The side-effects of cancer treatment are never the same for any two individuals. So how patients choose to deal with them should be unique as well, writes dietician PANG WAI LING.

WHEN we are healthy, eating right to get the nutrients our body needs is usually not a problem. That is why all nutritional guidelines stress on the importance of consuming adequate vegetables, fruits, and wholemeal products such as brown rice, wholemeal breads or pasta; limiting consumption of red meat, especially processed types and those high in fat; cutting back on fat, sugar, and salt; and maintaining a healthy weight.

A healthy diet keeps various diseases at bay and allows a person's body to function at its best. And for people with cancer, this factor becomes even more important. A healthy diet among cancer patients ensures better reserves to help maintain strength, prevents body tissue from breaking down, rebuilds tissue and maintains defences against infection.

Tolerance towards the side-effects of cancer treatment also improves, enabling a person to handle higher doses of drugs better. In fact, some cancer treatments are more effective in people who are well-nourished.

Although the need of healthy eating among cancer patients is important, the actual practice of eating healthily can be challenging. This is especially so when treatment for cancer commences and the side-effects affect appetite. The common side-effects of the treatment of cancer include:

- loss of appetite - weight loss - sore mouth or throat - dry mouth - dental and gum problems - changes in taste or smell - nausea - vomiting - diarrhoea - constipation - fatigue - depression

Understanding the side-effects that might occur and the ways to overcome them can help to reduce anxiety. It can also reduce the stress and confusion in a cancer patient, thus allowing him of her to more in control of the treatment. The following serves as a guide on how to handle some of the nutritional issues one may experience during cancer treatment.

Individualise meal plan

Remember that the degree of intensity of side-effects differs from person to person. Hence, every individual will need a different kind of diet for their condition.

If a lack of appetite is your main problem, focus on having small but frequent meals. This gives you a sense of accomplishment when you are able to finish a meal. while making the task less daunting.

For those experiencing drastic weight loss, a high-energy diet should be followed. Make food more energy-dense to get more out of each mouthful. For example, add margarine or oil to rice, put some ice cream when making smoothies and add full cream milk, instead of low fat, to beverages.

This may appear to go against a healthy diet, but always focus on the issue at hand. Adequate energy intake ensures that the protein consumed helps the repair and rebuilding of tissue, rather than being burned off as energy.

Have food on hand

Appetite during cancer treatment can be peculiar. For example, a patient may initially have an appetite, but could lose it after preparing the food. This makes it necessary to ensure that snacks are easily available.

The snacks need not be elaborate; they can be some cut-fruits in the fridge, dried nuts in the living room, dried fruits near a favourite resting chair or even biscuits that can be carried around in the pocket.

Plan ahead

Exhaustion could be a problem for some cancer patients as a result of treatment, not eating well or medication. Therefore, getting adequate rest is a vital part of the recovery process.

If tiredness is easily felt, get help organising meals as the preparation alone can drain a person of energy. Seek assistance whenever needed, whether to shop or cook a meal. When buying food, consider buying larger amounts to be stocked in the pantry and freezer.

When cooking, try preparing larger portions so that they can be divided and stored in the freezer, to be reheated whenever needed.

Be sensible about diet

Cancer patients need more protein and energy than usual to maintain strength, rebuild tissue and keep infection at bay. Studies have shown that individuals who eat well are able to cope with the side-effects of treatment better.

Therefore, exercise caution before embarking on any diet. Among the popular choices are fasting, detoxification diets, vegetarian diet, consuming megadoses of vitamin and mineral supplementation, and avoiding food deemed "harmful" to the body.

Some of these diets are restrictive in nature and can cause nutrient deficiency if practiced for long. Others can make the body lose fluids and electrolytes. Some may even effect the efficiency of the treatment. A balanced diet providing adequate nutrients, vitamins and minerals is a safer bet to ensure that the body is well-prepared to fight the cancer.

Be adventurous, try new foods

Taste may change during treatment. Some foods which were not enjoyed previously, may taste good now. Having a change in diet also prevents taste fatigue and boredom which arises from having the same type of food everyday. Besides allowing the body different vitamins that come from different kinds of food, exploring various cooking styles gives one something to look forward to at mealtime.

Diet and nutrition during the treatment of cancer come with unique challenges for each individual. There will be some barriers along the way, but with some effort, continued persistence and some trial and error, one should be able to find a solution that works best for him or her.

* Pang Wai Ling, a clinical dietician at the National Heart Institute, is also a member of the Malaysian Dietitians' Association. This article is courtesy of the association.