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Treatment Side-Effects and Nutrition

Changes in Taste of Food

Changes in how foods taste may be caused by radiation treatment, dental problems, mouth sores and infections, or some medicines. Many mesothelioma patients who receive chemotherapy notice a bitter taste or other changes in their sense of taste. A sudden dislike for certain foods may occur. This can cause a loss of appetite, weight loss, and a decreased quality of life. Some or all of a normal sense of taste may return, but it may take up to a year after treatment ends. The following may help mesothelioma patients who have taste changes:

  • Eat small meals and healthy snacks several times a day.
  • Eat meals when hungry rather than at set mealtimes.
  • Eat favorite foods and try new foods when feeling best.
  • Eat poultry, fish, eggs, and cheese instead of red meat.
  • Eat citrus fruits (oranges, tangerines, lemons, grapefruit) unless mouth sores are present.
  • Add spices and sauces to foods.
  • Eat meat with something sweet, such as cranberry sauce, jelly, or applesauce.
  • Find nonmeat, high-protein recipes in a vegetarian or Chinese cookbook.
  • Use sugar-free lemon drops, gum, or mints if there is a metallic or bitter taste in the mouth.
  • Rinse mouth with water before eating.
  • Eat with family and friends.
  • Have others prepare the meal.
  • Use plastic utensils if foods have a metal taste.

Extra tip - Taking zinc sulfate tablets during radiation therapy has been shown to help the normal sense of taste come back quicker. 

 

Dry Mouth

Dry mouth is often caused by radiation therapy to the head and neck and by certain medicines. There may also be in increase in cavities and gum disease due to the lack of saliva being produced. As you can guess, the number one treatment for dry mouth for mesothelioma patients is to make sure that they are drinking plenty of fluids. Having water available at all times and taking sips to keep the mouth moist is the key to alleviating dry mouth. Some other ways to prevent dry mouth include:

  • Eat moist foods with extra sauces, gravies, butter, or margarine.
  • Eat foods and drinks that are very sweet or tart (to increase saliva). Think lemons or lemon drops.
  • Eat ice chips or frozen desserts (such as frozen grapes and ice pops).
  • Suck on hard candy or chew gum.
  • Use a straw to drink liquids. (People are known to drink more fluids when using a straw)
  • Clean teeth (including dentures) by brushing and rinsing mouth out at least 4-5 times a day. Avoid any mouth washes that contain alcohol as alcohol can dry the mouth.

Mouth Sores and Infections

Mouth sores can be caused by chemotherapy and radiation therapy. These treatments affect fast-growing cells in mesothelioma patients, but that also means that fast –growing healthy cells are also impacted. One area that has fast-growing cells is the inside of the mouth. Chemotherapy and radiation will work to stop these mouth cells from growing and cause mouth sores. Mouth sores can be painful and become infected or bleed and make it hard to eat. Below are some ways to prevent and treat mouth sores and infections:

  • Eat soft foods that are easy to chew and swallow, such as the following:
    • Soft fruits, including bananas, applesauce, and watermelon
    • Peach, pear, and apricot nectars
    • Cottage cheese
    • Mashed potatoes
    • Macaroni and cheese
    • Custards and puddings
    • Gelatin
    • Milkshakes
    • Scrambled eggs
    • Oatmeal or other cooked cereals
  • Stay away from the following:
    • Citrus fruits and juices (such as oranges, tangerines, lemons, and grapefruit)
    • Spicy or salty foods
    • Rough, coarse, or dry foods, including raw vegetables, granola, toast, and crackers
  • Use a blender to make vegetables (such as potatoes, peas, and carrots) and meats smooth
  • Add gravy, broth, or sauces to food
  • Drink high-calorie, high-protein drinks in addition to meals
  • Cook foods until soft and tender
  • Eat foods cold or at room temperature. Hot and warm foods can irritate a tender mouth.
  • Cut foods into small pieces
  • Use a straw to drink liquids
  • Numb the mouth with ice chips or flavored ice pops before eating.
  • Clean teeth (including dentures) and rinse mouth at least four-five times a day (after eating and at bedtime).

Nausea

Nausea can be caused by both radiation therapy and chemotherapy. If you are experiencing nausea, please ask a doctor about getting a medication to help. These anti-emetics are given by mouth, into a vein or both. Some common nausea medications include steroids, Seratonin 5-HT3 antagonists, Dopamine antagonists, anti-anxiety drugs and cannabinoids.   Besides a doctor administering drugs, there are things that a mesothelioma patient can do to help control nausea. Some examples are below:

  • Eat before cancer treatments. This should be a light meal so that you are not full but also do not have an empty stomach.
  • Relax. Try to distract yourself from what your body is experiencing.
  • Rinse out the mouth before and after eating. This will help eliminate the taste of food in the mouth.
  • Eat foods that are bland, soft, and easy-to-digest, rather than heavy meals. Eat small meals several times a day.
  • Eat dry foods such as crackers, bread sticks, or toast throughout the day.
  • Eat foods that are cold or at room temperature.
  • Slowly sip fluids throughout the day. Sipping through a straw has shown that people will drink more.
  • Suck on hard candies such as peppermints or lemon drops if the mouth has a bad taste.
  • Stay away from foods that are likely to cause nausea. For some patients, this includes spicy foods, greasy foods, and foods that have strong odors.
  • Sit up or lie with the upper body raised for one hour after eating.
  • Don't eat in a room that has cooking odors or that is very warm. Keep the living space at a comfortable temperature with plenty of fresh air. A patient does not want to feel to warm or too cold.
  • Ask other mesothelioma patients, new ideas are always helpful to try.
  • Ginger has been shown to help with nausea. You can ingest ginger in the form of capsules, ginger tea or ginger candies. 
  • Peppermint is also supposed to help as peppermint oil relaxes the muscles in the stomach which tense up when nausea hits.
  • Chamomile tea is also a calming. Chamomile also aids digestion and reduce spasms in the stomach and cramps that may cause nausea.
  • Other herbs that can reduce nausea include cinnamon, cloves, and fennel. These can be had in supplement form or made into a tea and sipped on for fast relief. Cinnamon is an antibacterial and antiviral and can help reduce gas and bloating as well as relieve nausea and vomiting. Chewing on a few cloves or drinking a tea made with cloves may help with quick relief of nausea symptoms. Fennel acts as a stimulant to the digestive system and can treat indigestion and colic.

Diarrhea

Diarrhea is the passage of loose or watery stools 3 or more times a day with or without discomfort. It happens when the water in the intestine is not being absorbed back into the body for some reason. Diarrhea can be caused by chemotherapy, radiation therapy or anxiety. Diarrhea caused by chemotherapy or radiation therapy may last for up to 3 weeks after treatment ends.  Long-term diarrhea may lead to dehydration (lack of water in the body) or low levels of salt and potassium, which are important minerals needed by the body.

The following may help cancer patients control diarrhea:

  • Go on a clear liquid diet. Eat broth, nectar, water, weak tea, apple juice, peach nectar 
  • Drink plenty of fluids during the day. Liquids at room temperature may cause fewer problems than hot or cold liquids.
  • Drink at least one cup of liquid after each loose bowel movement.
  • Stay away from the following:
    • Greasy foods, hot or cold liquids, or caffeine.
    • High-fiber foods—especially dried beans and cruciferous vegetables (such as broccoli, cauliflower, and cabbage).
    • Milk and milk products, until the cause of the diarrhea is known.
    • Foods and beverages that cause gas (such as peas, lentils, cruciferous vegetables, chewing gum, and soda).
    • Sugar-free candies or gum made with sorbitol (sugar alcohol).
  • Sit in a warm bath to reduce discomfort. 
  • Be sure to wash the anal area with warm water and soap.

Low White Blood Cell Counts and Infections

A low white blood cell count may be caused by radiation therapy, chemotherapy, or the cancer itself. Patients who have a low white blood cell count have an increased risk of infection. It is a good idea to have an oral thermometer so that you can check whether there is a fever which is a common side effect of an infection.  A fever is the body “heating up” to fight an infection and kill germs. The following may help cancer patients prevent infections when white blood cell counts are low:

  • Stay away from:
    • Raw eggs or raw fish.
    • Old, moldy, or damaged fruits and vegetables.
    • Food sold in open bins or containers.
    • Salad bars and buffets when eating out.
  • Wash hands often to prevent the spread of bacteria.
  • Thaw foods in the refrigerator or microwave. Never thaw foods at room temperature. Cook foods immediately after thawing.
  • Keep hot foods hot and cold foods cold.
  • Cook all meat, poultry, and fish until well done.
  • Refrigerate all leftovers within 2 hours of cooking and eat them within 24 hours.
  • Buy foods packed as single servings, to avoid leftovers.
  • Do not buy or eat food that is out of date.
  • Do not buy or eat food in cans that are swollen, dented, or damaged.
  • When you get a fever, drink plenty of fluids.
  • Use a cold compress to help bring down a fever.
  • Keep covered if you are feeling cold or having chills and use a sheet if you are burning up.

Dehydration

Keeping the body hydrated is key. The body needs lots of fluids in order to function normally. When you are feeling sick and vomiting or have nausea, a patient needs to keep drinking liquids even though they may not feel like drinking liquids. One sign of dehydration is feeling very tired. A patient can prevent dehydration by doing the following:

The body needs plenty of water to replace the fluids lost every day. Nausea, vomiting, and pain may keep the patient from drinking and eating enough to get the amount of water the body needs. Long-term diarrhea causes a loss of fluid from the body. One of the first signs of dehydration (lack of water in the body) is feeling very tired. The following may help cancer patients prevent dehydration:

  • Drink liquids. A patient should be consuming 8 to 12 cups of liquid a day. This liquid can come from drinking water, juice, or milk. A patient can also eat foods that are high in liquid such as popsicles or jello.
  • Caffeine dehydrates a person. Stay away from drinks that have caffeine in them, such as sodas, coffee, and tea (both hot and cold).
  • Take a water bottle whenever leaving home. It is important to drink even if not thirsty.
  • Drink most liquids between meals.
  • Use medicines that help prevent and treat nausea and vomiting.

Constipation

Constipation is very common for mesothelioma patients. Constipation is defined as having fewer than three bowel movements a week. It is a good idea to keep track of a patient’s bowel movements so that a problem can be addressed immediately. Constipation may be caused by the following:

  • Too little water or fiber in the diet.
  • Not being active.
  • Cancer treatment, such as chemotherapy.
  • Certain medicines used to treat the side effects of chemotherapy, such as nausea and pain.

There are many ways to prevent constipation that should be followed. 

  • Eat more fiber-containing foods. Twenty-five to 35 grams of fiber a day is best. Some foods that are high in fiber are: whole-grain breads and cereals; fresh raw fruits with skins and seeds; fresh, raw vegetables; fruit juices; and dates, apricots, raisins, prunes, prune juice, and nuts.
  • Fluid must be incorporated as it flushes the fiber though the body. Drink 8 to 12 cups of fluid each day. Water, prune juice, warm juices, lemonade, and teas without caffeine can be very helpful.
  • Avoid foods and drinks that cause gas, such as cabbage, broccoli, and fizzy drinks.
  • Avoid or cut back on any foods that make you constipated, such as cheese or eggs.
  • Take walks and exercise regularly.
  • When the urge to have a bowel movement presents itself, act on the urge immediately.

To treat constipation:

  • Continue to eat high-fiber foods and drink plenty of fluids. Try adding wheat bran to the diet; begin with 2 heaping tablespoons each day for 3 days, then increase by 1 tablespoon each day until constipation is relieved. Do not take more than 6 tablespoons a day.
  • Stay physically active.
  • Use over-the-counter constipation treatments, if needed. The use of over-the-counter treatments should only be used with the oversight of a doctor. These over-the-counter treatments include:
    • Bulk-forming products (such as Citrucel, Metamucil, Fiberall, and Fiber-Lax).
    • Stimulants (such as Dulcolax and Senokot).
    • Stool softeners (such as Colace and Surfak).
    • Osmotics (such as milk of magnesia).
  • Cottonseed and aerosol enemas can also help. Do not use lubricants such as mineral oil because they may keep the body from using important nutrients the way it should.