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Nutrition

*New Service*

The dietetic arm of the team is trialing a weekly virtual telephone clinic offering support to patients and families from initial diagnosis right through their cancer journey. Offering an initial assessment over the phone almost immediately to highlight patients at risk of malnutrition and implementing care plans as early as possible to try and minimise nutritional deficits. 

Please feel free to contact us if you would like an appointment allocating: 01270 273803.

Nutrition in Upper Gastrointestinal Cancers 

Before making any changes to your diet, it can help to talk to a dietitian, your consultant, GP or specialist nurse. A dietitian can help you make changes, and can also advise you about any other dietary problems during or after your cancer treatment.

Upper Gastrointestinal Cancers include:

  • Oesophageal Cancer
  • Stomach Cancer
  • Biliary Cancer
  • Liver Cancer
  • Pancreatic Cancer

 

Cancer affecting any part of your digestive system can affect your nutritional intake greatly, whether that is due to a lack of appetite, feelings of fullness, nausea and vomiting, reflux or other symptoms experienced. Being able to minimise the effect the cancer has on your nutritional status is something we try our best to do.

Simple steps that you can take at home to help assess your nutritional status:

  • Weighing yourself at home, watching for any weight loss
  • Monitoring how clothing and jewellery fits
  • Monitor your intake, keep a food diary if you are worried about your intake
  • Raise any concerns with your specialist nurse/GP/dietitian
  • Please don’t put off raising concerns. The majority of the time our aim is to minimise further weight loss and stabilise your weight as soon as possible.

 

If you are worried about weight loss some simple steps you can take to add calories into your diet using food fortification are:

  • Adding butter, oil, margarine onto vegetables, boiled potatoes, mashed/jacket potatoes
  • Adding cream and butter to things: adding cream to soups, mashed potatoes, porridge
  • Creamy sauces: making up packet sauces with milk instead of water
  • Creamy snack: Rice pudding, custards, yogurts, crème brulees
  • Nourishing fluids: hot chocolate made up with full cream milk, milkshakes, smoothies, malted drinks with full milk
  • Full cream milk or gold top milk that has extra cream in. Aim for 1 pint a day
  • Adding skimmed milk powder to soups, milk puddings, custards, mashed potato, try adding a couple of tablespoons into these foods
  • Don’t choose diet products, full fat yogurts, cheeses, cream, mayonnaise
  • Where this advice may differ is if you have diabetes, please discuss referral to a dietitian if you are not already under the service.
  • Your GP may consider a multivitamin if your diet has been restricted for long periods of time.

 

žAffects you may experience linked to cancer treatment on your nutritional intake:

  • Sore mouth
  • Taste changes
  • Nausea and Vomiting
  • Fatigue
  • Loss of appetite
  • Reflux
  • Loose bowels

 

Tips to help with nausea and sickness: 

  • Keep meals small and eat regularly
  • If the smell of cooking your food makes you feel nauseous
  • Eat cold food
  • Ready prepared meals
  • Let someone else prepare you meals for you
  • Dry food, such as toast or crackers
  • Avoid rich or overly fatty foods
  • Take drinks in between meals rather than with meals
  • If you are struggling with sickness
  • Try and keep yourself hydrated through small sips of fluid through he day
  • Try and take fluids containing calories such as lemonade, Lucozade, juices

 

Unfortunately, treatment may lead to you experiencing changes to your taste buds that lead to things tasting unpleasant, different or completely lacking in taste. Tips to help with taste changes:

  • Try having foods that you enjoy the taste of
  • Try sharper tasting foods that may help to refresh your mouth
  • Keep up good oral hygiene
  • Use seasoning and herbs to flavour your foods
  • If you can no longer tolerate tea and coffee try having alternative hot drinks such as hot chocolate, Horlicks, herbal teas

 

Numerous medications and treatments can lead to you having a dry/sore mouth. Tips to try and help with this:

  • Sharper foods such as grapefruit, lemon, pineapple help to stimulate saliva production
  • Try boiled sweets to stimulate saliva
  • Try chewing gum to stimulate saliva
  • Ice lollies or ice cubes to help sooth your mouth
  • Avoid foods that stick to the roof of your mouth
  • There are alternative artificial saliva that can be prescribed, ask your GP or specialist nurse about this
  • Eat foods at a moderate temperature as foods that are too hot or cold can be painful
  • Drink plenty of fluids
  • Avoid spicy or salty food if you are suffering with a sore mouth
  • Try and keep foods moist with gravy, sauces, cream etc

 

Food hygiene considerations when undergoing treatment:

  • Making sure that you store and prepare food in a hygienic way especially if you have undergone any chemotherapy is very important
  • You may be at higher risk of catching any infections because your immune system will be weakened you need to make sure that your food hygiene is up kept
  • Wash hand thoroughly before eating
  • Wash fruits and vegetables thoroughly
  • Use special care when handling raw meat, fish, eggs and poultry
  • Store food in the appropriate setting and appropriate temperature

 

One side effect of pancreatic cancer can be symptoms malabsorption. You may experience  

  • Loose stools or undigested food in stool
  • Steatorrhea (pale, floating, oily stool)
  • Abdominal pain after eating
  • Delayed gastric emptying
  • Nausea
  • Issues with Reflux
  • Bloating/flatulence
  • Weight loss despite good oral intake
  • Vitamin deficiencies (fat soluble)
  • Hypoglycaemia in diabetics

  

If you have any of the above symptoms please contact your specialist nurse or dietitian to discuss the option of trialling enzyme replacement. Enzyme replacement allows us to support your absorption by replacing some of the enzymes your pancreas may not currently be able to make. Dosage of enzyme replacement is very individual and depends on symptoms therefore needs to be discussed through a consultation with your dietitian or GP. 

If you have had an oesophageal stent placed as part of your cancer treatment you should have seen a dietitian regarding appropriate diet. If you haven’t again please contact your GP/Dietitian/Specialist nurse.

If you are concerned or think any of the above applies to you please contact your GP who can refer you to the appropriate service.

 

What can I eat now?

Please find below a link to a video with some help and advice for patients post surgery.

Link to video

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