A bowl of cottage cheese is in focus. Blueberries and raspberries are on top of the cottage cheese.
Cottage cheese is a great source of protein for someone undergoing chemotherapy—and it’s also recommended to help reduce nausea. (For Spectrum Health Beat)

Altered taste buds. Nausea. Constipation. Diarrhea. Weight changes.

If you’re undergoing chemotherapy, you might experience some, or all, of these negative side effects. The good news is dietitians like Randalynn Hajek are here to help.

“We want to try to improve patients’ quality of life and help them get through chemotherapy,” Hajek said. “Nutrition plays a role in that to keep their energy as high as possible.”

Hajek is part of the team of board-certified oncology registered dietitians at Spectrum Health Cancer Center at Lemmen-Holton Cancer Pavilion. They’re available to meet with patients one-on-one to discuss nutrition needs before, during and after cancer treatment.

Recognizing that each patient is different, of course, Hajek offered some general tips for those undergoing chemotherapy.

1. Get enough protein.

Protein helps you maintain lean body mass and muscle during chemotherapy. An excellent source of protein is lean meat, but Hajek has found that meat doesn’t taste good to many chemotherapy patients. Alternatives include eggs, cheese, peanut butter and, if needed, protein supplements. Hajek urges patients not to rely on protein supplements as their main source of nutrition—rather, they should use them sparingly.

2. Eat smaller meals more often.

Hajek finds that chemotherapy patients often tolerate frequent small meals better than larger meals a few times a day.

3. Fight nausea.

In addition to smaller meals, try softer foods that are not hard to chew. Instead of hot food, try cold or room temperature foods, which might taste better. Rinse your mouth with a baking soda-and-salt mixture (1/4 teaspoon of both mixed with water) before eating. This clears and cleans the mouth and might make food taste better, Hajek said. It can also help alleviate thicker saliva or secretions.

Don’t be afraid to ask other people to cook for you while you sit by an open window or on the porch, so that you’re not smelling the food, Hajek said. You can also order takeout so that you’re not filling your house with overwhelming cooking aromas. If you can’t tolerate a meal, try snacking on yogurt, cottage cheese, pudding or ice cream.

Hajek also recommends taking anti-nausea medicine to prevent vomiting. “Sometimes no matter how much you think you’re getting along without it, you need it,” she said. “If you’re vomiting all your food, you are not getting the nutrients you need.”

4. Counteract chemotherapy’s effect on your taste buds.

Chemotherapy (and radiation) can mess with your taste buds, making food taste bland, unpleasant, salty or metallic. Use plastic or wooden utensils rather than metal ones, which accentuate the metal taste.

The same applies to glass or ceramic cookware rather than metal. Stronger-tasting marinades can also help, including sweet-and-sour sauce, barbecue, Italian dressing, lemon juice and soy sauce. If food tastes overly salty, add sugar. If food tastes overly sweet, add salt.

5. Stay regular.

While chemotherapy can cause diarrhea in some, others will deal with constipation. Hajek recommends drinking plenty of water and getting plenty of fiber—20 to 30 grams a day. Smoothies with plenty of veggies and fruit can help with this, while also providing added nutrients. Getting some exercise, or as much activity as your strength allows, will also help keep you regular.

6. Maintain a healthy weight.

One thing Hajek hates to hear from cancer patients: “Well, I have cancer, but at least I am going to lose some weight.”

First of all, Hajek points out that many types of chemotherapy cause patients to gain weight. She also tells patients that losing a lot of weight during cancer treatment is not a good thing.

“Fat loss and muscle loss are different,” Hajek said. “Once chemotherapy is over and they get better and start eating again, if they have less muscle, the same amount of fat is going to come back on. They will be weaker in the long run.

“That’s why we’re here—to make sure they maintain their strength, to get through treatment by maintaining their muscle and lean body mass.”

7. Watch your sugar—but don’t buy the myth that sugar makes your cancer spread.

Some people have a misconception that those with cancer should not eat sugar because it causes cancer to grow faster.

Sugar does not speed or slow the growth of cancer cells, Hajek said. All cells in your body—including cancer cells—depend on blood sugar (glucose) for energy.

“You’re feeding your cancer cells, but you’re also feeding the rest of your cells,” she said. “If you don’t get carbs, which sugar is a form of, your body will make glucose from protein and fat.”

While she does urge healthier sources of carbohydrates, including fruits, vegetables and whole grain pasta, the occasional sugar indulgence isn’t going to hurt.

“If you want ice cream or cake, you should have it,” she said. “Don’t say I can’t have this because it’s feeding my tumor. Do so and let your treatments do their job. We can talk later about reverting back to other things. But I would rather you eat something than nothing.”

8. Don’t wait too long before getting nutrition help.

Often, patients come to Hajek when they have already lost a lot of strength. She urges patients to visit right after diagnosis. This can prevent problems during or after treatment.