Lisa: What I learned about nutrition and cancer during chemo and radiotherapy
Lisa, who was supported through cancer treatment by our team in Edinburgh and is also a qualified nutritionist, explains how her eating was affected during chemo and radiotherapy, and shares some top nutrition advice for other young people.
I was diagnosed with non-Hodgkin lymphoma in October 2019, two weeks before my 25th birthday. I had six rounds of chemotherapy which made me quite unwell.
I had to become very reliant on my partner and family during this time which I found difficult; I had been pretty independent since I moved out at 17 for university, and now I was back to needing help with simple everyday tasks like housework and making dinner as I constantly felt tired or sick.
I am also used to cooking from scratch, so I had to adapt my shopping lists to include more convenient foods which I would often avoid in the past.
How chemo and radiotherapy affected my eating
The chemotherapy affected my eating quite a bit. I found it difficult in hospital as I would have to choose my meals for the following day. I knew the staff in the ward were busy, so I never liked to complain about not wanting any of the meals on the menu. I have never been a fussy eater, and I work as a nutritionist dealing with fussy children, so I found it difficult when I became the fussy one with what was put in front of me.
Changes in taste and appetite
My mum often came to stay during my treatment and was always making me soup which helped me eat more vegetables as I completely went off the thought of eating fruit and veg – apart from bananas, I still tried to stomach those as I hated the potassium drinks at the hospital if my levels were low. I preferred to eat soft saucy foods such as macaroni cheese as it was easy to eat.
I also struggled with my taste being affected; I complained to my partner that the hospital food was horrid as they couldn’t even make a sandwich properly as it tasted metallic; it took me a while to realise it was the treatment altering my taste. My food choices completely changed from when I was healthy too, as I have always had a sweet tooth but when I started treatment it was savoury food that I wanted to eat.
Another thing I learned during treatment was that mealtimes were affected, I would eat snacky foods more frequently rather than have 3 proper meals a day, as I could not stomach the quantities of food and my appetite had changed.
I have always been into meal planning for food shops but during treatment I found this difficult. My food choices would constantly change; one day I would really want to eat a certain food and the next day I would not want it.
Being on steroids also altered my eating, I would become more obsessed with food during some periods and always be eating. I found it didn’t alter my portions as such but I would find myself snacking more and my diet would include a wider variety of food.
When I was finished chemo, I had 15 sessions of radiotherapy. This also impacted on my eating due to the location I was having the therapy. It made swallowing exceedingly difficult and which also had an impact on my drinking. I ended up adapting to drinking through a straw, and I had to ensure that when I was planning my meals for the week it included food that was soft and easy to swallow.
Keeping up calories
During my treatment I was surprised that little fuss was made over what I was eating. You were never pushed to have certain foods and nutrients in your diet, the staff would be pleased to see that you were eating.
Professionals always give the advice to follow a healthy balanced diet and plan your meals – during treatment this is not easy, even with my strong interest in diet and nutrition I found it difficult to follow so don’t feel guilty if you don’t always adhere to it.
When I felt at my worst during treatment I would rarely finish meals or manage meals at my usual times, so I would just eat what I wanted, and snacked as much as I wanted during the day – calories are important.
How my diet and outlook have changed since treatment
Since treatment, my diet has become more balanced again which has helped me get back to full strength and my energy levels to increase. I have been cooking from scratch more often as I enjoy trying new recipes and having the energy to stand and cook again.
My experience has influenced my outlook on nutrition, as I have a nutrition degree and have been working with early years nutrition for the last few years, but I do not have much knowledge on the clinical side. This has made me more interested to expand my knowledge in nutrition. I have been keen to share my journey as I found it beneficial and relatable to hear first-hand experiences compared to reading generalised information.
My advice on nutrition and cancer for other young people
- Do not obsess about what you are eating. Do not worry if you are not eating as healthily as you were before your diagnosis. Remember to make changes to your diet – full fat foods are good during treatment
- Do not worry if you may not be taking in 5 portions of fruit and veg, or you are compensating with more unhealthy foods – your body needs calories so make sure you are eating something. If it’s fruit and veg this is a bonus, as the vitamins will help with your immune system and the fibre will help keep your gut healthy and avoid constipation which is often an issue with chemotherapy
- Desserts are a good way to keep your calories up – I often enjoyed custard with mashed banana
- Do not stress if you find it difficult to keep to the advice from professionals regarding your diet, follow it as much as you can. I listened to my body and if I wanted to snack I would, and if I had an appetite for certain food, I would eat it regardless if it was healthy or not
- My food choices constantly changed; one day I would like something, the next day I could not stomach it – allow your meal planning to change depending on what you want to eat
- I often ate soup to help with my vegetable intake – my favourite was lentil soup. Here is a lentil soup recipe for you to try, it is easy to make as little food prep is needed
- I used a soup maker which I found to be a great buy during treatment as you just add all your ingredients and it cooks and blends the soup for you requiring little energy. Here is a link to a soup maker
- I enjoyed foods in a sauce for mealtimes. These included chicken stir-fry which was another good way to get some vegetables into your diet. I found the stir-fry packs from the supermarket to be useful as the chicken was already in a sauce and the vegetables prepared which reduced the time spent making dinner, or here is a chicken chow mein recipe to try
- Batch cooking is great as it means you do not have to cook when you are feeling at your worst. I found recipes like cottage pie to be good during treatment as it was soft and easier to eat
- I used my slow cooker to help with batch cooking as it required less time and energy from me which was useful during treatment. I would buy jars of sauces such as sausage casserole and throw all the ingredients into my slow cooker for a tasty yet simple meal! Here is a link for a slow cooker
- If you do not have the energy, do not push yourself to cook meals from scratch – ready meals or convenient foods like jars of sauces are tasty options too.
If you aren’t doing the cooking, share your eating preferences and these top tips with whoever is nice enough to be cooking for you – talking is a must, as it is important to share how you are feeling with those who are helping you out.
Lisa Kerr, BSc Nutrition