What I Eat as a Chemo Patient
Key takeaways:
Chemotherapy can change the way foods taste or smell.
Side effects of chemo, such as nausea and mouth sores, can complicate eating.
Those who have gone through chemo say worrying about food does more harm than good.
Our “What I Eat” series explores what real people eat when they have a medical condition.
On the third day of her first round of in-hospital chemotherapy for carcinosarcoma of the uterus, Amy Kerschbaum called for a nurse because her lunch contained spoiled food. Or so she thought.
“It was as if somebody had covered the inside of my mouth with tin foil,” recalls Amy, now 63, of her 2019 treatment. Homemade, well-blended protein shakes — containing different combinations of over-the-counter protein drinks and powders, vegetables, fruits, or oatmeal — became her go-to meals.
Rachel Belkin thought she would also turn to fruit-heavy blended beverages when she was undergoing chemotherapy after a mastectomy. But the fruits’ acidity only aggravated her chemo-caused mouth sores.
“I didn’t have an appetite, and nothing tasted good,” says Rachel, 44, who underwent chemotherapy 13 years ago. “I just wanted very bland comfort foods … At one point, my doctor said, ‘Don’t worry about nutrition. Just eat anything.’”
Chemotherapy can change the way foods taste or smell, and stimulate an appetite or suppress it. (It’s a misconception that people receiving chemotherapy lose weight. Some do; some don’t.) Favorite foods can become repulsive, enjoyable smells can be intolerable, and side effects like nausea and mouth sores can further complicate the eating equation.
Every person has a different experience and different needs, which is why Stephanie Meyers advises patients to add a dietitian/licensed nutritionist to their care team. She’s a 47-year-old senior oncology clinical dietitian for a telehealth service that provides oncology care.
“Being on chemo can make it very difficult to eat,” says Stephanie. “People tell me that things taste rotten or like the bottom of a shoe. The descriptions people offer from their lived experience of eating during cancer are really detailed.”
“The experience of eating is such a personal one, and the loss of it — of pleasure and joy around food — can be really profound for people,” Stephanie says. “One of the ways we connect and show affection to each other is through food, and [people undergoing cancer treatment] can feel even more of a sense of isolation when food is not pleasant or fun for them.”
Rachel and Amy told GoodRx what they were able to eat during chemotherapy, while Stephanie shared tips her patients have found useful.
‘It’s like how perfumes smell different to different people’
Amy’s cancer was rare and aggressive and required 3-day-long in-patient chemo. She met other patients who were going through similar treatments and talked about their changing relationship with food.
“Some had no problem eating. Some were so nauseous they couldn’t eat. It all depends on the chemo you’re taking and your personal chemistry and how your body processes it,” says Amy, who left her corporate job after treatment to become a cancer coach. “It’s like how perfumes smell different to different people.”
Sometimes Amy wouldn’t want to eat anything because of her nausea. But the lack of food in her stomach would make her feel even sicker. She found only a few foods to be tolerable: crackers with peanut butter, banana slices, applesauce, hard-boiled eggs, and yogurt.
“Some days, I just choked it down because I needed something in my stomach,” she says. “People don’t appreciate how messed up taste buds diminish your appetite and ability to enjoy food.”
Foods that once brought comfort now disgusted her.
“The things I thought I’d want, I didn’t want. People would bring me [ice-cream based milkshakes], and they tasted horrible. One day, they brought me pancakes — and the syrup tasted like a toxic chemical,” she remembers.
On the flip side, she changed her mind about some flavors she used to reject.
“I didn’t even like cherries,” she says of the fruit she now appreciates. “I started trying [other] foods I didn’t like before, like fish. Now I enjoy the taste.”
But the palate changes didn’t disappear when the chemo ended. Amy says the treatment has permanently altered her taste buds.
“I didn’t like spicy food before cancer. Now I can’t get enough of it,” she says. “I was always afraid food would be too spicy, and now I’m like, ‘Yeah, give me the double-blackened chicken.’”
‘Bland comfort foods and carbs’ were easiest to get down
When Rachel’s chemotherapy began, well-meaning friends came by with prepared meals for her to enjoy. The food was eaten — by her husband and parents.
“It was great that they’d bring by lasagna and other heavy, family-friendly meals. But they weren’t for me,” recalls Rachel, from Austin, Texas. “I couldn’t do anything too spicy or with heavy sauces.”
Because Rachel found eating so challenging, her care team recommended she indulge in anything that appealed to her.
“They said, ‘Just treat yourself.’ I know everybody has different positions about nourishing your body and whole foods. But there was already so much stuff to worry about. And I didn’t want to worry about whether I was getting good fats,” says Rachel, who is now on the board of the Breast Cancer Resource Center of Texas and a volunteer who works with cancer patients.
The foods that went down the easiest were “bland comfort foods and carbs.” That meant mac and cheese, bagels, crackers, mashed potatoes, plain rice, and pasta. Fruit was too acidic, but jello and yogurt were palatable. Mint tea and ginger ale became her preferred liquids.
After her treatment ended and the chemo aftereffects faded, Rachel focused on eating balanced meals. The Tex-Mex cuisine fan can again enjoy her old favorites, like chips and queso. But she also keeps an eye on meeting her daily nutrition goals.
“It’s really about listening to your body,” she says. “Before my diagnosis and before I went through chemo, I was relatively healthy. I ate relatively well. And I’ve always been active and worked out and ran and walked. I think starting out [in good physical condition] really helped me power through everything I went through.”
Don’t stress over nutritional goals
Amy and Rachel had very different experiences with eating while undergoing chemotherapy. And that’s to be expected, Stephanie says. Since every person is different, their chemo eating journey also differs. But there’s always one overlapping priority: hydration.
For those who, like Amy, develop a pervasive metallic taste in their mouths, Stephanie recommends a pre-meal mouth rinse that includes salt or baking soda. She also recommends fresh lemons to improve a dish’s flavor or smell.
Stephanie says that people like Rachel who feel nauseous will often turn to foods that are “dry, bland, and salty.” For those who find their taste buds dulled, Stephanie suggests trying to reinvigorate them by getting creative — adding cinnamon, tarragon, or oregano. For others, the idea of adding spices is nauseating, so Stephanie points them towards simpler foods, including Greek yogurt or low-fat cheese.
Getting enough protein and fiber is important, but also is not feeling stressed about meeting nutritional goals or the harmfulness of certain foods, she says.
It’s important for people going through cancer treatment to be compassionate with themselves, Stephanie says.
“Don’t beat yourself up,” she says. “Things tend to change and evolve over time. It’s important for people to hear that they’re not alone in this experience.”
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