The effects of cancer therapy can be draining on the body and spirit.  Side effects like diminished taste sensation and upset stomach affect one’s ability to enjoy food and stay nourished.  Dietary changes throw off physical and emotional balance.  With proper thought and safe experimentation, nutritional continuity can be enhanced.

Caregivers looking for additional help with nutrition can ask the primary care doctor or oncologist to refer them to a registered dietician.  Cancer specialists have excellent resources and may be able to locate a dietician who specializes in nutrition for cancer patients. 

Nutritional techniques that work for one individual experiencing a given type of cancer may be less effective for someone whose cancer is in the same location, but has spread to other areas.  The reverse may be true also, as everyone has different food likes and dislikes.  A willingness and tolerance to adapting diet changes over the course of therapy lies with both loved one and caregiver.  Reducing the stress factor of meal preparation and selection is a primary goal, along with providing fulfilling options.

ANATOMY IS A BIG FACTOR
Head and neck surgeries, bowel resections and any removal of organs will affect the body’s ability to process foods.  The stress the body undergoes during surgery (and before, when it is out of balance) requires healing time and nutritional support.  In the case of part of the bowel being removed, there is less area and thus less time for the intestinal tract to process the food taken in.  This is true for the stomach and any surgery involving the digestive tract.  Proper chewing of food, slow and methodical, until the food has been “ground down” is a way of getting around the problem.

But chewing and swallowing can be affected by cancer therapy, too.   Smoothies are often recommended to help load up on calories (keeping weight and energy stable).  Minimal “work” is involved to consume a smoothie, and a variety of types can be created, with or without protein powders. 

When snacking outside of the house, ask about smoothies (or their variations, in juice and coffee bars) that can have protein added to them.  Sugar contents may be higher from one establishment to another, but adding protein will offset the high carbohydrates, as will choosing an appropriate size.  Nutritional statements are usually available, and one need only ask for one or check online for each company’s “facts on snacks.”

Smoothies provide hydration, especially when mixed with ice (as they usually are).  They also have the ingredients processed sufficiently that they may digest better. 
Individuals with head and neck challenges can find chewing a difficult task.  Digestion does start in the mouth, where enzymes are released to start absorbing nutrients.  Reducing the workload reduces the potential to shy away from food, because it’s just too hard to deal with.

NUTRITIONAL SUPPLEMENTS ARE AN OPTION
Different formulas of nutritional supplement drinks can be ordered by the physician to round out the body’s need for a “complete” meal.  These drinks supply the expected vitamins (B vitamins and C for example), cholesterol and fats (needed by the nervous system) and even “prebiotics.”  Prebiotics are carbohydrates that cannot be digested, but encourage the body to produce bacteria to balance the digestive tract.  Nutritional supplements can be taken alone or with a meal.  While they may taste similar to a milkshake, sugar content is more controlled than a fast food shake.

Smoothies and supplement drinks may feel “heavy” on the stomach and patients may choose to alternate them with juice.  It’s important to read labels whether you are buying from a “health food store” or grocery.  Prepackaged drinks may be labeled “organic,” but may still contain sugar or artificial sweeteners, or a mixture of juices that dominate the advertised juice.

Sugar is always a factor, but many juices (such as cranberry, blueberry and pomegranate) come in “100% pure” offerings.  They contain no added juices or sweetener.  They are excellent options, especially when dealing with kidney and bladder infections, related to cancer therapy or not.  These juices come in concentrates, providing fruity nutrients that can be taken by the conservative spoonful, or mixed with water to flush bacteria that sticks to the lining of the bladder.  The “pure” juices can be more costly than those with apple or grape juice added, but in the long run they may be versatile in ways the mixtures can’t be.
Ready to drink juices come in a wide variety, and both standard grocery and health food stores have good selections.  Select two or three types and offer a “tasting event” instead of a full meal, pairing small amounts of juice with snack sized portions of a meal. 

VITAMINS AS “HELPING HANDS”
Vitamin supplements may be beneficial, but discuss usage with the dietician.  Liquid vitamin supplements may be easier to swallow and stay down, with less opportunity for reflux.  Pills in general have a tendency to “back up” the esophagus, often when taken with small amounts of fluid.  Liquid vitamins may not have an ideal flavor, but manufacturers have made improvements over the years. 
Liquid vitamins can be added to juices that have their own intense flavor.  Pomegranate, acai berry and cranberry are bold flavors that mix well with other juices and might mask vitamin odors.

Enzymes help the body to digest food and pull nutrients from the meal.  They lighten the work that the digestive tract has to do, and some people find they get more out of a meal when these are taken.  Papaya tablets have been popular for years, and for those who do not want to eat the fruit itself, they’re a quick supplemental fix. 

Other types of digestive enzymes are sold in stores, and while many do the same work, read the labels to narrow down choices.  Find one that does the trick and stick with it.  A rule of thumb to determine how well it’s working is how good one feels.  There can be more energy from the same meal taken with enzymes than when no enzymes are taken.  Time between meals may last longer because the feeling of satisfaction lasts. 

FOODS AND HEALING PORTIONS
If portion size is an issue, “size down” the serving plate to a less intimidating one.  It may be easier on your loved one to be given a teacup with soup instead of a bowl, and a quarter or half sandwich on the teacup’s saucer, instead of the traditional serving of bowl and plate.  Remind your loved one that “seconds are always available,” or incorporate psychology that benefits you both.  “I made extra in case we get hungry later” is one way of leaving the option open for a later meal, with no guilt on anyone’s part for making and putting away the additional food.

Soup can provide both nutrients and hydration, and is a good choice if your loved one is having trouble with small meals.  There are many selections in boxed and canned varieties.  Allow your loved one to have a variety in case they lose interest in one type. 

Bathroom cups are about three ounces and can be filled with soups that taste good cold.  Served in this fashion, they can be prepped in advance, allowing your loved one to serve themselves, retaining independence.  Covered serving ware can fill the need also, but be sure your loved one can open them by themselves.  If conserving strength is the priority, opt for the bathroom cups covered in plastic wrap.

If your loved one is spending time in bed after cancer therapy, consider investing in a portable fridge to keep drinks and snacks in, to allow them easy access and give you a break from preparation and serving. 

KEEP IT SIMPLE, KEEP YOUR SANITY
Cancer diagnosis is devastating to everyone involved.  The healthcare system has its imperfections, but with proper navigation, help can be found.  Nutritional consultants, adjunct therapy like prescribed supplements and counseling are only a few options that caregivers can access to make sure their loved one is receiving what they need. 

Make changes as needed, and allow yourself to adapt to your loved one’s nutritional needs and food requests.  You don’t need to empty the pantry and start over.  Add a few selections, keeping what works and letting the rest go.  Your natural creativity as a caregiver will give you strength and ideas to help your loved one as you both proceed through cancer treatment.

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