BREAST CANCER TREATMENT
 
Nutrition for Breast Cancer Patients
   
   
Maintaining a well-balanced diet during breast cancer treatment can help patients better cope with side effects, regain strength, and rebuild tissues damaged by cancer.  However, some patients may find it difficult to eat well during treatment due to certain side effects (such as nausea or diarrhea) or the emotional burden a diagnosis of breast cancer can bring.  This section discusses the importance of maintaining a healthy diet during breast cancer treatment and offers suggestions on how to cope with side effects of treatment that may affect a patient’s eating habits(1).
Common side effects of breast cancer treatment that may affect eating include:

    * Loss of Appetite
    * Nausea
    * Vomiting
    * Dry Mouth
    * Diarrhea
    * Constipation
    * Weight Gain or Loss

Eat Well During Breast Cancer Treatment
The National Cancer Institute and the American Cancer Society recommend maintaining a varied diet during cancer treatment.  A varied diet includes daily servings of fruits and vegetables, proteins, grains, and dairy products.  Each person’s diet should be to modified to fit her personal needs.  For instance, if a certain breast cancer treatment causes diarrhea, a patient may want to temporarily reduce her intake of high-fiber foods (such as vegetables, fruits, cereals, and whole grains).  Breast cancer patients should talk to their physicians, nurses, or registered dietitians about maintaining proper nutrition during treatment.  Certain foods, vitamins, or minerals may interfere with cancer treatment. 
 
A varied diet provides several nutritional benefits:

    * Fruits: Good sources of vitamin C.  Fruits are usually low in calories and fat.
    * Vegetables: Excellent sources of fiber and vitamins (A and C).  Deep-yellow or dark-green vegetables are rich in vitamin A.
    * Proteins: May provide protein, iron, zinc, and B vitamins.   Meats, beans, nuts, and seeds provide these benefits.  Some seeds, like almonds, are good sources of vitamin E.
    * Dairy products: Milk and cheese provide calcium, protein, and vitamin B12.
    * Grains:  Breads, pasta, rice, and cereals provide carbohydrates and B vitamins.  Carbohydrates are an important source of energy. 

The following are suggestions for maintaining a well-balanced diet while experiencing side effects of breast cancer treatment.  Patients may want to try a variety of different suggestions or talk to a registered dietitian for more tips that may help during treatment.
 
Loss of Appetite
Loss of appetite can occur from a variety of breast cancer treatments, including chemotherapy,   radiation therapy, and several drug therapies including Aromasin. Loss of appetite may also result from other side effects such as nausea or vomiting or from the emotional burden of breast cancer.
 
Suggestions for coping:

    * Eat several small meals instead of three regular meals.
    * Stock up on a variety of foods.
    * Try different settings when eating – the dining room, kitchen, with background music, watching television – anything that makes eating more appealing

Nausea
Nausea can be a side effect of surgery, chemotherapy, radiation, drug therapies, or other aspects of breast cancer.  Nearly 50% of patients experienced nausea and vomiting during their first treatment with the drug, Herceptin.
 
Suggestions for coping:

    * Ask a physician about medications called antiemetics that help control nausea
    * Eating toast, crackers, yogurt, oatmeal, skinned chicken (not fried), and ice chips may help ease nausea.
    * Eat foods slowly and in small amounts.
    * Drink plenty of fluids but avoid drinks during meals because they may cause a bloated feeling.
    * Avoid eating right before treatment if treatment causes nausea.
    * Try cool foods.  Warm foods may worsen nausea.
    * Keep track of what foods can increase nausea, and try to avoid those if possible.

Vomiting
 
Vomiting often follows nausea.  Often, if a patient can control nausea, she can prevent vomiting.   Vomiting is a common side effect of chemotherapy, and drug treatment with Herceptin or Arimidex (generic name, anastrozole). 
 
Suggestions for coping:

    * Ask a physician about medications called antiemetics that help control nausea and vomiting.
    * Do not eat or drink until vomiting is under control.
    * Talk to a physician about trying a full-liquid diet until the vomiting has subsided and regular food can be kept down.   

Dry Mouth
 
Dry mouth is a side effect that can be associated with several breast cancer drugs or other treatments.  When a patient has dry mouth, foods may be more difficult to chew or swallow. 
 
Suggestions for coping:

    * Take small sips of water every few minutes to help moisten the mouth.
    * Eat sweet foods or drinks such as lemonade to help the mouth produce more saliva.
    * Eat moist foods with sauces or gravies to make swallowing easier.
    * Talk to a physician about other options to treat dry mouth.

Diarrhea
 
Chemotherapy, drug therapies, or other breast cancer treatments as well as coping with the stress of breast cancer may cause diarrhea.  Patients with severe diarrhea (lasting more than a few days) should contact their physician immediately.  Patients with diarrhea can lose valuable vitamins and nutrients and become dehydrated.   Diarrhea is a common side effect of several breast cancer drugs, including Herceptin, Arimidex, and Ellence.
 
Suggestions for coping:

    * Drink plenty of liquids and drink beverages at room temperature.
    * Eat several small meals rather than three large ones.
    * Try low-fiber foods such as rice, noodles, yogurt, bananas, lean beef, skinned turkey or chicken, etc.
    * Avoid fried foods, raw and high-fiber vegetables, and fruits. 

Constipation
 
Some drugs used to treat breast cancer (such as Herceptin) may cause constipation.  Constipation may also occur if there is a lack of bulk or fluids in the diet. 
 
Suggestions for coping:

    * Drink plenty of liquids.
    * Eat high-fiber foods (such as cereals or pastas), fresh fruits and vegetables, and whole grain products.
    * Exercise if the physician recommends it.
    * Talk to a physician about medications to ease constipation. 

Weight Gain or Weight Loss
 
 Some cancer patients find that they gain or lose weight during treatment from certain drug therapies or from stress. Patients should talk to their physicians if they experience any significant weight fluctuation during treatment.  Weight gain during cancer treatment could be due to water retention or other effects of treatment rather than an increased caloric intake.  An attempt to lose weight during treatment could cause increased health problems in some patients.  Diuretics can usually be prescribed to reduce excess water in the body.
 
Weight loss is a possible side effect of tamoxifen. The drug Aromasin has been shown to increase or decrease appetite in some patients.  Weight gain or loss may also occur from the stress of breast cancer treatment.
 
Additional Resources and References

    * (1) Many of the suggestions for coping with side effects of cancer treatment in this article are recommended by the National Cancer Institute (NCI).  The NCI provides a wealth of information on all aspects of breast cancer, from screening and diagnosis to treatment and survival.  Visit http://www.cancer.gov/ for more information eating hints for cancer patients.   NCI also provides free brochures through its Cancer Information Service.  For more information, call 1.800.4.CANCER.
    * The American Cancer Society provides information on nutrition during cancer treatment at http://www.cancer.org/
    * To learn more about breast cancer treatment with chemotherapy or radiation therapy, please visit http://www.imaginis.com/breasthealth/chemo.asp and http://www.imaginis.com/breasthealth/radio_bctreatment.asp respectively.
    * To learn more about breast cancer treatment with drugs (such as tamoxifen, Herceptin, or others) please visit http://www.imaginis.com/breasthealth/bc_drugs.asp