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In Association with

Eating Well Through Cancer



by Holly Clegg & Gerald Miletello, M.D.

Not all treatments will cause nausea, vomiting or loss of appetite. The acute side effects, such as nausea, are caused by the destruction of rapidly dividing cells lining the gastrointestinal tract. This is one of the primary causes for the loss of appetite, nausea, vomiting and sore mouth.

I recommend a low fat, light meal prior to your treatment, including foods such as cereal, toast, oatmeal, grits, fruit cocktail, peach or pear nectar. Twenty-four hours following your treatment, I would try liquids, soups, puddings or sandwiches. Try to avoid high fat, fried or greasy foods for the first twenty-four to forty-eight hours following treatment. If you find that only two foods appeal to you, then there is nothing wrong with eating those foods until you feel like expanding your diet. Water is essential. I recommend eight to ten glasses of water per day. Supplements such as Boost are excellent choices if you only feel like drinking.

You may experience a sore or dry mouth as well as a total loss of appetite. This may require a little creativity on your part to keep your nutritional status on the positive side. You may find it impossible to eat three large meals per day. This is the first time in your life that someone is going to recommend to you that you eat snacks daily. Six small meals instead of three large meals will increase your caloric intake. Remember hydration is of utmost importance. Keep a glass of liquid available at all times. (Water with a slice of lemon, apple juice, carrot juice, cranberry juice etc.) Do not forget your mouth care protocol. This really will keep your mouth refreshed and decrease ulcer formation.

Mix one teaspoon of salt with one teaspoon of baking soda in a quart of water. Rinse and spit after each meal or at least four times per day. Mix fresh each morning using tap water.

Remember your mouth will get better. The soreness normally clears within a few days. Food is medicine. You have to eat to get through these treatments and get back to normal. Rinsing with Ulcerease, Viscous Xylocaine, or Cephacol lozenges may soothe your mouth before a meal. Avoid any food that may irritate your mouth. This would include oranges, lemons, tomato sauces, crackers and alcohol. Avoid hot or extremely cold foods since they tend to irritate your mouth.

Foods at room temperature or slightly cool foods are much more soothing. Try cutting your food into small pieces, cook food until tender or even try pureeing foods with a food processor. Drinking with a straw will sometimes help liquids go down easier.


Day of Chemotherapy and Following Treatment Tips

•  Eat smaller portions more frequently. Drink fluids between meals instead of with food.

•  Eat by the clock at regularly scheduled times. Your appetite signal may not be intact.

•  Eat between meals with high-protein diet supplements, milkshakes, puddings, or nutritional energy drink supplement.

•  Add cream or butter to soups, cooked cereals, and vegetables to increase calories. Add gravies and sauces to vegetables, meat, poultry and fish until weight loss is no longer a problem.

•  Add extra protein to your diet by using fortified milk, peanut butter, cheese and chopped hard-boiled eggs.

•  Try things to enhance smell, appearance, and texture of food. Be creative with desserts.

•  Choose foods you like as long as you do not have dietary restrictions.

•  Exercise approximately 30 minutes before meals, to try to stimulate your appetite.

•  Try to make mealtimes pleasant by setting an attractive table and by eating with family or friends.

•  Plan menus in advance. Have some food frozen and ready to heat and serve.

If you experience changes in your taste, hopefully these suggestions will help:

•  Tart candies, peppermint or lemon drops may reduce the sensation of bitter or sour taste. Try choosing sugarless kinds. Try tart foods such as lemonade.

•  If you experience that "metallic" taste in meat, try marinating meat in a reduced sodium soy sauce or fat free Italian dressing to intensify the flavor. If red meat doesn't work, try eating chicken, seafood or beans for protein.

•  Add extra seasoning or salt but a rule of thumb is to add a little at a time to see if you can perk up those taste buds. Use stronger seasonings such as garlic and onions.

•  Add strongly flavored juices or relishes.

•  The taste of cold foods may not affect your taste buds so try more of them.

•  Try eating foods that don't have strong odors.

•  Eat foods at room temperature.

•  Use plastic utensils if you're bothered by a bitter or metallic taste.

•  Here's a great time to try new foods. Maybe foods that you didn't enjoy in the past will be palate pleasing now.

•  Sucking on a thin slice of dill pickle, prior to meals, will sometimes stimulate your taste buds.

Stocking the Pantry

Preparation and organization are the two key words. The goal of a well-stocked pantry should be to have enough food stored to prepare satisfying meals to limit the trips to the grocery store. Be sure to consider, along with the pantry, the refrigerator and freezer.

Begin by including items that you know you like and use most often. Gradually add to your herb and spice inventory. Remember, at this time in your life, your tastes might be slightly different and the pantry may need to include items that appeal to you now. A variety of pasta, rice, and beans and grains may be included, however, if you don't have the exact kind called in for a recipe, just substitute another type you have in the pantry. Canned broths, canned tomatoes, and olive oil are staple items that will be used often.

For the freezer, purchase skinless boneless chicken breasts, pork tenderloins, and ground sirloin. Whenever you are buying meat, always look for the leanest cuts which have round or sirloin in their name. Then trim any visible fat before preparing. Try making individual hamburger patties wrapped in plastic wrap for a quick pull out. They can be used for sandwiches or defrosted for a recipe. Frozen yogurts are great for that ice cream urge and bags of frozen fruit will be useful. When preparing soups, double the recipe and freeze in zip top bags. Get rid of the air bubbles and they stack easily in the freezer. Convenience items such as frozen veggies are a must and can include spinach, broccoli or your favorites.

For the refrigerator, purchase low fat or fat free dairy products. If you need extra calories, there will be other opportunities, as you don't need extra saturated fat. Eggs, margarine, and cheese are also dairy staples.

Tips to Ease At-Home Cooking

•  Wash and dry lettuce and seal in plastic containers or a greens bag for easy use.

•  Wash, cut up and store veggies to have ready for snacks or use in recipes.

•  Raid the salad bar for cut up veggies for recipes or for ready to eat products.

•  Shred cheese and store in zip top bags or buy shredded cheese.

•  When chopping onion or garlic, chop more than needed and store in zip top bags in the freezer for later use.

•  Double recipes to freeze some for a later date or freeze extra.


The simple combination of noodles, eggs, and a white sauce translate into a great breakfast dish that can be made ahead.

1 (8-ounce) package wide noodles

1/4 cup all-purpose flour

cups skim milk

1 teaspoon Worcestershire sauce

Salt and pepper to taste

1/2 teaspoon garlic powder

6 hard-boiled large eggs, whites only, chopped

2/3 cup shredded reduced-fat Cheddar cheese

Preheat oven to 350 degrees. Cook the noodles according to package directions, omitting any salt and oil. Drain; set aside. In a small saucepan, mix together the flour and milk. Cook over a medium heat, stirring until thickened. Add the Worcestershire sauce, salt and pepper, and garlic powder. Arrange half of the egg whites in the bottom of a 2-quart casserole dish coated with nonstick cooking spray. Cover the egg whites with half of the noodles, then add half the cheese, then half the white sauce. Repeat layers. Bake for 30 minutes.

Makes 6 servings

Doc's Notes:

Use this dish for breakfast, lunch, or dinner. Remember, if it appeals to you at the time, it is OK to eat it whenever. The eggs provide a great source of protein, vitamins, and minerals while the cheese adds protein and calcium.


Calories 245

Protein (g) 16

Carbohydrate (g) 36

Fat (g) 4

Cal . From Fat (%) 15

Saturated Fat (g) 2

Dietary Fiber 9g) 1

Cholesterol (mg) 44

Sodium (mg) 194

Diabetic Exchanges: 1 lean meat, 2 starch, 0.5 skim milk


This hearty version of a favorite remedy with barley and pasta quickly became a favorite in my house.

2-1/2 pounds skinless, boneless chicken breasts, cut into 1-inch pieces

1 cup chopped celery

1-1/2 cups chopped onion

2 cups thinly sliced carrots

1 bay leaf

12 cups water

1/2 cup pearl barley

Salt and pepper to taste

1/2 teaspoon dried basil leaves

3 chicken bouillon cubes

1 (16-ounce) package bow-tie pasta

Place the chicken, celery, onion, carrots, bay leaf, and 12 cups water in a large pot. Bring to a boil and add the barley. Reduce the heat, cover and cook until the chicken and barley are done, about 30 minutes. Season with salt and pepper, and add the basil and bouillon cubes. Meanwhile, cook the pasta according to package directions, omitting oil and salt. Drain and set aside. Remove the bay leaf and add the pasta.

Makes 10 to 12 servings

Doc's Notes:

This goes great any time post-treatment. Barley is a whole grain and a high fiber substitute for rice or pasta.


Calories 296

Protein (g) 28

Carbohydrate (g) 39

Fat (g) 2

Cal. from Fat (%) 7

Saturated Fat (g) 1

Dietary Fiber (g) 3

Cholesterol (mg) 55

Sodium (mg) 360

Diabetic Exchanges: 2.5 very lean meat, 2.5 starch, 1 vegetable


When I was testing recipes my family made me promise to repeat this dish often. The simplicity of the dish is very appealing.

2 pounds boneless skinless chicken breasts

1/3-cup all-purpose flour

Salt and pepper to taste

1 cup canned fat-free chicken broth

2 tablespoons olive oil

1 tablespoon cornstarch

Juice of 1/2 lemon

2 tablespoons chopped parsley

Dust the chicken breasts with flour and salt and pepper. In large skillet, sauté the chicken in olive oil until brown and almost done. Mix together the chicken broth and cornstarch; add to the skillet. Stir in the lemon juice. Sprinkle with parsley before serving.

Makes 8 servings

Doc's Notes:

Nutritious yet simple and elegant and low fat. Anyone in the house can prepare this main course.


Calories 180

Protein (g) 27

Carbohydrate (g) 5

Fat (g) 5

Cal. from Fat (%) 25

Saturated Fat (g) 1

Dietary Fiber (g) 0

Cholesterol (mg) 66

Sodium (mg) 152

Diabetic Exchanges: 3 very lean meat, 0.5 starch

Excerpted from Eating Well Through Cancer by Holly Clegg & Gerald Miletello, M.D. Copyright © 2001 by Holly Berkowitz Clegg. All rights reserved. Excerpted by arrangement with Wimmer Cookbooks. $19.95. Available in local bookstores or click here.

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