The Experts Weigh In: What to Eat When You Have Cancer

There’s no one-size-fits-all diet strategy for battling cancer, mainly because cancers behave differently and because people respond uniquely to cancer and cancer treatments. Some folks have trouble eating enough; others put on too much weight. Sometimes cancer takes people on a roller coaster ride of changing tastes where they absolutely crave cheesecake one day and can’t stand the sight of it the next. To help you deal with the ins and outs, we turned to a handful of top experts in the field of diet and cancer for advice. Need more info? Check out the links each expert recommends.

Chef Rebecca Katz routinely lectures and leads culinary workshops at top medical institutions including Johns Hopkins. Top on her agenda is always a list of nutrient-dense, cancer-fighting foods like berries, avocados, and almonds. But Katz’s real magic is a cooking system she calls FASS. (The acronym stands for fat, acid, salt, and sweet.) Making sure there’s some level of FASS in a dish helps any cook punch up the flavor to entice those with a lackluster appetite. Look for details in her book, The Cancer-Fighting Kitchen (Celestial Arts, 2009) or on her website.

These five recipes offer that perfect FASS balance (fat, acid, salt, and sweet) to stimulate the appetite and please the taste buds.

• Shrimp, Avocado, and Grapefruit Salad
• Melon Gazpacho with Frizzled Prosciutto
• Steak Sandwiches with Pickled Onion and Herb Aioli
• Spicy Thai Coconut Chicken Soup 
• Greek Yogurt with Warm Black and Blueberry Sauce

 

After 30 years in the field, Birmingham, Alabama, oncologist Luis F. Pineda, MD, says he still gets frustrated when patients don’t enjoy eating. “At the end of the day, I wanted to know what I could do to help people with cancer eat better,” says Pineda. “I was interested in the biochemical changes that happen with taste and smell.” So Pineda attended culinary school every Friday, Saturday, and Sunday for a few years. The end result: a cookbook called Prescription to Taste: A Cooking Guide for Cancer Patients. Full of chili-laced entrées and desserts (to spark appetite and squelch nausea), it can be downloaded for free at www.cookingwithcancer.org.

Pineda finds spicy foods help to combat nausea and pique the appetite so stick with these recipes featuring jalapeños or cayenne pepper.

• Poblano Jalapeño Chili
• Cilantro-Jalapeño Limeade
• Cranberry-Jalapeño Granita
• Spicy Jalapeño Corn Bread  
• Blackened Cumin-Cayenne Tilapia 

At the Block Integrative Center for Cancer Care, experts use a combination of conventional and complementary therapies that look at the mind and body as a whole. Top on the list is a plant-based diet. “There are thousands of disease-fighting chemicals in plant foods,” says Jacki Glew, MS, RD, Lead Clinical Nutrition Manager, “so we’re encouraging people to get as much fruit, vegetables, legumes, and whole grains into their diets as possible.” Also key: “Stop eating junk!” Too much white sugar, white bread, and white rice can elevate blood sugar and give cancer cells fuel to grow.

Glew suggests eating “foods from the ground” like fruits, vegetables, legumes, and whole grains because of the antioxidants they contain.

• Golden Beet Salad with Wheat Berries and Pumpkinseed Vinaigrette
• Three Bean Vegetarian Chili
• Roasted Winter Vegetables
• Cumin-Scented Carrots
• Greens with Garlic and Lemon

Just starting cancer treatments? Be ready for symptoms and tastes to change from day to day or even hour by hour, says Michele Szafranski, MS, RD, a board certified specialist in oncology nutrition with the American Cancer Society. “I tell people to stock up on single-serving foods with lots of flavor and variety.” Try small cartons of yogurt for when you crave tart and creamy or trail mix for sweet and salty flavors with a crunchy texture. “If you’ve got a day when cheesecake is the only thing you feel like eating, then have cheesecake,” she says. ACS’s cookbook What to Eat During Cancer Treatment offers recipes that treat various symptoms.

Because your tastes can change each day from different cancer treatments, Szafranski suggests stocking up on foods that vary in flavor and texture.

• Cranberry Swirl Cheesecake
• Honey-Roasted Nuts and Fruit
• Cinnamon Crisps with Blackberries and Yogurt
• Sweet-Spicy Glazed Salmon
• Prosciutto, Peach, and Sweet Lettuce Salad

“For people who are struggling to avoid weight loss, sometimes getting enough calories, protein, and other nutrients can only be accomplished with very concentrated sources of calories,” says Karen Collins, MS, RD, Nutrition Advisor to the American Institute for Cancer Research (AICR.) Good choices include dried fruits, fruit smoothies, and healthy fats such as avocados and nuts. Gaining weight? Limit calorie-dense, nutrient-poor foods. Large weight gain, more common with breast and prostate cancer, lead to poorer outcomes, says Collins. Need more details? Check out AICR’s Cancer Resource.

The side effects of cancer treatments have been known to cause weight gain in some and weight loss in others. The first three recipes are nutrient dense while the others pack in fewer calories but the same great taste.

• Cilantro-Lime Chicken with Avocado Salsa
• Blueberry Power Smoothie
• Toasted Almond and Pecorino Snap Peas
• Avocado-Mango Salsa with Roasted Corn Chips (low cal)
• Sunshine Smoothie (low cal)

Organic garlic farmer Diana Dyer, MS, RD, crams “36 hours of work into every 24-hour day” on her family’s Ann Arbor, Michigan farm. But 17 years ago this registered dietitian was battling breast cancer and sifting through scientific journals for ways to make her diet healthier. Her book, A Dietitian’s Cancer Story (Swan Press, 2010) and website, give detailed advice about what, and how much, to eat if you’re battling cancer. From whole soy foods to cruciferous vegetables (broccoli, cabbage) to winter squash, Dyer says the first step: “Set aside time to cook, and think of it as healing time, not drudgery.”

Dyer suggests a low-fat, plant-based diet that includes small amounts of animal products for both variety and nutrition.

• Szechuan-Style Tofu with Peanuts
• Lemon-Parmesan Broccoli
• Quinoa-Stuffed Squash
• Kimchi-Style Cabbage
• Pumpkin Hummus

“So much of our culture revolves around showing love through food,” says Mayo Clinic dietitian Katherine Zeratsky, RD. “But try to imagine what it would be like to not have an appetite or to have a sore mouth.” She urges family members to be respectful of a loved one’s symptoms and gradually work with them to find foods they can tolerate. Here’s a long list of tips to help you do just that. Foods taste blah? Try punching them up with bold-flavored ingredients like barbecue or teriyaki sauce. Meat not appealing? Search out other protein-rich foods like lentils, peanut butter, or yogurt.

Side effects from treatment may make foods lack flavor or taste too sweet, salty, or metallic. These recipes have sauces, marinades and seasonings to perk up the flavor and help meet protein, vitamin, and mineral needs.

• Barbecue Salmon 
• Pan-Fried Udon Noodles with Teriyaki Sauce
• Arctic Char with Cilantro-Yogurt Sauce  
• Peanut Butter, Banana, and Flax Smoothies
• Sloppy Lentils in Pita