Diet during treatment for breast cancer

What to eat and what to avoid

After surgery

Most people feel ready to eat again the day after surgery, and find their appetite increases as the days progress. Eating well will help the tissues of the body recover and heal. You should balance a healthy diet with foods you enjoy.

Nutritional supplement drinks should only be taken with the advice of your specialist or dietitian.

Chemotherapy

It’s hard to tell how your body will react to chemotherapy – you may find you can eat normally throughout or your eating habits may change because of the side effects of your treatment.

Appetite

Eating little and often can be better than facing a large meal in the early days. You may find you eat more because some of the drugs given during treatment stimulate the appetite. If you are worried about putting on weight you might want to:

• choose low-fat foods and drinks
• eat plenty of fresh fruit and vegetables
• regularly monitor your weight.

Nausea

Anti-sickness drugs can help with nausea and vomiting. Talk to your chemotherapy nurse to find one that works for you.

Drink as much as you can during treatment. Frequent sips are better than large amounts.

Eating little and often is a good way to combat nausea. Herbal teas such as mint and ginger can also help settle the stomach.

Sore mouth

Chemotherapy can make your mouth sore or dry, making it uncomfortable to eat.

You might find the following helpful:

• cleaning your teeth or dentures with a soft brush after eating
• choosing soft, moist foods such as soups, stews and dessert
• soothing your mouth and gums with ice cubes and sugar-free lollies
• drinking sugar-free fizzy drinks to freshen mouth
• using a straw
• avoiding crunchy, salty, very spicy, acidic or hot foods.

Taste changes

Your taste may change during chemotherapy, making foods taste bland or different. Some drugs can give foods a metallic taste.

Herbs and spices or stronger flavoured foods can help with this. Sharp tasting foods may appeal, such as grapefruit or pineapple. Try a variety of foods to find the ones you like the best.

Constipation

Eating and drinking less, reduced activity, and some medications can lead to constipation. Consuming high fibre foods such as the following can help:

• wholemeal bread
• high-fibre breakfast cereal
• beans and lentils
• fresh and dried fruit.

You should drink plenty of fluid and take regular, gentle exercise. If you are still having problems with constipation, ask your GP or specialist for a suitable laxative.

Diarrhoea

Occasionally, some certain chemotherapy drugs can cause diarrhoea. If this is a problem, try the following:

• reduce your fibre intake
• eat small amounts of fruit and vegetables
• drink plenty of fluid.

Your GP or specialist can prescribe medication if needed.

Radiotherapy

Having radiotherapy should not cause any dietary problems but it may help to eat a well balanced diet and drink plenty of fluids. If you have to travel for your treatment take a drink and snack with you and plan easily prepared meals for when you get home.

Shopping and cooking

Shopping and cooking can seem exhausting during your treatment and as you recover. You should consider accepting any offers of help, even if you are used to coping on your own. Take advantage of online shopping if you have access to the internet, or ring round local shops to see if they have a telephone ordering and delivery service.

It is important to have fresh food in your diet, but if you can't shop regularly, frozen and tinned vegetables are full of nutrients and can be eaten daily.

Weight gain

Some people find they put on weight during and after treatment, which can be distressing. This may be due to:

• the side effects of some drugs (increasing appetite)
• the body retaining fluid
• being less active
• overeating when anxious
• the menopause (from your treatment).

It can be helpful to check your ideal weight with your GP or practice nurse, who can also offer dietary advice.

Following treatment, aim for a realistic weight loss of about 0.5-1kg (1-2lb) a week until you reach your ideal weight. To achieve this you will need to reduce your intake of fatty and sugary foods and increase your daily exercise routine.

Weight loss

If your treatment is causing you to lose weight, some simple changes to your diet can help. To maintain or put on weight you need more calories and more protein. The following can help:

• add extra oil, butter, margarine or cheese to savoury dishes 
• make hot drinks with milk rather than water
• avoid low fat or so called ‘healthy option’ foods
• add calorific supplement powders to your food.

Your GP can prescribe dietary supplements in the form of high-protein or high-energy drinks and soups if you need extra help.

Bone health

Bone loss increases as part of the natural ageing process, which can lead to osteoporosis – a loss of bone density and general weakening of the bones.

Some breast cancer treatments such as chemotherapy or hormone therapies can affect bone health. During this time it is important to get enough calcium, which is vital for healthy bones, from your diet.

The recommended daily intake of calcium in your diet is 700 milligrams. Dairy foods such as milk, cheese and yoghurt are rich in calcium. If your diet does not include dairy foods, make sure you are eating other calcium containing foods such as:

• sardines
• tinned salmon
• spinach
• baked beans
• white bread
• muesli
• figs.

Vitamin D helps the body to absorb the calcium. Vitamin D comes from sunlight and from foods such as oily fish, butter and margarine.

Dietary supplements

Unless you are having problems recovering from treatment, supplements such as iron or multi-vitamins are not needed.

As supplements have the potential to do harm as well as good, it is advisable to discuss this with a dietitian or your specialist before taking them.

Alcohol

Drinking large amounts of alcohol can increase the risk of developing breast cancer. However, there is conflicting evidence about whether alcohol is harmful for people who have breast cancer.

Drinking in moderation (one to two units a day) is not thought to be harmful. One unit of alcohol equals:

• half a pint of beer
• one 125ml glass of wine
• 25ml measure of spirits.

Some people find that a sherry or glass of wine before a meal can improve their appetite. If you are concerned about putting on weight, remember that alcohol is high in calories.

Diets for other medical conditions

You may already be following a specific diet because you have an existing medical condition, such as diabetes, Crohn’s disease or irritable bowel syndrome (IBS).

Having breast cancer does not mean your diet has to change, but if you are concerned about how your breast cancer treatment may affect your diet or any existing condition, talk to your breast care nurse or cancer specialist team.

They can liaise with the dietitian or other medical staff to ensure any existing condition remains under control during your treatment.