The best way to stop feeling sick during chemo

Chemotherapy, radiation, targeted therapy, and immunotherapy can all affect the healthy cells in your body, making you feel sick during chemo and radiation.

Usually, the mouth, stomach, and intestines are first to get hit, causing you to feel sick with:

mouth sores
taste changes
loss of appetite
nausea
vomiting
diarrhea
fatigue
body aches
constipation

Whether you have all, some, or none of these side effects, there are ways to stop feeling sick during chemo or radiation.

We will dive into the nuances of:

What helps with bad taste from chemo
How to get rid of mouth sores from chemo
What can help nausea from chemo
How do you stop chemo vomiting
How to get rid of diarrhea from chemo
How to stimulate bowels to relieve constipation

That being said,

1) Always talk to your oncology-certified dietician before applying any nutritional advice, as this is general and not specific to your needs.

2) Never take any supplements without talking to an oncology-certified dietician or your physician.

3) There is no such thing as eating a cancer diet or fatigue-reducing diet. Rather, research shows, that certain eating patterns have been shown to be helpful.

STARTING AT THE MOUTH— Taste Changes and Mouth Sores,

Cancer, chemo, and radiation can all cause TASTE CHANGES leaving you with a bitter/metallic, sweet or salty taste in your mouth.

How it affects you may be different, as each person’s sense of taste differs.

Usually, it goes away after treatment ends,

but it may also linger after treatment.

When something as “small” as taste changes and is not treated properly, it can cause severe:

weight loss
weakness
fatigue
nutrient loss
Especially when accompanied with MOUTH SORES.

How to Stop Feeling Sick During Chemo and Radiation — The “secret” is:

Enhancing flavor where possible
Eating cool or frozen palatable foods

A) IMPROVING YOUR PALATABILITY.

The best way to help with bad taste from chemo is to improve your palatability.

Whether you have a metallic taste, or are sensitive to strong flavors, the key is to counter.

For example, if food tastes too salty, add some sweeteners to improve the flavor, and if it’s too sweet, add something salty or bitter to counter the taste.

Also, be careful with canned and/or high-protein food in particular, such as steak and chicken, which can have an iron-like taste.

If food tastes like iron, marinate them with different herbs and spices, such as:

Onion
Garlic
Basil
Oregano
Ginger
Rosemary
Lemon
Mint
Chili Powder
Curry

Different marinades are also a great addition to change the flavor and keep the meat more tender, such as:

Citrus fruits
Vinegars
BBQ, Teriyaki, A1 Sauce, etc.
Italian dressing
Pickled flavors
Mustard
Ketchup

All these can bring a tasty touch when protein-rich foods become less appealing.

If that doesn’t help, try a variety of protein-rich sources that contain umami.

Umami-rich foods in particular are savory foods that can improve your taste such a:

Mushrooms
Eggs
Cheese
Salmon
Steak
Anchovies
Cooked and Sun-dried Tomatoes
Potatoes
Sweet Corn
Carrots
Asparagus
Sautéed Onion or Garlic
Vinegar
So Sauce
Hot Sauce

You can also change meats for other high-protein, plant-based protein foods:

Beans
Peas
Tofu
Nuts
Seeds

When it comes to any chemo-related side effects with the mouth, the general principles of eating cool or frozen food bland foods at small amounts always apply.

You want to choose foods that are soft, tender, can be mashed, blended, and eaten at cool or frozen temperatures.

The temperature of your food can either cause irritation if it’s hot and make it taste worse if it’s warm.

Therefore, use cool, frozen or room temperature to soothe your mouth and improve its taste.

Particularly when it comes to fruits and veggies, frozen or cool is going to be your best option for getting in some healthy, naturally sweet snacks. For example, you can freeze:

Melon Balls
Grapes
Yogurt
Strawberries
Pineapples
Mangos
Milk
Sorbets and Popsicles
Protein Shakes and smoothies.

All these are great options for bringing flavor back to life and help with bad taste from chemo,

MOUTH SORES are another common side effect of chemotherapy and can appear 1 to 2 weeks after treatment starts.

They can also come and go if treatment is given in cycles, which can become a pesky situation.

Some treatments are more likely to cause mouth sores than others, and healing may take 2 to 4 weeks when treatment completely ends.

However, if not properly managed, it can be painful and lead to:

Dehydration
Poor Nutrition
Muscle Loss.

B) WHAT TO EAT/AVOID.

Focus on easy-to-chew, soft, moist, textured foods in tender, small pieces.

Eat foods at room temperature and avoid acid-based, spicy, hot, hardy, crispy/crunchy foods (such as pretzels or potato chips).

It’s always best to mash, blend or purée foods to make them easier to eat and more digestible.

It is common to have food aversion during this period; therefore, avoid eating your favorite foods when they don’t taste or feel the same.

Stick to the list above, and avoid the following if you have mouth sore:

Raw Vegetables
Carbonated Drinks
Alcohol
Tobacco.
Chips or Pretzels
Tomato, Orange, Grapefruit Juices
Lime or Lemon (and their juices)

These tips will help with mouth sores from chemo.

Severe muscle and weight loss can be an issue when mouth sores, food aversion, and taste changes all appear.

Therefore, it’s important to focus on high-calorie and high-protein foods if you are having difficulty maintaining your weight, BUT remember, this too shall pass.

TIPS & TRICKS

Rinse out your mouth before and after eating, and suck on a hard candy, such as peppermint or lemon to reduce a bad taste in your mouth.
Use plastic silverware and glass cups
Drink out of a straw to limit strong tastes and odors.
Use a soft toothbrush, alcohol free mouth wash, and/or mouth swabs to clean your teeth and prevent mouth sores from chemo
When it comes to mouth sores, the same principles as managing taste changes apply, but some medication may be needed, and what you eat/how you eat it matter most. Your doctor, can prescribe special mouthwashes or sprays to reduce pain when you eat.

UNCOMFORTABLE TUMMY— Nausea and Vomiting

There are different types of nausea and to more specifically target your type of nausea checkout:

What Helps Nausea During Chemo and Radiation Blog.

It’s important to get ahead of it early by meeting with a certified oncology dietician and your oncologist to treat your side effects as soon as they start.

Do not wait until it is severe. If they aren’t treated properly, they can bring:

Anxiety
Dehydration
Weight Loss
Fatigue
Potential Delay of Treatment, which, in turn, can reduce survival

If you have side effects like vomiting and diarrhea, this can cause you to lose vitamins and nutrients, making your condition worse.

YOUR DOCTOR CAN HELP and prescribe medicine to prevent nausea and vomiting, as there are medications that can be given before and after each dose of chemotherapy that can usually prevent nausea and vomiting.

Tell your doctor if you have persistent vomiting and cannot keep liquids down. It is important to prevent dehydration if you are vomiting.

WHAT YOU EAT, WHEN, AND HOW ALL MATTERS when your stomach doesn't agree with you.

Even something as simple as hot food can aggravate your stomach.

The key is to limit strong odors that can trigger your nausea or vomiting and avoid eating for an hour or two before treatment.

Just like with mouth sores, avoid:

Eating large meals
Overly Fatty, Greasy, Fried, Sweet, or Spicy foods
Carbonated Drinks

Instead, eat small amounts of bland food often and slowly at room temperature or cooler.

Try eating foods that will be gentle on your stomach while giving you the nutrition you need such as:

Toast or Crackers
Frozen or Regular Yogurt
Sherbet, Gelatin, Pudding
Canned fruits—peaches, pears, etc.
Skinned Chicken (baked, boiled)
Oatmeal
Cool Broth
Real Cranberry Juice or Flat Soda
Ginger
Peppermint

TIPS & TRICKS

When possible, recognize times, foods, smells or events that trigger your nausea, and try to change your schedule or diet to avoid them and adjust accordingly. For example, if nausea in the morning is a problem, keep crackers and soda at your bedside to nibble on before getting up.
Sip cooled or chilled beverages between meals instead of with a meal.
Don’t eat or drink until your vomiting has subsided. Once vomiting is under control, try drinking small amounts of clear liquids.

BONUS: Rest and movement

Eat sitting up, and rest sitting up or reclined with your head raised for about an hour after eating.
Walk briskly daily, 10-20 mins a day to help reduce nausea. Research shows that patients who reach 90-150 mins of a brisk walk a week experience less nausea from chemo and stop vomiting during chemo.

OUT THE OTHER END— Diarrhea and Constipation

Chemotherapy, surgery, targeted therapy, immunotherapy and radiation to the stomach can all irritate the your digestive system and cause DIARRHEA.

Depending on the type of treatment being given, diarrhea can start within hours, days, or weeks after receiving treatment and can last several weeks or months after treatment ends.

Diarrhea, if not managed properly, can lead to dehydration, nutrient loss, and weakness, Thus, proper management is crucial.

WHAT TO EAT, DRINK AND AVOID.

Due to increased risk of nutrient loss, it’s important to avoid high fiber foods and replace them with potassium-rich foods.

In addition, to decrease dehydration it’s important to eat salty food and drink plenty of fluids to stay hydrated.

Drinking plenty of liquids each day at room temperature will also help your stomach settle.

Focus on the following carbs, fats, and proteins to maintain your health and reduce diarrhea":

Rice, Noodles, or Potatoes
Crackers
Well-cooked Eggs
Fish
Skinned Turkey or Chicken
Popsicles or Gelatin
Bananas
Apricots
Applesauce
Yogurt
Puréed Vegetables
Mashed Potatoes,
Broths and Soups,
Low-fat Cottage Cheese

What you drink is also important. Eat high-sodium (salty) foods and pair them with your drinks to retain fluids.

Sports drinks or Water
Kefir
Diluted Juices (e.g. apple juice)
Diluted Peach or Apricot Nectar
Decaffeinated Coffee/Tea.

On the other hand, avoiding products that aggravate your stomach is important.

High-fat, fried, or greasy foods linger in your stomach and can make matters worse.

Stay away from spicy, sugar alcohol, acidic foods and citrus juices or carbonated soft drinks and avoid high-fiber foods, such as dried/raw fruits or vegetables, which might make diarrhea worse.

Milk or Milk Products
Pastries, Candies, or Rich Desserts,
Jams and Jellies,
Alcohol
Tobacco.
Nuts, Seeds, and Whole Grains,
Beans
Peas
Onions
Broccoli
Corn
Cabbage
Cauliflower

Sugar-free Gum

TIPS & TRICKS

As diarrhea improves, try eating small amounts of easy-to-digest foods. If diarrhea keeps getting better after a day or 2, start small, regular meals.
Drink at least 1 cup of liquid such as water, sports drinks, or bouillon after each loose bowel movement

CONSTIPATION, on the other hand, may not always be directly linked to the treatment.

Instead, it can be caused due to nutritional changes occurring during treatment.

Lack of exercise, activity, changes in nutritional intake, and poor hydration during treatment make constipation worse.

Most of the time, this can be healed rather quickly with proper nutritional intake of fiber and fluids, which allows for enough fluid and movement in your digestive system and stimulate your bowels to relieve constipation.

YOUR DOCTOR CAN HELP. Sometimes, over-the-counter medications such as stool softeners or laxatives can help.

You may even be prescribed fiber supplements if necessary.

However, more medication is not always the answer, as it can lead to more side effects.

Always ask your cancer team before using stool softeners or laxatives and over-the-counter anti-gas products. Always check with your doctor before self-medicating, even with over-the-counter medications.

Lastly, DO NOT use enemas or suppositories, and ask your cancer care team if eating more high-fiber foods every day is right for you, such as:

Whole-grains
Cereals
Fresh Raw Fruits with skins
Fresh Raw Vegetables
Fruit Juices

WHAT TO EAT, DRINK AND AVOID. Drink more liquids, aiming for at least eight 8-ounce glasses a day. Liquids can help keep stools soft.

Eating a large breakfast, including a hot drink, pasteurized fruit juices, and high-fiber foods in the morning will prepare you for your day.

Walking and other forms of exercise will also be helpful in improving bowel movement, as well as maintaining health gut bacteria. Good choices food and drinks to add:

Prune Juice
Hot Lemonade
Decaffeinated Teas
Whole-Wheat Toast
Dates, Apricots, Raisins
Prunes and Prune Juice
Nuts

Lastly, you should avoid foods and drinks that cause gas, or cause constipation, such as:

Cheese
Eggs
Milk
Apples
Avocados
Beans
Peas
Onions
Cabbage
Broccoli
Corn

Cauliflower
Cucumbers
Carbonated drinks

TIPS & TRICKS

Try to eat at the same times each day. If possible, try to move your bowels at the same time every day.

Get as much exercise as possible.
Keep track of bowel movements so that problems can be noticed quickly, and go to the bathroom as soon there is an urge.
Avoid chewing gum
Use a straw to drink

Every time you provide yourself with the right nutrients, vitamins, minerals, and phytochemicals, you alleviate side effects and reinforce your healthy cells.

Dietary changes are an important facet of your cancer treatment and can help you manage many side effects.

Mouth sores, taste changes, loss of appetite, nausea, vomiting, diarrhea, and constipation, lets you know which area of your body is being affected and needs to be protected or reinforced.

Whether it’s appetite loss, constipation, diarrhea, loss of taste, or nausea that you’re experiencing, what you eat matters.

Cancer treatment can lead to fluctuations in appetite and body weight, so it’s important to pay close attention to your diet—how you eat, what you eat, and when you eat matters.

Proper nutrition during treatment can have profound effects on your health and treat many side effects, improve energy, preserve immune function, and reduce inflammation.

Regardless of the side effects you feel, the best general rules of thumb to get the most out of your nutrition and limit side effects is to:

1) Avoid foods that irritate your stomach and increase risk of food-borne illnesses:

Alcohol/Smoking
Lightly cooked or raw fish, such as sushi
Soft-cooked Eggs or foods containing Raw Eggs
Mayonnaise
Unpasteurized cheeses
Milk
Unwashed Fruits or Vegetables,
Cruciferous Vegetables
Processed Food
Fried, Fatty, Greasy, Hot, Spicy Food

2) Focus on the basics of nutrition and hydration:

Drink through a straw, and frequently between meals
Drink plenty of liquids without a meal and—aim for at least eight 8-ounce glasses each day
Drink water, diluted juice, broth, decaffeinated coffee/ tea.
Try blended drinks—milkshakes, smoothies, Orgain, Ensure, or Kate Farms.
Drink/eat either cool, frozen, or room temperature foods
Keep liquids caffeine-free
Eat a bland diet at small amounts throughout the day
Focus on adding strong sweet, citricy, or acid marinades and spices.

3) Finally, rest and move your body.

Rinse your mouth several times a day with water or a baking soda mixture.
Avoid commercial mouthwashes with alcohol
Rest with your head elevated
Walk for 5-10 mins after each meal, aim to get 20 mins a day of brisk walk to help with digestion.

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