It can be challenging to know what to eat during chemotherapy, and sometimes one simply doesn’t feel like eating.

Chemotherapy can make foods taste kinda funny. Some drugs can leave a metallic taste in the mouth. Some medications cause cold-sensitivity and very cold foods should be avoided. Sometimes, nausea is at the root of the problem, or even constipation. In that case, there doesn’t feel like there is any room for food to go. Sometimes mouth sores are the problem, and those need to be resolved before one is able to eat better. Some chemotherapy regimens involve steroids, so those patients may actually feel hungrier than usual. In addition, psychological concerns like depression or anxiety can interfere with the desire to eat.

It is good to eat a variety of healthy foods during treatment. (See Johns Hopkins for an article on this). This means fruits and vegetables, low fat chicken and fish, and beans, nuts, and seeds. Whole grains are a good choice. Milk products are good and these should be pasteurized. Healthy fats like avocados are another good choice. Avoid under-cooked or raw foods such as sushi.

In general, eating more frequent and smaller meals can help. Avoid things that are very spicy. Stay away from extreme tastes. Addressing underlying factors like constipation and nausea can help. Following up with a registered dietician can also be helpful, and they are often part of a cancer treatment team. Avoiding strong and overwhelming smells can be helpful too. See what does and doesn’t work for you. Keep track of symptoms and attempted remedies so that you can share this with your provider if necessary.

Let’s talk about some of the specific side effects and ways to deal with them (see Memorial Sloan Kettering’s website for more tips):

Taste

If there is a residual metallic-type taste, avoid metal utensils which can add to the effect. Use plastic utensils instead. Also avoid items from cans which can add to the metallic taste. Try to avoid cooking in metal pans when possible.

Nausea

Your care team should have provided you with a prescription for an anti-nausea medication such as zofran prior to treatment. If not, ask them to send one to your pharmacy. This type of medication can help with break-through nausea. If it continues to be a problem, reach out to your care team as there are additional medications that can be used.

Mouth sores

Reach out to your care team if you are getting mouth sores. They will want to know. Mouth rinses can be helpful but you will want to avoid alcohol-based mouthwashes during treatment. A basic mouthwash involves baking soda, salt, and water. You can use one teaspoon of baking soda and one teaspoon of salt in one quart of water. There are variations on this recipe, so always check with your care team first. Rinsing a few times a day can help.

Try different techniques to see what works best. By doing this and keeping in touch with your care team, you can find what works best for you.