Ten expert tips to prepare for your cancer treatment


Top ten tips from our expert oncology dietitian.

Learn how to improve your nutritional fitness and get your body ready for cancer treatment


Taking positive action to get fitter and prepare the body for any medical treatment is called Prehabilitation. Eating well and exercising safely, depending on your individual abilities, are key parts of this process and can really help your body cope with stressful treatment such as chemotherapy, surgery or radiotherapy.


Consider how athletes prepare for a sporting event to perform at their best when it matters most, on competition day. They train hard but also pay particular attention to their nutrition, mental focus and emotional wellbeing. In the same way, improving your diet, physical activity and emotional resilience can really increase your tolerance of the upcoming treatment and help you through what can be a very tough time.



We know from studies that people engaging with a structured prehab programme that includes nutritional optimisation before surgery leave the hospital sooner and recover faster. Those undergoing chemotherapy and radiotherapy tolerate the treatment better and have fewer treatment breaks (interruptions in treatment forced by intolerable side effects). Malnutrition can often go undetected and really have a negative impact on recovery from the stresses of any treatment. The right amounts of nutrients such as protein, vitamins and minerals are needed to repair tissues regain function and get strong again.


Everybody is different, and whilst there is no substitute for in-depth consultations with a suitably qualified nutritional professional there are some general principles that apply, and I really hope you find them helpful.


1. Eat regular meals – an optimal pattern is breakfast, lunch, dinner and a bedtime nourishing drink or snack (include snacks if you have long breaks between meals)


2. At each meal, including a generous portion of protein alongside your whole-grain carbohydrates. An example for a great breakfast would be porridge oats made with milk and some high protein yoghurt and fruit on top, for lunch perhaps a tuna jacket potato with salad, and for dinner, a roast chicken dinner would be perfect with lots of vegetables like carrots, peas and cabbage.



3. Choose a variety of different vegetables to have with your meals (different colours and types are best, use raw/cooked/tinned as they all have different qualities). Ideally vegetables should cover half of your plate! Variety is key to getting all the right level of vitamins and minerals your body needs to repair and recover and build up for times when you may not feel like eating during treatment.


4. Only take a nutritional supplement if advised by your healthcare professional. For most people, vitamin D is the only extra supplement needed, at around 10mcg per day. If you are vegan you will need specialist advice on how to optimise your vitamins and minerals for treatment. Taking supplements during treatments like chemotherapy is not always a good idea, so please discuss with your treatment team before considering taking any supplements.


5. Ensure you have a good intake of iron by eating, for example, green leafy vegetables, nuts and oily fish. For more tips on iron see this link Iron (bda.uk.com). Iron is essential to rebuild blood cells, which are often lowered by chemotherapy and blood loss (for example in bowel cancers).


6. Improving your muscle strength by exercising pre-cancer treatment is a good idea, but do ensure you have a bedtime nourishing drink or snack. Your bedtime snack should include both carbohydrates and protein - good examples are a glass of milk (cows or a dairy alternative) blended with a banana (for extra energy and protein, if you need to gain weight add a dessert spoon of nut butter) or if you don’t want a drink try cheese or nut butter and seeded crackers.



7. Include fruit and nuts as snacks throughout the day (aim for 2 portions of fruit per day) but be careful with grapefruit because it can interfere with many medications. Please discuss with your doctor or pharmacist if eating grapefruit would be a problem. .

8. Hydration is essential to prepare for cancer treatment especially if you are exercising too. On average, women should aim for 1500ml (8 glasses per day) and men 2000ml (10 glasses per day) of non-caffeine and non-fizzy drinks.


9. Aim to reduce your alcohol intake, it can dehydrate you and it can affect your ability to utilise your B vitamins needed for energy and optimal body function.


10. If you have any eating problems – for example, swallow problems, un-planned weight loss, a low appetite, bowel problems like diarrhoea or constipation you should make sure you speak to a suitably qualified registered dietitian to support you.


Note – if you have any swallow problems or are at risk of bowel blockage then nuts, seeds and certain other foods may need to be avoided - please make sure you seek advice from your health care professional or ask to see a dietitian make sure you are eating the best and safest diet for you and your upcoming treatment.


Prehabilitation is the counterpart of rehabilitation (getting in shape BEFORE as well as AFTER!).


These tips are nutrition-focused, but to maximise your benefit from prehabilitation you also should optimise your activity, wellbeing and overall lifestyle. The impact of stress and anxiety on how you cope should not be underestimated. If you need individualised advice please seek suitably trained support.


Georgina is an HCPC registered dietitian with over 20 years of experience working in the NHS and freelance. She is an advanced specialist in cancer, gastroenterology and rehabilitation. She uses a client centre approach to optimise health and wellbeing. Georgina has completed Masters training competency to support clients with late effects from cancer treatment. Book Georgina's expertise and receive trusted expert advice on cancer prevention or recovery.




References

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Arrieta O, Ortega RMM, Vilanueva-Rodriguez G et al. Association of nutritional status and serum albumin levels with development of toxicity in patients with advance non-small cell lung cancer treated with paclitaxel-cisplatin chemotherapy: a prospective study. BMC Cancer 2010;10:50

Bennett A and White J. Improving care and quality of life for patients with lung cancer. Nursing Standard. 2013;28 (9): 50-58.

Mitsuru Tashiro, Suguru Yamada, Tsutomu Fujii, Norifumi Hattori, Hideki Takami, Masaya Suenaga, Yukiko Niwa, Masamichi Hayashi, Naoki Iwata, Mitsuro Kanda, Chie Tanaka, Daisuke Kobayashi, Goro Nakayama, Hiroyuki Sugimoto, Masahiko Koike, Michitaka Fujiwara, and Yasuhiro Kodera. (2018) Clinical implication of nutrition for neoadjuvant therapy and impact of nutritional support in pancreatic cancer. Journal of Clinical Oncology. 36:4_suppl, 416–416.

Van Cutsem E, Arends J. The causes and consequences of cancer-associated malnutrition. European Journal of Oncology Nursing 2005;9:S51-S63. Suppl 2:S51-63

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