Frequently Asked Questions

Sugarless gum, especially those that are citrus flavored, can increase saliva formation. Keep a water bottle nearby and take sips often throughout the day. Mouth sprays and saliva substitutes can also help. Choose foods high in moisture, or add sauces, gravies, or oils. High-calorie shakes and blenderized drinks can also help. Canned nutritional supplement drinks and other high calorie shakes can be useful. Any food can be pureed, mashed, blended, or mixed to be softer and easier to swallow. Drink liquids together with small bites of solid foods. Moist and soft foods such as eggs, custards, yogurt, cottage cheese, fruits, soft-cooked vegetables, and soft meats, are usually easier to swallow.

Loss of appetite and nausea are common symptoms during and after cancer treatment. Your sense of taste can change during treatment. Using more spices and condiments might help to increase food appeal. Try spices and flavorings often, as your tastes may have changed. Sometimes medicines can be very helpful to reduce nausea. There are also medicines that can help to increase appetite. Ask your doctor or nurse if those might be good for you.

Nutrition and physical activity can help reduce fatigue. Patients and survivors have fatigue for a number of different reasons. Some fatigue may occur because they do not eat enough or do not exercise enough. Starting slowly with an exercise program, even if only for a few minutes each day, can help to restore energy. You can then increase how often and how long you exercise. Some fatigue is due to specific medical problems like anemia, which also can be treated. Talk to your doctor about the reason for your fatigue.

Anemia can occur during cancer treatment and sometimes after treatment as well. It can result from blood loss, chemotherapy, and/or radiation therapy, or from the cancer itself. A balanced diet can help support the body's repair system that will produce new blood cells, but diet alone may not correct the anemia caused by cancer treatment. Iron supplements should be taken only after talking with your doctor. Extra iron is useful if the anemia is caused by too little iron, but there are other causes of anemia. Iron is not helpful for other conditions, and it can cause digestive system side effects, such as constipation and nausea. Good food sources of iron include meats, leafy greens, and fortified grain products. Consuming sources of vitamin C (such as oranges, strawberries, and peppers) with fortified grain products will help you better absorb the iron in those foods. There are several causes of anemia in cancer survivors, and some of these are best treated with medicines or blood transfusions. Talk to your doctor about the cause of your anemia.

Weight loss often occurs in the early stages of cancer treatment and recovery, but this is not a good time to lose weight. To keep from losing too much weight, focus on eating more and using less energy. Try between-meal snacks of foods and beverages that are good sources of calories, fat, and protein. While physical activity may be useful in helping to reduce stress and increase strength, high levels of activity make weight gain more difficult.

In the short term, during some cancer treatment, weight gain can't be avoided. After treatment, a program of regular physical activity and healthy food choices can usually stop the pattern of weight gain and lead to slow and controlled weight loss. Maintaining a healthy body weight should be a long-term goal to help reduce the risk of new or recurrent cancers, heart disease, and diabetes.

After the treatment phase, survivors who are overweight can benefit from modest, slow weight loss of up to 2 pounds per week. There are real benefits from stopping weight gain and beginning weight loss, even if that process is slow. If you are overweight, it is likely that any amount of weight loss will be helpful, even if you do not reach your ideal weight. The best way to lose weight is through a healthy, well-balanced diet and moderate physical activity.

A woman's bones often lose some of their calcium and become weaker (osteoporosis) after menopause, whether it is a natural menopause or one that has been caused by cancer treatment. Estrogens can increase bone strength, but they are not recommended for women who are at high risk for breast cancer, and their safety in women who have had estrogen-responsive breast or endometrial cancers is uncertain. Soy-based foods and supplements and other sources of phytoestrogens have been suggested as a substitute for estrogen, but it is also unknown whether these products are safe for women who are at risk for or survivors of breast or endometrial cancer. A man's bones may become less dense as he ages. Thinning of bones is also a side effect of hormonal treatment for prostate cancer. Increasing calcium and vitamin D (from foods and supplements), prescription medicines (such as bisphosphonates), and exercise can be effective for women and men with osteoporosis. Bone density can be easily measured to determine the need for treatment.

Estrogens can reduce menopausal symptoms, but estrogen therapy may not be a good choice for women who have had estrogen-responsive breast cancer or endometrial cancer, are at high risk for breast cancer, or have had complications that can be worsened by estrogens, such as blood clots. If hormone replacement therapy is a consideration, most doctors now recommend that it should be used only for a short time to relieve symptoms. They discourage most women from long-term hormone replacement. Other methods of controlling menopausal symptoms include regular exercise, healthy eating, avoiding caffeine, reducing alcohol use, stress reduction, and non-hormone prescription medicines. Many dietary supplements taken to manage symptoms of menopause contain estrogens, so you should talk to your doctor before using them.

Lymphedema is swelling in the arm or leg following cancer surgery or radiation. It is caused by a blockage of flow of the lymph fluid. Although a high protein, low sodium diet has been suggested by some, there is no evidence that this approach helps. Exercise, specifically range-of-motion exercises, may be helpful. Ask your doctor or nurse about specific physical or massage therapy programs designed to treat lymphedema.

Moderate exercise reduces fatigue, promotes a sense of well-being, and can speed recovery from cancer. It is not known whether exercise will reduce the chances of cancer recurrence or will slow cancer growth. The benefits of regular exercise for weight control and cardiovascular health also make regular, moderate physical activity a good choice for cancer patients and survivors.

There may be special precautions you should consider, depending on your treatment or side effects of treatment. For example, if you have severe anemia, you should delay exercise until the anemia has improved. If you are having radiation treatment, you should avoid swimming pools, because chlorine in pool water can be irritating to irradiated skin. If your immune system has been affected by your cancer treatment, you should avoid public gyms (and other public places) until your white blood cell counts return to normal. You should always consult your doctor or nurse before beginning an exercise program.

The right exercise program is one that starts slowly and gradually increases in time and intensity, as you are able. Your muscles will tell you when you need to slow down and rest. Strength, flexibility and aerobic fitness are all important features of an effective exercise program.

The best source of vitamins and minerals is foods. During and just after cancer treatment, you may not eat everything your body needs, so a vitamin and mineral supplement may be needed. The best choice is a balanced multivitamin/mineral supplement containing as much as 100% of the 'Daily Value' of most nutrients (formerly known as the 'RDA'). Some people believe that if a little bit of a nutrient is good for you, then a lot must be better. This is not true. In fact, high doses of some nutrients can be harmful. Doctors may prescribe a vitamin and/or mineral supplement for people with certain health problems such as osteoporosis, anemia, or during pregnancy. Be sure to discuss vitamin and mineral supplement use with your doctor.

No. More than 100 healthful compounds are found in fruits and vegetables. The small amount of dried powder contained in the pills that are sold provide only a small fraction of the substances found in whole foods. Many of the benefits of vegetables and fruits are from the combined effect of several of the nutrients they contain and therefore cannot be duplicated in supplements. And, some of the helpful small nutrients (called micronutrients) in plant-based foods are not available as supplements because they have yet to be discovered.

It is not a good idea to take large doses – or 'mega-doses' – of any vitamin or mineral, including the antioxidant nutrients, at any time. High doses of antioxidants may interfere with cancer treatments such as chemotherapy and radiation therapy. So be sure to discuss your use of supplements with your doctor. Fruits and vegetables are the best source for antioxidants.

Supplements containing 5 mg or less of beta-carotene are not likely to be harmful because this is similar to the levels found in foods. Higher dose supplements should not be taken because higher doses may actually increase risk for certain cancers such as lung cancer, especially if you smoke.

Although soy foods such as tofu are a good source of protein, taking large amounts of soy protein, as found in most soy pills or powders, could have effects on cancer risk that are not yet certain. Women with breast and endometrial cancer should not take high doses of soy without first talking with their doctor. They should limit whole food sources of soy - such as soybeans, tofu, and soy milk - to no more than 3 servings per day.

Use only reliable sources of information, such as well-known and respected national organizations, prominent cancer treatment centers, or national government agencies. Beware of testimonials or information that comes only from those who are selling a product. Be sure to tell your doctor or nurse about any methods you wish to use, including vitamins, supplements, herbals, etc. so they may advise you about any benefit or interference with your cancer treatment. It is also best to remember that if it sounds too good to be true, it likely is not true.

Start with the American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention to find a diet that is right for you. These guidelines form the basis for a healthy diet. They emphasize:

• vegetables and fruits
• legumes and whole grains
• low fat or nonfat dairy products
• limited amounts of red meat (lean meats are preferred over processed meats and those high in fat.

If you have special dietary needs, as with diabetes, you will want to discuss your needs with a registered dietitian or your doctor

Everyone should eat at least five servings of vegetables and fruits each day. During cancer treatment it may be difficult to eat five servings per day, but with balanced meals, nutritious snacks, and juices, it is quite possible. Serving sizes are quite small, smaller than you might think: 1 medium piece of fruit 1/2 cup chopped, cooked or canned fruit 1/4 cup of dried fruit 6 oz 100% fruit or vegetable juice 1 cup raw leafy vegetables 1/2 cup cooked or raw vegetables.

Yes. In fact, frozen foods are often more nutritious than fresh foods because they were usually picked ripe and quickly frozen. Canning can reduce some of the nutrients, but the nutritional value of canned fruits and vegetables is often the same as those that are fresh.

Juicing is not necessary, but juicing can add variety to the diet, and can be a good way to get your fruits and vegetables if you have trouble chewing or swallowing. Juicing also improves the absorption of some of the nutrients in fruits and vegetables in your body. If you buy juiced products, make sure that they have been pasteurized.

There is no evidence that the low levels of pesticide residues in fruits and vegetables affect cancer growth. Pesticides can be toxic, but only in very high doses. To reduce exposure to pesticides, thoroughly wash fruits and vegetables.

Wash all foods thoroughly. Do not allow meats and dairy products to stay at room temperature. Cook all meats, poultry and seafood well. Do not drink un-pasteurized beverages.

Unless your doctor suggests otherwise, you should try to drink at least 8 cups of liquid each day. This can include water, juice, or other liquids, such as broth, gelatin, etc. Many symptoms of fatigue, light-headedness, and nausea can be due to too little liquid in your body (called dehydration).

No more than 2 drinks per day for men, and 1 drink per day for women can help prevent heart disease. But these same levels increase the risk of cancer of the mouth, throat, larynx, esophagus, liver and breast. Although there is little information on alcohol and cancer recurrence, most experts recommend that survivors of these cancers avoid frequent use of alcohol.

Limiting caffeine will not affect your cancer, but it can help control many heart problems and help you sleep better.

Yes. Fiber from whole grains and from high fiber cereals can improve bowel function and help to decrease the risk of heart disease. But so far, studies have not shown that fiber supplements reduce cancer risk. Fruits and vegetables are good choices, both for their fiber content and because they contain many other nutrients that reduce the risk of some chronic diseases, including some cancers. Beans are also high in protein and are good meat substitutes.

It appears that the type of fat eaten, rather than the total amount eaten, may have more impact on chronic diseases like cancer and heart disease. During cancer treatment, adding moderate amounts of fat-containing foods can help to improve calorie intake. This is important if you were already underweight before you started treatment, or if you have side effects from treatment that make eating difficult.

After treatment, you should eat a diet low in saturated fats (found in red meats and dairy products) and trans fatty acids (found in cookies and cakes). Instead, foods that contain monounsaturated and omega-3 fatty acids (such as fish, olive oil, walnuts and other nuts, seeds, and beans) are recommended as healthier sources of fats.

Refined grains and foods high in sugar (cakes, cookies, candies, etc.) can cause fatigue due to changes in blood sugar levels. It is wise to limit intake of refined sugars in favor of more nutritious foods. The main sources of carbohydrates in the diet should be whole grains, legumes, vegetables and fruits. When choosing grain products, look for those that list 'whole grain' as the first ingredient on the label's ingredient list.

You don't need to stop eating meat after cancer, but eating less red meat (and less of other sources of saturated fats) can reduce your risk of heart disease, and may also reduce the risk for colon and prostate cancers. A vegetarian diet can be quite healthy if it is carefully planned. Diets including lean meats in small to moderate amounts can be healthy as well. If you choose a vegetarian diet, check with your doctor or a registered dietitian about whether you should take a multivitamin/mineral supplement.