or snacks.
- Keep prepared snacks on hand. Try these healthy portable munchies.
- Use healthy fats like olive oil, avocado, and nut butters to add calories.
- Sip water often. If water is unpleasant, try drinking other clear liquids such as broth, ginger ale, or lemonade to prevent dehydration.
- To make chewing easier, choose soft foods. You can also cut foods into bite-sized pieces or grind or blend them.
- Your taste may change, so it’s important to try a variety of new foods and recipes to find what you may like.
Food Safety During Blood Cancer Treatment
“Food safety is very important during cancer treatment,” says Apicella. “Patients’ blood counts can fluctuate throughout, and we want to make sure that there’s no risk of infection; more specifically foodborne illness.”
Food safety guidelines for cancer patients undergoing treatment include:
- Avoiding raw or undercooked foods.
- Avoiding unpasteurized beverages, such as fruit juice, milk, and raw milk yogurt.
- Avoiding food that’s been left out or touched by others, such as foods from salad bars, buffets, or party platters.
- Making sure all fruits and vegetables are washed properly.
- Stick to tap or bottled water.
Some patients, like those who have neutropenia—a condition where you have lower-than-normal levels of neutrophils (a type of white cell)—or have had a stem cell transplant may have stricter food safety rules than other patients. These patients may need to follow special guidelines that help protect them from bacteria and other harmful organisms found in some food and drinks.
If you’re having trouble eating or are unsure what foods are safe for you, ask your doctor to refer you to a dietitian or a nutritionist for specific advice and guidance.
Antonella Apicella is a registered dietitian at the Lenox Hill Hospital Outpatient Nutrition Program.
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Getting the proper nutrition
through treatment for
00:00:08,102 --> 00:00:11,040
blood cancers is crucial.
00:00:11,040 --> 00:00:15,084
I often tell my patients that you have
to think of the food as medicine.
00:00:15,084 --> 00:00:21,301
00:00:21,301 --> 00:00:26,253
Unfortunately, some of the main
side effects are nausea and
00:00:26,253 --> 00:00:31,270
that can affect patients' nutrition.
00:00:31,270 --> 00:00:34,980
Side effects related to the treatment
may affect someone's eating by
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decreasing the appetite.
00:00:36,250 --> 00:00:40,910
Ultimately, that's the first side
effect that a patient might experience.
00:00:40,910 --> 00:00:43,500
Even if they might not experience
any other side effects,
00:00:43,500 --> 00:00:47,410
the appetite is always the first
to be affected and/or compromised.
00:00:47,410 --> 00:00:51,060
The goal would be to prevent
weight loss during treatment.
00:00:51,060 --> 00:00:53,240
We know that when there's
weight loss during treatment,
00:00:53,240 --> 00:00:55,680
it can increase the risk
of the side effects, but
00:00:55,680 --> 00:01:00,230
also compromise the nutrition and
decrease tolerance to the treatment.
00:01:00,230 --> 00:01:04,600
Patients with supressed immune
systems should really incorporate
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a general healthy diet, which does
incorporate fruits and vegetables,
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whole wheat, whole grains,
lean proteins, and healthy fats.
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We try to stress calories,
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I try to tell patients that
their body is actually
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hypermetabolic through these
types of therapies, and
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they are actually requiring more
calories than they would normally.
00:01:30,140 --> 00:01:33,820
If the patient feels that
they're not wanting to eat, we do
00:01:33,820 --> 00:01:38,780
work with the patient closely to see what
would be a realistic goal for the patient.
00:01:38,780 --> 00:01:42,870
So even though the patient might not be
able to tolerate a large quantity of food
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at one time, we do encourage the smaller,
frequent meals for our patients.
00:01:47,840 --> 00:01:51,530
Food safety is very important during
cancer treatment because we know that
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the patient's blood counts can fluctuate
throughout, and we wanna make sure that
00:01:55,350 --> 00:01:59,990
there's no risk of infection,
more specifically food-borne illness.
00:01:59,990 --> 00:02:04,640
The food that I was allowed
to have was it had to be
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cooked, I can't have sushi,
I couldn't have raw stuff.
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Anything that people, or
restaurants, or whatever,
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have that they don't clean right away,
I can't have.
00:02:22,540 --> 00:02:26,350
Some food safety guidelines include
making sure that all meat is cooked
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throughout, nothing undercooked or raw,
just for the risk of contamination.
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We also wanna make sure that our
patients are washing their fruits and
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vegetables very well.
00:02:35,870 --> 00:02:37,040
Any dairy products,
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we do ask that the patients use
pasteurized dairy products only.
00:02:40,890 --> 00:02:46,810
Proper nutrition can help our
patients manage side effects,
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improve healing, and
prevent complications down the line.
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AML treatment side effects. Rye Brook, NY: Leukemia & Lymphoma Society. (Accessed on February 15, 2021 at http://www.lls.org/leukemia/acute-myeloid-leukemia/treatment/side-effects.)
Nutrition for a Person with Cancer During Treatment. Atlanta, GA. American Cancer Society. (Accessed on February 15, 2021 at https://www.cancer.org/treatment/survivorship-during-and-after-treatment/staying-active/nutrition/nutrition-during-treatment.html)
Benefits of Good Nutrition During Cancer Treatment. Atlanta, GA. American Cancer Society. (Accessed on February 15, 2021 at https://www.cancer.org/treatment/survivorship-during-and-after-treatment/staying-active/nutrition/nutrition-during-treatment/benefits.html)