Cancer, one of the important health problems of our age, threatens human life biologically, psychologically and economically. Different treatment methods have been developed from past to present in order to reduce or eliminate all these threats. Chemotherapy drugs, one of the treatment methods, distribute throughout the body through the bloodstream and prevent the uncontrolled proliferation of cancer cells. Chemotherapy is administered alone or with additional treatment, depending on the individual’s condition. The main goal is to treat patients as well as reduce symptoms and improve quality of life.
Effects of Chemotherapy on Nutrition
The most important issue that affects and supports the treatment of cancer patients is nutrition. Malnutrition, which refers to insufficient and poor nutrition, slows down the individual’s treatment process and can cause severe consequences. Malnutrition is a very common symptom seen in individuals with cancer and is a consequence of both the presence of the tumor and anti-cancer treatments. For this reason, it is very important to diagnose malnutrition early in cancer patients, to screen it regularly and evaluate it in detail. Despite all this, studies show that only less than 30% of cancer patients apply nutritional assessment or diet. Many individuals with cancer experience unintentional weight loss due to malnutrition, chemotherapy drugs, and tumor cell activity. This condition is called cancer cachexia, and the degree of cachexia varies depending on the location of the tumor, its extent, and the stage of the disease. During diagnosis, unintentional weight loss of more than 10% of the initial weight is observed in approximately 15% of patients. Correct and timely nutritional care is very important during and after active treatment. Therefore, nutrition plays a central role in cancer management, in addition to anti-cancer treatments. Nutritional therapies should not be ignored as they prevent cancer cachexia and shorten hospitalization periods. When nutritional therapy is part of early treatment, it helps to improve the risk of malnutrition and the general condition of cancer patients. Maximizing the recovery phase can only be achieved by preserving muscle mass and function and preventing involuntary weight loss during the cancer treatment process.
Individuals receiving chemotherapy experience many side effects that disrupt daily life. Although these side effects vary depending on the chemotherapy drugs, they generally include loss of appetite, nausea-vomiting, weakness, pain, fatigue, taste changes in the mouth, hair loss and anemia. In addition to all these, anxiety, depression and sexual problems may also occur. Diet and nutrition during chemotherapy, This is challenging in terms of side effects. Therefore, it is very important for patients and healthcare professionals to manage the process in cooperation. With the decrease in saliva secretion in the mouth, changes in taste and smell, difficulty in swallowing, oral wounds (mucositis) and tooth decay are encountered. Changes in taste and smell are seen in 45-80% of cancer patients and are caused by chemotherapy regimens applied especially in smokers and current smokers and in head and neck cancer patients. Taste changes in cancer patients manifest as increased or decreased sensitivity of one or more of the five basic tastes (sweet, sour, salty, bitter, umami). It also includes altered sensory experiences of certain foods and smells. Although chemotherapy-induced taste changes have been reported to occur in the early stages and come and go intermittently during the treatment process, they may also remain constant throughout chemotherapy. These changes affect the individual’s food preferences, causing him to reduce his food intake. Nausea and vomiting are among the most serious and disturbing symptoms and are seen in approximately 38-80% of patients. Risk factors that may play a role in the individual as a result of nausea and vomiting are fluid and electrolyte imbalance, weight loss, dehydration (excessive fluid loss) and malnutrition. Of course, it is possible to control all these side effects that affect the body balance.
Nutrition During Chemotherapy Process
Proper application of nutritional therapy during the chemotherapy process helps the individual prevent involuntary weight loss, reduce nausea and vomiting, and minimize damage to the oral mucosa. In addition, the course of the disease can be changed with appropriate nutritional treatment.
- One of the most important things that cancer patients undergoing chemotherapy should pay attention to is fresh vegetables and fruits. Unwashed raw vegetables and fruits pose a risk. In addition, consumption of vegetables and fruits that are moldy, have damaged skin and are in direct contact with the soil is risky. Thin-skinned fruits (kiwi, apple, peach, etc.) are not recommended; Thick-skinned fruits (banana, orange, tangerine, etc.) should be preferred instead. Consumption of dried fruits, cereals containing dried fruits and frozen soft fruits (raspberries, strawberries, etc.) is not recommended for cancer patients. Compote can be consumed easily. It is important that the vegetables are cooked well.
- Pasteurized milk and its products should be consumed; Unpasteurized milk and its products (street milk), homemade yoghurts, and openly sold ice creams, which are susceptible to bacterial contamination, should not be preferred. Consumption of kefir and similar probiotic/prebiotic containing products should be restricted.
- Care should be taken not to consume moldy, herby and Roquefort-like cheeses and soft and immature cheeses. Hard, cooked, packaged, processed (curd, cottage) cheeses can be consumed.
- Raw or cracked eggs and sauces prepared with raw eggs (cream, mayonnaise, etc.) are extremely risky. Eggs should be cooked well.
- Undercooked meats, sushi, sausages, salami, bologna and shellfish should be avoided as they contain high levels of microorganisms that negatively affect immunity. Meat, chicken and fish should be consumed well cooked; When there is difficulty in consuming meat, turkey or chicken meat should be preferred. Bay leaves and lemon can be used to improve the smell and taste of fish. In addition, it has been reported that thyme, mint, rosemary and basil are more compatible with the tastes of oncological patients.
- Products purchased from outside, such as hamburgers, and foods prepared in the open, such as barbecue, should not be consumed as they are vulnerable to potential risks.
- There should be restrictions on the intake of unheat-treated nuts and delicatessen products, honey, ready-made soups and ready-made biscuits. Unroasted packaged nuts can be consumed.
- Another issue that is often overlooked is tap, stream or natural water consumption. Bottled water should be consumed instead. Since it will be easier for microorganisms that may affect body immunity to enter the body, not every water source offered under the name of “natural” should be preferred.
- Since hot foods and drinks may cause discomfort, room temperature or cold foods and drinks can be preferred. Information should be given about avoiding excessively salty, sweet, spicy and fatty foods. For this reason, attention should be paid to the consumption of excessively salty foods such as pickles, pickled olives, and fried products.
Nutrition After Chemotherapy
It should not be forgotten that in the post-chemotherapy period, body resistance is open to potential risks. The important points applied in nutritional treatment are often valid after chemotherapy. In particular, ways to alleviate discomfort caused by ongoing side effects are sought. For example, since an empty stomach can trigger a feeling of nausea, it is recommended that patients eat small portions and frequently. Drinking liquids between meals rather than during meals also prevents nausea. Liquids are consumed slowly. For this reason, drinks can be consumed with a straw. It is recommended that individuals who are uncomfortable with the metallic taste left in the mouth by metal spoons as a result of taste change, use plastic spoons and forks. Chewing gum and sucking ice chips stimulate the secretion of saliva, moisturizing the inside of the mouth and relieving the pain. Since the aftertaste in the mouth seriously affects food intake, mouth cleaning can be achieved by gargling. In cases where chewing and swallowing are difficult, foods can be cooked until they become soft or consumed in puree form. Soft foods such as omelet and pudding can be preferred.
General Recommendations That Can Be Applied
- Wooden tools such as wooden chopping boards should not be used as they are risky.
- Frozen products should be consumed within 24 hours or bought fresh and cooked.
- Cooked food should be consumed immediately, leftover food should not be reheated and consumed.
- It should not be consumed by adding spices to cooked dishes; if spices are to be added, they should be added during cooking.
- Raw and cooked foods should be stored in separate places.
- Oral hygiene should be paid attention to and smoking and alcohol should be avoided.
As a result, if nutrition, which constitutes an important part of the treatment, is managed correctly, it will contribute greatly to successfully controlling side effects, increasing the effectiveness of anti-tumor treatment and improving the quality of life of individuals. Improving your nutrition will help you achieve better results in cancer treatment.
