Nutrition and cancer

• Once you have been diagnosed with cancer, try to eat as well as you can before starting treatment.
• Eat a variety of foods and do some physical activity to build muscle (if you are feeling well enough).
• If you have lost weight and/or you are not eating as well as usual, you may need food with more energy (kilojoules) and protein.
• Ask your general practitioner (GP) or oncologist for a referral to a dietitian for advice about diet. You can also be referred to other health professionals, such as physiotherapists, exercise physiologists and psychologists. These health professionals can work together to help prepare you for cancer treatment.

• You may need food with more energy (kilojoules) and protein. If you don’t have much appetite, eat small, frequent meals or snacks, rather than three large meals a day.
• Ask for a referral to a dietitian if weight loss is ongoing or rapid.
• Do regular physical activity to improve appetite and mood, reduce fatigue, help digestion and prevent constipation. A physiotherapist or exercise physiologist can help you develop an exercise plan.
• Check with your doctor or dietitian before taking vitamin or mineral supplements or making major changes to your diet.

• Try to maintain your weight to speed up recovery.
• Eat a variety of foods and do some physical activity to rebuild muscle and recover from the side effects of cancer treatment. You can ask to see a physiotherapist or exercise physiologist for help developing an exercise plan.
• If you continue to experience treatment side effects that affect what you can eat, talk to a dietitian for further assistance.

• Focus on healthy eating once you’ve recovered from the side effects of treatment.
• Maintain a healthy weight and be physically active to help lower the chance of cancer coming back.
• Visit your doctor for regular check-ups.

• Good nutrition can improve quality of life.
• Adjust food choices and eating patterns to meet your changing nutritional needs.
• Talk to your doctor about medicines that may boost appetite.
• Relax usual dietary restrictions, e.g. use full-cream rather than low-fat milk.
• Consider nutritional supplements if you can’t eat enough. Discuss options with your doctor, palliative care specialist or dietitian.

There are many different types of cancer and many different causes of cancer, only some of which are understood. Cancer starts when cells begin to grow out of control. The reason for this change is not always known, but lifestyle and diet sometimes play a part. Poor eating habits combined with other lifestyle factors (such as smoking, too little exercise, drinking too much, being overweight and too much sunlight exposure) may, over a long period of time, increase the risk of developing some cancers.

The World Health Organization classifies processed meats such as bacon, ham and salami as Group 1 carcinogens because there is strong evidence that processed meats cause bowel cancer. WHO puts processed meats in the same category as other proven causes of cancer such as tobacco, alcohol and ultraviolet (UV) radiation.

WHO classifies red meat as a Group 2A carcinogen because there is growing evidence that eating too much red meat increases the risk of bowel cancer but the evidence isn’t as conclusive as it is for processed meats.

These classifications do not indicate the risk of getting cancer from these foods; they describe the strength of the evidence that these foods are linked to cancer.

To reduce cancer risk, Cancer Council and the Australian Dietary Guidelines recommend that you:

• eat little, if any, processed meat such as bacon, ham and salami
• aim for no more than 455 g of cooked lean red meat (e.g. beef, lamb, pork, kangaroo, goat) per week. This could be one serve a day (65 g cooked) or 2 small serves at 3–4 meals a week. You can swap a serve of red meat for fish, chicken, eggs or legumes (e.g. chickpeas or lentils) and get adequate amounts of the nutrients you need. If you are losing weight or finding it hard to eat enough during cancer treatment, ask your doctor or dietitian what foods to eat to help you get enough energy and protein.

You can swap a serve of red meat for fish, chicken, eggs or legumes (e.g. chickpeas, lentils) and still get the nutrients you need. If you are losing weight or finding it hard to eat well during cancer treatment, ask your doctor or dietitian what foods to eat for energy and protein.

Organic farmers and food producers grow and produce food without using synthetic pesticides or fertilisers. They also don’t use seeds, plants or animals that have had their genetic make-up altered in a laboratory, or expose food to radiation to extend shelf life.

Some people believe it’s better to eat organic food because they’re not eating extra chemicals in their food. However, there is no strong evidence that organic food is better for you, or that it will help you recover faster or reduce the risk of cancer coming back.

Organic fruits and vegetables contain the same vitamins and minerals as those grown in the usual way and can be more expensive to buy. Focus on eating a variety of fruits and vegetables, rather than whether or not they’re organic.

If you’ve been diagnosed with cancer, you may be thinking about changing your diet to help your body cope with the effects of cancer and its treatment, and to give yourself the best chance of recovery. After a cancer diagnosis, some people find that they give more attention to having a well-balanced diet, which can have many benefits. Others need to adjust their diet to make sure they are getting the nutrition they need.

Some people claim that a particular diet can cure or control cancer on its own. Often these diets are promoted on websites or in the media. However, there are no special foods, diets or vitamin and mineral supplements that have been scientifically proven to do this.

Many unproven diets encourage people to: eliminate one or more basic food groups (e.g. all dairy or all carbohydrates); include large amounts of specific fruits and vegetables or their juices; and take special supplements. These diets are often expensive and can be harmful.

Following one of these unproven diets can cause unwanted weight loss and fatigue, and weaken your immune system. This may make it harder for you to cope with treatment and lead to malnutrition. Diets that cut out whole food groups are likely to be low in energy, protein, fat, iron, calcium, zinc and vitamins, all of which are essential for your organs to work properly. Unusual diets can also make it hard to eat at restaurants or other people’s homes, which may prevent you from enjoying social occasions.

While everyone should try to limit added sugar in their diet, sugar occurs naturally in many foods, and carbohydrates (such as potatoes, pasta and grains) break down into sugar in the body. You may hear that because cancer cells use sugar to grow, cutting out all sugar and carbohydrates from your diet will stop the cancer growing. This is a myth and can be harmful. The healthy cells in your body also use sugar to grow, so changing your diet in this way would mean missing out on the sugar that helps your vital organs work. If you are losing weight or struggling to eat enough, eating foods with sugar in them may help to keep your energy levels up. You can talk to a dietitian about what foods are right for you after a cancer diagnosis.

Some people think that eating very little (fasting) helps treat cancer, but there is not enough evidence to support this and it can be harmful. Not eating enough can leave you feeling tired, weaken your immune system and affect your ability to cope with treatment. This may lead to treatment delays or reduce the amount of treatment you receive. It is important to try to eat a wide variety of food, and to eat enough to meet your body’s needs so you maintain strength during treatment.

Cancer treatment often causes side effects that affect your mouth and teeth, such as mouth ulcers, dry mouth, tooth decay and mouth infections. These problems can make it hard to eat, and poor oral health can make them worse. This is why it is important to have a check-up with your dentist before treatment starts, especially if your treatment includes radiation therapy to the head or neck, some types of chemotherapy, or the drugs known as bisphosphonates (used to treat bone disease).

Your dentist can check the health of your teeth and identify any problems early. You can also ask your dentist or your cancer treatment team for advice about caring for your teeth and mouth before, during and after treatment.

Download our fact sheet ‘Mouth Health and Cancer Treatment’

Along with eating well, physical activity is important for general health and wellbeing. Any activity that gets your body moving and speeds up your breathing and heartbeat can help you achieve or maintain a healthy body weight, improve your mood, and prevent some conditions, such as heart disease, type 2 diabetes
and even some cancers.

Australia’s Physical Activity and Sedentary Behaviour Guidelines encourage everyone to move more and sit less. Adults should aim to be active on most, preferably all, days of the week. Any physical activity is better than none, so if you are not physically active at all, try to gradually build up to the
recommended amount. The aim is to be as physically active as your abilities and condition allow.

Exercise is now recommended for most people during and after cancer treatment. Research shows that regular physical activity can:

• help manage fatigue and other common side effects of cancer treatment
• increase appetite
• speed up recovery
• strengthen muscles and bones
• improve circulation and energy levels
• reduce stress and improve your mood
• reduce the risk of the cancer coming back (for some cancer types) and of developing other health problems
• reduce isolation (if exercising with others)
• improve quality of life.

Check with your oncologist or GP before starting an exercise program, and see a physiotherapist or exercise physiologist to develop an exercise plan that suits your situation. A physiotherapist or exercise physiologist may be part of the team at your hospital or treatment centre, or your GP can refer you to one in private practice.

Download our booklet ‘Exercise for People Living with Cancer’

Possible side effects from treatments are:

surgery (the partial or total removal of a tumour or body part) – difficulty chewing and swallowing, diarrhoea, difficulty absorbing nutrients, weight loss

chemotherapy (the use of drugs that kill or slow the growth of cancer cells) – loss of appetite, nausea, vomiting, constipation, diarrhoea, mouth sores, taste changes, difficulty swallowing, lowered immunity, fatigue, weight loss

radiation therapy (the use of targeted radiation to kill or injure cancer cells; also known as radiotherapy) – loss of appetite, fatigue, taste changes, nausea, vomiting, diarrhoea, dry mouth, difficulty swallowing, bowel obstruction, mouth sores, weight loss

steroid therapy (drugs used to treat inflammation and some blood cancers) – increased appetite, weight gain, increased risk of infection, stomach irritation

stem cell transplant (the process of replacing stem cells destroyed by high-dose chemotherapy) – lowered immunity, sore mouth and throat, nausea, vomiting, diarrhoea, fatigue, loss of appetite, weight loss

hormone therapy (drugs that block the hormones that help some cancers grow) – weight gain, increased cholesterol levels

targeted therapy (drugs that attack specific particles within cells that allow cancer to grow and spread) – diarrhoea, nausea, vomiting, constipation, taste changes, mouth sores, fever, increased risk of infection, weight loss

immunotherapy (drugs that use the body’s own immune system to fight cancer) – diarrhoea, bloody stools, abdominal pain, bloating, weight loss or weight gain

Cancer and some treatments (such as chemotherapy and stem cell transplants) can weaken the body’s immune system by affecting white blood cells that protect against infection. If you are having these treatments, you will be encouraged to take care preparing food, because this lowered immunity can make you more prone to foodborne illness.

General precautions

• Wash your hands and knives, cutting boards and food preparation areas thoroughly with hot soapy water before and after cooking.
• Take care when eating out, as it can be difficult to know whether food safety guidelines are being followed. Where possible, ask for meals to be made fresh and avoid pre-prepared foods that have been sitting for unknown periods of time.

Making safer food choices

chicken – cook thoroughly

• refrigerate leftover chicken immediately – don’t let it cool on the benchtop
• eat within 24 hours; eat straight from the fridge or reheat until steaming hot
• avoid purchased, ready-to-eat chicken

meat – cook thoroughly

• refrigerate leftover meat immediately – don’t let it cool on the benchtop
• eat within 24 hours; eat straight from the fridge or reheat until steaming hot

seafood – eat well cooked fresh seafood

• refrigerate leftover seafood immediately, and eat within 24 hours
• avoid raw seafood (e.g. oysters, sushi) and ready-to-eat peeled prawns
• avoid ready-to-eat smoked seafood

cold meats – store home cooked cold meats in fridge

• avoid ready-to-eat cold meats from the deli counter and packaged, sliced ready-to-eat cold meats

sandwich – eat freshly made

• avoid pre-made sandwiches

salad – wash thoroughly before preparing

• refrigerate leftover salad immediately, and eat within 24 hours
• avoid ready-to-eat or pre-packaged deli salads (including pre-cut fruit salads)

eggs – store clean, uncracked eggs in fridge

• avoid cracked, dirty and raw eggs
• avoid food containing raw eggs (e.g. homemade mayonnaise, raw cake mix and biscuit dough)

cheese and other dairy products – eat hard or processed cheese; store pasteurised dairy products in fridge

• store cheese in fridge
• avoid soft, semi-soft and surface-ripened cheeses (e.g. brie, camembert, ricotta, fetta, blue)
• avoid unpasteurised dairy products

packaged food – use withing use-by dates

• store unused portions of perishable food in fridge in clean, sealed containers, and use within 24 hours

ice-cream – keep frozen

• avoid soft serve ice-cream

A common side effect of treatment is feeling extreme and constant tiredness. This is known as fatigue. It is different to normal tiredness because it usually doesn’t improve with rest. Fatigue can be caused by treatment side effects that reduce the number of red blood cells (anaemia) or that affect your appetite.

How to manage fatigue

• Plan ahead for when you feel too tired to cook. Prepare food in advance and store in the freezer.
• Cook in the morning when you are less likely to be tired.
• Shop online for groceries instead of going to the shops.
• Ask for and accept offers of help with shopping and cooking from family and friends.
• Consider using apps such as CanDo and LOVLIST to coordinate offers of help.
• Do regular exercise to help improve fatigue and appetite.
• Keep snacks such as muesli bars, dried fruit, nuts and crackers in handy locations, e.g. in your bag or car. This will allow you to keep your energy levels up if you have unexpected delays.
• Use services such as Meals on Wheels or other home delivery meal companies that bring pre-prepared food to you. There are also companies that deliver prepared ingredients with recipes that you can cook at home yourself.
• Eat with others to make meals as enjoyable as possible, particularly if you are feeling too tired to eat.

Download our fact sheet ‘Fatigue and Cancer’

You may lose your appetite because of the effects of cancer itself, the treatment, or side effects such as feeling sick, not enjoying the smell of food, or feeling upset. This is a common issue for people diagnosed with cancer, but it is important to keep trying to eat well so your body gets the nourishment it needs to maintain your weight.

How to manage loss of appetite

• Eat small meals frequently, e.g. every 2–3 hours. Keep to a regular eating pattern rather than waiting until you’re hungry.
• Use a smaller plate – a big plate of food may put you off eating.
• Eat what you feel like, when you feel like it, e.g. have cereal for dinner or a main meal at lunch. Some people prefer to prepare their own meals so they can eat whatever they feel like at the time.
• Include a variety of foods in your diet as this may help improve your overall intake.
• Sip fluids throughout the day, and replace water, tea and coffee with fluids that add energy (kilojoules) and protein, such as milk, milkshakes, smoothies or soup. These are also good if you find drinks or soups easier to manage than a meal.
• Relax dietary restrictions. During treatment, maintaining your weight or regaining weight you have lost is more important than avoiding full-fat and other high-energy or high-sugar foods.
• Gentle physical activity can stimulate appetite, e.g. take a short walk around the block.
• Make meals as enjoyable as possible to encourage your appetite, e.g. play music, light candles or eat with friends.

Some treatments and their side effects can change the way some foods taste or smell. Chemotherapy can change the taste receptors in the mouth. Radiation therapy or surgery to the head, neck and mouth area can damage the salivary glands and tastebuds on the tongue. Food may taste bitter or metallic, or may not have as much flavour as before.

It’s common to have taste changes during treatment and for a short time afterwards. People with cancer often say, “All food tastes the same”, “Food tastes like cardboard”, “Food tastes metallic”, or “I no longer like the taste of my favourite food”. If you lose most or all of your sense of taste, focus on other appealing aspects of food, such as the colours and presentation of the meal. You could try experimenting with different textures and temperatures to make food more enjoyable (e.g. hot apple pie with cold ice-cream). It may take several months for taste to return to normal. In some cases, taste changes may be permanent.

If you have a sore mouth, sore throat or swallowing difficulties, talk to your doctor, speech pathologist, dentist or dietitian.

How to manage changes in taste

• Add extra flavour to food if it tastes bland (e.g. fresh herbs, lemon, lime, ginger, garlic, soy sauce, honey, chilli, pepper, Worcestershire sauce or pickles).
• Experiment with different foods, as your tastes may change. You may not like bitter drinks (e.g. tea, coffee, beer, wine) or sweet food (e.g. chocolate), even if you liked them before treatment. It is common to prefer savoury food.
• If meat tastes unpleasant during treatment, replace it with other protein sources (e.g. cheese, eggs, nuts, dairy foods, seafood, baked beans, lentils, chickpeas).
• Add small amounts of sugar to food if it tastes bitter or salty.
• Use bamboo or plastic cutlery if metal cutlery adds a metallic taste.
• Drink through a straw so the taste isn’t as strong. Metal straws may add a metallic taste so paper or plastic straws may be better.

How to manage changes in smell

• Choose cold food or food at room temperature – hot food smells stronger.
• Try not to eat your favourite foods during chemotherapy. Some people find afterwards that they cannot tolerate the smell of foods associated with their treatment.
• Avoid using large amounts of strong-smelling ingredients (e.g. garlic, onion).
• If cooking smells bother you, ask family or friends to cook and stay out of the kitchen when food is being prepared.
• Turn on the exhaust fan, open a window and cover pots with lids to help reduce cooking smells, or cook outside on the barbecue.
• Avoid eating in stuffy or overly warm rooms.
• Practise good mouth care, as a bad taste in the mouth can make things smell unpleasant.

Radiation therapy to the head or neck area, some chemotherapy drugs and some pain medicines can change the amount of saliva in your mouth and make your mouth dry. This is known as xerostomia. It can increase the risk of tooth decay and infections such as oral thrush, which will make eating harder.

How to relieve a dry mouth

• Use mouthwashes regularly to prevent infections. To avoid irritation, choose an alcohol-free mouthwash.
• Gargle with ½ tsp salt and/or 1 tsp bicarbonate of soda in a glass of water.
• Use a soft toothbrush when cleaning your teeth.
• Ask your dentist or health care team about suitable mouth rinses or oral lubricants.
• Avoid rough, crunchy or dry foods (e.g. chips, nuts, toast, dry biscuits); salty or spicy foods that sting your mouth; or very hot or cold food.
• Soften food by dipping it into milk, soup, tea or coffee, or moisten it with sauce, gravy, cream, custard, etc. You may find soup easier to eat.
• Cut, mince or puree food with sauce or gravy to avoid it drying out when chewed.
• Sip fluids with meals and throughout the day.
• Limit alcohol and coffee as these remove fluids from the body, and avoid smoking.
• Chew sugar-free gum to stimulate the flow of saliva.
• Suck on ice cubes or frozen grapes to moisten your mouth.
• Moisten the inside of your mouth with a small amount of grapeseed oil, coconut oil or olive oil. This can help at night.
• Use a moisturising lip balm to keep your lips moist.

Cancer treatment can cause difficulties with chewing and swallowing. These are usually temporary, but can sometimes be permanent.

Problems chewing – People with dentures who lose weight may find their teeth become loose, making it hard to chew. Treatment for head and neck cancer sometimes involves removing teeth.

Sore mouth – Chemotherapy and radiation therapy can damage the cells lining the mouth and digestive tract, leading to ulcers and infections. This is known as mucositis and it can make it painful to eat and swallow. Mucositis usually gets better a few weeks or months after treatment ends, but you may need softer food until then.

Problems swallowing – If you’re having difficulty swallowing (dysphagia), you may need to change the consistency of your food by chopping, mincing or pureeing. Signs that the texture of food is causing problems include taking longer to chew and swallow; coughing or choking while eating or drinking; food sticking in your mouth or throat like a ball; or throat clearing after meals. A speech pathologist can monitor your ability to swallow, and a dietitian can suggest foods and make sure you are getting enough nutrition.

A person with severe difficulty swallowing will need a feeding tube to ensure adequate nutrition. This is rare for most people with cancer, but is more of a possibility with cancers affecting the head and neck, stomach or oesophagus. If a feeding tube is required, your treatment team will discuss this with you.

Suggestions for a texture-modified diet

If you need to adjust the texture of your food, this sample menu provides some ideas. Your speech pathologist and dietitian will be able to suggest many other options.

Check with your dietitian if you have another health condition, such as diabetes, or if you have been told you need thickened fluid – you may not be able to have
all of the foods suggested here, or you may need to modify them.

Food textures

Soft – Food can be chewed but not necessarily bitten. It should be easily broken up with a fork and need little cutting. Sauce or gravy can be added to make it softer.

Minced and moist – Food should be soft and moist and easily form into a ball in the mouth. Small lumps can be broken up with the tongue rather than by biting or chewing.

Smooth pureed – The texture of smooth pureed food means it can be moulded, layered or piped to make it look more appealing. You can add sauce or extra liquid
if you prefer.

Breakfast

• Soft – scrambled or poached eggs; soft chopped fruit and yoghurt
• Minced and moist – oatmeal porridge or wheat biscuits with lots of milk and little texture; well-cooked rice pudding; congee (rice porridge) with little texture
• Smooth pureed – strained or pureed porridge (made with milk); strained or pureed congee

Lunch

• Soft – egg and commercial mayonnaise sandwich with crusts cut off; baked beans
• Minced and moist – soup with vegetable or meat pieces (no bigger than 5 mm); well-cooked lentil dhal with very soft rice
• Smooth pureed – well-cooked pasta that has been pureed in a blender with added sauce; pureed canned tuna with commercial mayonnaise, pureed mashed potato; pureed soup strained to remove lumps

Dinner

• Soft – casserole with small pieces of tender meat and well-cooked vegetables; well-cooked rice or wheat noodles (not fried) with boiled vegetables and crumbled soft tofu or tender meat
• Minced and moist – moist macaroni cheese; mashed or scrambled tofu with small, soft vegetable pieces (no bigger than 5 mm); moist risotto
• Smooth pureed – pureed chicken blended with extra gravy or sauce and pureed noodles; pureed lentil dhal or curry and pureed rice

Snacks, dessert and drinks

• Soft – mango; stewed fruit pieces; yoghurt with soft fruit pieces; soft cake with lots of custard; fruit smoothie
• Minced and moist – mashed banana; steamed egg pudding; soft cheesecake without the crust; semolina pudding; creamed rice; milkshake; milk or soy milk
• Smooth pureed – pureed pear or apple pushed through a sieve; yoghurt with no fruit pieces/lumps; ice-cream; mousse; milk or soy milk

Foods to avoid

• Soft – nuts; dried fruit; dry or gristly meat; raw vegetables; muesli; hard cheeses (unless melted)
• Minced and moist – nuts; hard vegetables; all bread and crackers; dried food; lollies (jubes, marshmallows)
• Smooth pureed – meat; eggs; cereals or vegetables that have not been pureed in a blender; peanut butter

If you are having chemotherapy, you will be given anti-nausea medicine with your treatment and to take at home afterwards. In many cases, this will prevent severe nausea (feeling sick) and vomiting, but some people do still feel sick and may vomit. Radiation therapy, other medicines and the cancer itself can also cause nausea and vomiting.

Nausea and vomiting can also be triggered by stress, food odours, gas in the stomach or bowel, motion sickness or even the thought of having treatment. After a person has had a few treatments, they may connect certain sights, sounds or smells with treatment and feel nauseated when they experience them. This is known as anticipatory nausea or vomiting, and it is more common in people receiving chemotherapy.

How to cope with nausea

• Take anti-nausea medicines as prescribed, paying special attention to the timing (e.g. if your prescription says to take before food). Let the doctor know if the medicines don’t seem to be working, as they can offer you a different one to try.
• Have a light snack before chemotherapy, and wait a few hours before eating again.
• Eat small meals frequently (every 2–3 hours) during the day. Going without food for long periods can make nausea worse.
• Snack on dry or bland foods, e.g. crackers, toast, dry cereals, bread sticks or pretzels.
• Choose cold food or food at room temperature instead of hot, fried, greasy or spicy foods.
• Eat and drink slowly, and chew your food well.
• Try drinks and foods with ginger, e.g. non-alcoholic ginger beer, ginger biscuits.
• Avoid foods that are overly sweet, fatty, fried, spicy or oily, or that have strong smells.
• Brush teeth regularly and rinse mouth to help reduce unpleasant tastes that may make you feel nauseated.
• Don’t eat your favourite food when feeling nauseated; otherwise, you may develop a permanent dislike.

How to cope with vomiting

• Sip small amounts of fluids as often as possible. Try dry ginger ale, cold flat lemonade, soda water, Lucozade, sports drinks or chilled tomato juice.
• Try sucking on a hard lolly, crushed ice cubes or an iceblock – this can be soothing.
• See your doctor if you are unable to keep fluids down, or if vomiting lasts for more than 24 hours, as there is a danger that you may become dehydrated.
• Introduce drinks slowly once the vomiting has stopped, e.g. clear, cool drinks; diluted fruit drinks; Bonox/Bovril (beef extract rich in iron, minerals and vitamins); clear broth; and weak tea.
• Start eating small amounts of plain foods once vomiting is under control, e.g. dry biscuits; pretzels; toast or bread; jelly; cooked cereals (such as lemon sago or boiled rice); and soft stewed fruits (such as apples, pears or peaches).
• Introduce milk gradually and in small amounts, or have yoghurt, which is more easily digested.
• Gradually increase your food intake until your eating returns to what is normal for you. Your doctor or dietitian may advise you to take a nutritional supplement on your good days to make up for the days when you can’t eat properly.

Constipation is when your bowel motions (stools) are infrequent and difficult to pass. It can be caused by different factors including: some chemotherapy and anti-nausea drugs; strong pain medicines (opioids); eating less fibre; not moving around as much; not drinking enough (dehydration); or not eating enough.

Severe constipation accompanied by other symptoms such as abdominal pain and swelling, nausea and vomiting can indicate a blockage in the bowel (bowel obstruction). This needs urgent medical attention.

How to manage constipation

• Soften stools by drinking 8–10 glasses of fluid a day (e.g. water, herbal tea, milk-based drinks, soup, prune juice).
• Eat foods that are high in insoluble fibre (e.g. wholegrain breads, cereals or pasta; raw and unpeeled fruits and vegetables; nuts and seeds; legumes and pulses).
• If you are increasing the amount of fibre in your diet, be sure to increase the amount of fluids to avoid the extra fibre making constipation worse.
• Ask your doctor about using a laxative, stool softener and/or fibre supplement.
• Aim to do some physical activity every day. Check with your doctor, exercise physiologist or physiotherapist about the amount and type of exercise that is right for you.
• If you have had surgery for bowel cancer, ask your health care team for specific dietary advice. They may advise a low-fibre diet to avoid constipation in your situation.

Diarrhoea is when your bowel motions become watery, urgent and frequent. You may also get abdominal cramping, wind and pain. Chemotherapy, radiation therapy to the abdomen or pelvis, some types of surgery (e.g. bowel), medicines, infections, reactions to certain foods, and anxiety can all cause diarrhoea.

If the tips below don’t work, ask your doctor about anti-diarrhoea medicines. Having diarrhoea can be exhausting, so rest as much as possible. For further support, you can call National Continence Helpline on 1800 33 00 66 or visit continence.org.au.

How to manage diarrhoea

• Drink plenty of fluids to avoid becoming dehydrated. Water, diluted cordials and oral hydration drinks (e.g. Gastrolyte) are better than high-sugar drinks, alcohol, strong caffeine or very hot/cold fluids.
• Watch for signs of dehydration such as dark yellow urine or less frequent urination.
• Avoid foods that are high in insoluble fibre (e.g. wholegrain breads, bran cereals, nuts and seeds, raw fruit, vegetable skins) and foods that increase bowel
  activity (e.g. spicy, fatty or oily foods; caffeine; alcohol or artificial sweeteners).
• Choose foods that are low in insoluble fibre (e.g. bananas, mashed potato, white rice, white pasta, white bread, steamed chicken without skin, white fish). It may also help to eat foods that are high in soluble fibre (e.g. oats, barley, rye, legumes, peeled fruits and vegetables, avocado, soy products).
• Try soy milk or lactose-free milk for a time if you develop a temporary intolerance to the natural sugar in milk (lactose).

Radiation therapy to the pelvic area can make the bowel swollen and sore. This is called colitis when it affects the colon (the large bowel), and proctitis when it affects only the rectum (the last part of the bowel before the anus). You may feel the need to empty your bowels often, perhaps without much result. Straining can cause discomfort, and there may be blood or mucus in bowel motions. Diarrhoea, nausea and vomiting are also common, but can be managed with medicines.

The small bowel may become irritated after chemotherapy or radiation therapy to the abdomen or pelvic area. This is known as enteritis and it can cause abdominal discomfort (like cramps or wind pain), episodes of pale and fluid bowel motions, and more wind than usual.

How to manage bowel irritation

• Eat and drink slowly, take small mouthfuls and chew your food well to avoid swallowing air.
• Try a diet low in insoluble fibre to reduce bowel irritation in the short term.
• Avoid fatty, spicy or fried foods, and rich gravies and sauces.
• Reduce foods such as corn, beans, cabbage, onions, pickles and fizzy drinks, which can produce wind.
• Drink plenty of water, and eat soft or cooked peeled fruit, fine wholemeal bread and bran to provide soft bulk.
• Do some gentle exercise, such as walking, to encourage healthy bowel movement.
• Tell your doctor if symptoms don’t improve. Bowel irritation is usually temporary, with colitis and proctitis lasting up to 8 weeks and enteritis lasting 1–2 weeks after treatment ends.

Some cancers and treatments can cause stomach contents to come back up into the oesophagus (food pipe). This is known as reflux and it can irritate the lining of the oesophagus, leading to a burning feeling in the upper chest, oesophagus and/or throat. This sensation is called heartburn or indigestion. It can be made worse by eating certain foods or lying down after eating.

Heartburn may make you feel too uncomfortable to eat much, which could lead to weight loss. Keeping a diary of the foods you eat and your symptoms can help you identify which foods trigger the heartburn. If the tips below don’t relieve heartburn, let your doctor know. They may be able to prescribe medicines to help.

How to manage heartburn

• Avoid large meals; try to eat three small meals and three snacks throughout the day.
• Eat slowly and enjoy your meal. Avoid wearing tight clothing (especially belts) while eating.
• Sip fluids between meals, rather than drinking large amounts at mealtimes.
• Limit or avoid foods that may make heartburn worse: chocolate, very spicy foods, high-fat foods (e.g. fried food, pastries, cream), tomato and tomato products, citrus fruits, coffee (including decaf), strong tea, soft drinks and alcohol.
• After eating, sit upright for at least 30 minutes and avoid lying down or activities that involve bending over (e.g. gardening).
• Lift the head of the bed by 15–20 cm by putting blocks under the bed legs or using a wedge under the mattress.

Malnutrition occurs when you eat less energy and protein than your body needs. This is most likely to occur in people with cancer during treatment or in the few weeks after treatment finishes. Factors that increase the risk of malnutrition include:

• surgery for cancers such as head and neck, lung and gastrointestinal cancers, which may make it hard to swallow and digest food
• increased nutritional needs caused by cancer and treatments such as chemotherapy, radiation therapy and surgery
• symptoms or side effects such as nausea, vomiting and dry mouth
• some medicines
• anxiety, stress and fatigue.

Many of the eating issues discussed in the sections above can contribute to, or be symptoms of, malnutrition. Other signs of malnutrition include weakness; significant weight loss; confusion; dry, brittle hair and nails; and pale or pigmented skin.

Malnutrition can increase your risk of infection and reduce your strength, ability to function and quality of life. It can also affect how your body responds to cancer treatment and recovery. A person can be malnourished at any shape or size − it is possible to be malnourished even if you are overweight. Talk to your doctor or dietitian if you think malnutrition may be an issue. It is important to do this early so that you can receive the right advice.

Surgery that removes part of the digestive system, such as the oesophagus, stomach or bowel, will change the way you eat and digest food. 

Surgery for bowel cancer – When part of the bowel is removed, many people have more frequent bowel motions (diarrhoea). This usually improves in a few months, but it may take longer for some people. Your doctor, nurse or dietitian might recommend a low-fibre diet that is easier to digest. In some cases, surgery for bowel cancer creates a temporary or permanent stoma, an opening in the abdomen that allows faeces to leave the body (a bag is attached to collect the
faeces). If you have a stoma, you may need to make some dietary changes until your body adjusts.

Download our booklet ‘Understanding Bowel Cancer’

You can also call 1800 330 066 for the Australian Government’s Improving Bowel Function After Bowel Surgery booklet.

Surgery to the head and neck area – Your ability to chew and swallow may be affected after surgery to the head and neck. If you are having difficulty eating or drinking, seek advice from your dietitian and speech pathologist. In some cases, you may be given a temporary or permanent feeding tube to help you maintain or gain weight during this time.

Download our booklet ‘Understanding Head and Neck Cancers’

Surgery for stomach cancer – Removing part or all of the stomach will affect what you can eat and how you eat. The change in the structure of the stomach may mean that you require smaller quantities of food more often and you feel fuller more quickly. In addition, foods high in sugar move through the stomach faster.
You may experience cramps, nausea, racing heart, sweating, bloating, diarrhoea or dizziness. This is called dumping syndrome, and it usually improves over time. Your treatment team can suggest dietary changes and medicines to help manage dumping syndrome.

Surgery for oesophageal cancer – Surgery that removes the oesophagus will change how you eat. After surgery, you will usually have a feeding tube, then progress to a liquid diet, followed by a diet of soft or moist foods. If you cough while eating or feel like the food is getting stuck in your throat when you swallow, consult your doctor, dietitian or speech pathologist immediately.

Download our booklet ‘Understanding Stomach and Oesophageal Cancers’

Surgery for pancreatic cancer – After surgery to remove part or all of the pancreas, your body may not be able to make enough enzymes to digest food and you may experience diarrhoea. If this occurs, your doctor and dietitian may advise you to take enzyme supplements with every meal. Some people develop diabetes before being diagnosed with pancreatic cancer or soon after surgery. The way diabetes is managed varies from person to person, but it usually includes a combination of dietary changes and medicines.

Download our booklet ‘Understanding Pancreatic Cancer’

People with cancer commonly lose weight because cancer cells can burn a lot of energy, and treatment side effects can cause a loss of appetite. Losing weight without trying may be a sign of malnutrition. However, weight loss can often be prevented with the support of your cancer care team, and maintaining your weight will help you stay strong and recover faster. To help avoid weight loss during and straight after cancer treatment, eat more protein, fat and carbohydrates. This approach is usually temporary − you can return to the usual guidelines for healthy eating once you have recovered.

How to manage weight loss

• Treat food like medicine: something you have to have in order to feel better.
• Set times for meals and snacks rather than waiting until you’re hungry.
• Carry snacks such as hardboiled eggs, muesli bars, dried fruit and nuts, crackers and fruit buns.
• Try ready-to-use nutritional supplement drinks when you are travelling or on other occasions when it is difficult to prepare a meal. Examples include Sustagen, Ensure and Resource.
• Choose nourishing fluids and snacks that are higher in protein and energy (kilojoules) − for example, drink milk rather than water and choose cheese and biscuits over lollies.
• Include high-energy and high-protein foods in every meal or snack.

Ways to add energy and protein

Add – full-cream cow’s milk, cream, coconut milk or soy milk (liquid or powdered versions)
To these meals and snacks – porridge, sauces, desserts, mashed vegetables, egg dishes, cream soups, scrambled eggs, congee, milkshakes, flavoured milk drinks (e.g. Milo, Akta-Vite)

Add – yoghurt or sour cream
To these meals and snacks – dips, salad dressings, fruit, potatoes, soups, rice dishes, lentil dhal

Add – butter, margarine or olive oil
To these meals or snacks – bread, toast, mashed potato, cooked vegetables, rice and pasta dishes

Add – cheese (e.g. cheddar, cream cheese, fetta, haloumi)
To these meals or snacks – scrambled eggs, sauces, soups, vegetables, casseroles, salads, toast, sandwich fillings, pasta sauce, crackers, tacos

Add – mayonnaise (commercial)
To these meals or snacks – egg or chicken sandwiches, potato salad, coleslaw, salad dressing, fish

Add – peanut butter or other nut butters
To these meals or snacks – bread, toast, porridge, crackers, pancakes, scones, fruit, smoothies

Add – avocado
To these meals or snacks – toast, sandwich fillings, dips, salads, crackers, smoothies

Add – nuts and seeds
To these meals or snacks – porridge, muesli, yoghurt, salads, baked goods, stir-fries, desserts

Add – beans or legumes
To these meals or snacks – rice dishes, toast toppings, salads, pasta dishes, soups

Add – egg or tofu
To these meals or snacks – toast, sandwich fillings, stir-fries, mashed potato, soups, pasta sauce, salads

Although it is more common to lose weight during treatment, some people gain weight. This can happen as a side effect of treatment. Some chemotherapy drugs and steroid medicines can cause your body to retain extra fluid in cells and tissues. This is called oedema, and it can cause weight gain and make you feel and look puffy. Hormone therapy lowers the amount of hormones in the body, which slows your metabolism. Steroid therapy can increase abdomen size, cause fluid retention, and lead to a rounded, puffy face. Feeling stressed or upset can also make some people eat more, and being tired because of the treatment may mean you exercise less.

If you gain weight during treatment and are concerned, speak to your doctor or dietitian about how to best manage it. It is important that your body gets enough food, so do not try a weight loss diet without guidance from a health professional.

If treatment side effects mean you cannot eat a balanced diet, or you are losing weight without trying, food-type nutritional supplements can increase nutrient intake and help maintain your strength and energy. They are best used as snacks between meals, or some can be added to drinks or meals.

Many pharmacies and supermarkets sell these specially formulated nutritional supplements. They come in different flavours and forms, including powdered (to sprinkle on food or into drinks or water), ready-to-drink liquids, and ready-made puddings, custards and jellies. There are versions to suit different nutrition needs, e.g. high fibre, neutral taste, low lactose, gluten free, low glycaemic index.

Ask your doctor or dietitian which ones would be most suitable for you. Although many supplements do not require a prescription, a prescription will sometimes reduce the cost. If you are having difficulty swallowing, talk to a speech pathologist for directions on thickening the supplement.

Vitamins and minerals are an essential part of a healthy diet and play an important role in the body’s immune system. It’s best to get your vitamins and minerals from eating whole foods, as these are easier for the body to absorb. If you are able to eat a variety of foods, you usually won’t need to take vitamin and mineral supplements. Some people believe that taking high doses of certain vitamins will strengthen the body’s immune system during cancer treatment. However, there is little evidence to support this claim. In fact, many vitamins and mineral compounds can be toxic at high levels, and may affect how radiation therapy,  chemotherapy and other medicines work.

If your appetite is poor, check with your doctor or dietitian before taking any vitamin or mineral supplements.

Many people with advanced cancer have problems with ongoing nausea and vomiting.

Nausea and vomiting may be caused by pain medicines, cancer growth, blockage of the bowel (see opposite), slower digestion, or high calcium levels in the blood (hypercalcaemia). Feeling tired or anxious may make the nausea worse.

Suggestions to reduce nausea

• Take anti-nausea medicines as prescribed, paying special attention to the timing (e.g. if your prescription says to take before food). Let the doctor know if the medicines don’t seem to be working, as they can offer you a different one to try.
• Have a light snack before chemotherapy, and wait a few hours before eating again.
• Eat small meals frequently (every 2–3 hours) during the day. Going without food for long periods can make nausea worse.
• Snack on dry or bland foods, e.g. crackers, toast, dry cereals, bread sticks or pretzels.
• Choose cold food or food at room temperature instead of hot, fried, greasy or spicy foods.
• Eat and drink slowly, and chew your food well.
• Try drinks and foods with ginger, e.g. non-alcoholic ginger beer, ginger biscuits.
• Avoid foods that are overly sweet, fatty, fried, spicy or oily, or that have strong smells.
• Brush teeth regularly and rinse mouth to help reduce unpleasant tastes that may make you feel nauseated.
• Don’t eat your favourite food when feeling nauseated; otherwise, you may develop a permanent dislike.

Suggestions to cope with vomiting

• Sip small amounts of fluids as often as possible. Try dry ginger ale, cold flat lemonade, soda water, Lucozade, sports drinks or chilled tomato juice.
• Try sucking on a hard lolly, crushed ice cubes or an iceblock – this can be soothing.
• See your doctor if you are unable to keep fluids down, or if vomiting lasts for more than 24 hours, as there is a danger that you may become dehydrated.
• Introduce drinks slowly once the vomiting has stopped, e.g. clear, cool drinks; diluted fruit drinks; Bonox/Bovril (beef extract rich in iron, minerals and vitamins); clear broth; and weak tea.
• Start eating small amounts of plain foods once vomiting is under control, e.g. dry biscuits; pretzels; toast or bread; jelly; cooked cereals (such as lemon sago or boiled rice); and soft stewed fruits (such as apples, pears or peaches).
• Introduce milk gradually and in small amounts, or have yoghurt, which is more easily digested.
• Gradually increase your food intake until your eating returns to what is normal for you. Your doctor or dietitian may advise you to take a nutritional supplement on your good days to make up for the days when you can’t eat properly.

People with advanced cancer may have a dry mouth or a sore mouth and throat. These problems may be caused by drinking less or by some types of treatment.

Download our fact sheet ‘Mouth Health and Cancer Treatment’

Surgery in the abdominal area sometimes causes the bowel to become blocked (bowel obstruction). This can also happen if the cancer comes back. Because waste matter (faeces) cannot pass through the bowel easily, symptoms may include feeling sick, vomiting, or abdominal discomfort and pain. To relieve symptoms of a bowel obstruction, you may have a small tube (stent) put in that helps keep the bowel open. The stent is inserted through the rectum using a flexible tube called an endoscope.

People with advanced cancer may develop a muscle wasting syndrome known as cachexia. This means the body isn’t using protein, carbohydrates and fats properly. Symptoms include:

• severe loss of weight, including loss of fat and muscle mass
• feeling sick (nausea)
• feeling full after eating small amounts
• anaemia
• weakness and fatigue.

Your doctor or dietitian will discuss the best way for you to manage cachexia. They may suggest a diet high in energy and protein, nutritional supplements, or medicines such as appetite stimulants. If you continue to have problems maintaining your nutrition, your treating team may recommend feeding via a tube in the nose (nasogastric or NG tube) or stomach (often known as a PEG tube). However, each person is different and, depending on your situation, tube feeding may not be recommended.

• baked beans on toast with grated cheese
• crumpets or muffins toasted with cheese, and fruit
• scrambled or poached egg on toast and a glass of orange juice
• tuna or sardines on buttered toast with fresh tomato
• cheese and mushroom omelette with buttered bread
• toast with cheese, avocado or peanut butter, followed by sliced banana and yoghurt
• toasted muesli with full-fat milk and yoghurt
• porridge or rice pudding made with milk and cream

• fresh or frozen fish with chips and salad
• grilled lamb cutlets, mashed potato with margarine or butter, and peas and carrots
• pasta with cheese and a ready-made sauce, e.g. pesto or bolognaise
• lentil dhal with chapatis or rice
• salmon, tuna or egg with commercial mayonnaise, salad and buttered bread roll
• frozen or fresh lasagne or moussaka
• frittata or quiche
• occasional takeaway such as noodles, stir-fry, curry and rice, hamburgers or pizza (ensure the food is freshly cooked)
• refrigerated leftover food from the previous day – reheat till steaming
• microwave potato with baked beans
• egg, tempeh and cooked vegetables with gado gado (peanut) dressing
• wrap with falafel, hummus and salad

• cheese or hummus and crackers
• buttered pikelets, scones, muffins, fruit buns, finger buns or raisin toast
• celery with cream cheese or peanut butter
• hard-boiled eggs
• dried fruit and nuts
• jaffles and sandwiches – try fillings such as egg and commercial mayonnaise, cheese, peanut butter, avocado, canned salmon or tuna
• milk puddings, such as creamed rice/rice pudding, custard, mousse and instant puddings
• fresh or tinned fruit with custard, yoghurt, jelly, ice-cream, cream or condensed milk
• creamy soup made with milk, and buttered toast
• hot chips, chicken nuggets or fish fingers
• instant noodles with frozen vegetables
• potato crisps, pretzels or corn chips with dips
• yoghurt or ice-cream
• frozen sausage rolls, meat pies or samosas

• enriched milk mixed with Akta-Vite, Milo or Horlicks
• milkshake
• banana smoothie
• mango or apricot lassi
• hot chocolate
• flavoured milk
• apricot lemon crush

These meal suggestions are simple to prepare, and some can be frozen to eat later. Most of these suggestions are suitable for a soft diet or can be minced or pureed, if needed.

Stewed fruit with custard or cream

Ingredients
3–4 pieces seasonal fruit (e.g. pear, apple, plum), peeled, cored, chopped
1 cup orange juice
1 cup full-cream custard or ice-cream (or 2 tbsp cream)

Method
Place fruit and orange juice in a medium saucepan over low heat. Cook for about 20–30 minutes, stirring occasionally until fruit softens (the total time will depend on the hardness of the fruit).

Serve with the full-cream custard, ice-cream or cream.

Congee

Ingredients
1 cup long-grain white rice (uncooked)
7 cups chicken or vegetable stock
2 cm knob of ginger, peeled and thinly sliced
salt, soy sauce or sesame oil (optional)
2 tbsp sliced green shallots (optional)

Method
Add rice, stock and ginger to a large pot and bring to the boil, then reduce heat to low. Simmer for 1 hour, stirring occasionally to stop rice sticking to the pot, until the congee is thick and creamy. Add salt, soy sauce or sesame oil to taste and top with green shallots if preferred.

For protein, add 200 g diced chicken breast near the end of cooking. Leave for 5 minutes or until chicken is cooked.

Meatballs

Ingredients
500 g beef, lamb, pork or chicken mince
½ cup plain breadcrumbs
herbs and spices (optional)
1 egg, lightly beaten
salt and pepper, to taste
1 tbsp margarine/butter or olive oil
2 tbsp flour
1½ cups water or stock

Method
Combine mince, breadcrumbs, herbs and spices (if using) and egg in a bowl. Season to taste with salt and pepper. Mix well with a fork and form into golf-sized balls. Heat the margarine or oil in a frying pan and cook meatballs until brown. Remove meatballs from pan.

Combine the pan juices, flour and water or stock and cook on a low heat until a thick gravy forms. Add the meatballs to the gravy and simmer for 1–1½ hours.

Serve with mashed potato, rice or pasta.

Cheesy vegetable bake

Ingredients
oil, for greasing dish
400 g sweet potato or pumpkin, peeled and thinly sliced
1 parsnip and 1 carrot, peeled and thinly sliced
4 potatoes, peeled and thinly sliced
½ cup thickened cream
½ cup cheddar cheese, grated

Method
Preheat oven to 180°C. Brush a medium ovenproof dish with oil. Layer the vegetables in the prepared dish. Drizzle each layer with a small amount of cream. Top with the remaining cream and sprinkle with cheese.

Bake for 1 hour or until vegetables are tender and top is golden brown.

You can use whatever vegetables you have.

Nourishing drinks are high in protein, energy, vitamins and minerals. They include ready-to-drink nutritional supplements, as well as drinks that you can make at home.

Enriched milk

Ingredients
1 L full-cream milk
4 or more heaped tbsp milk powder (increases nutrients and protein)

Method
Thoroughly mix ingredients in a jug until powder is dissolved. Use straightaway, or keep refrigerated and use within 24 hours (stir before use).

Use this enriched milk in tea and coffee, cereal, soups, sauces, scrambled eggs, milkshakes and smoothies.

Apricot lemon crush

Ingredients
425 g can apricot halves in natural juice
1 cup natural yoghurt
juice of 1 lemon
1 tbsp honey
2 tbsp wheatgerm
crushed ice

Method
Place all ingredients in a blender and blend until smooth.

Milkshake

Ingredients
1 cup milk or milk alternative (e.g. soy milk)
1 heaped tbsp milk powder*
1 scoop ice-cream topping, e.g. chocolate, strawberry, coffee, vanilla

Method
Place all ingredients in a blender or milkshake maker and blend until smooth.

Banana smoothie

Ingredients
1 cup milk or milk alternative (e.g. soy milk)
1 heaped tbsp milk powder*
1 ripe banana
1 scoop ice-cream
1 tsp honey (optional)

Method
Place all ingredients in a blender and blend until smooth.

You can use whatever fruit you have – fresh, frozen or tinned.

Mango lassi

Ingredients
1 cup canned mango slices in natural juice, with juice
1 heaped tbsp milk powder*
1 tsp honey
½ cup full-cream natural or vanilla yoghurt
3 ice cubes

Method
Place all ingredients in a blender and blend until smooth.

Use 1 cup canned apricot halves instead of mango if you prefer.

* Instead of milk powder, you can use a powdered nutritional supplement such as Sustagen Hospital Formula, Ensure Powder, Fortisip Powder or Enprocal – for the amount per serve, refer to the packaging or follow the advice of your dietitian. 

Soup can be easy to digest, nourishing and versatile. You can:

• try clear soups to stimulate the appetite and provide extra fluid, but don’t have them too often as they are low in protein and energy
• add energy and/or protein to soups with meat, chicken, legumes (lentils, chickpeas, beans), cereals (rice, pasta, noodles, barley), cheese, cream, butter, margarine and oil
• vary the taste with nutmeg, ground cumin or curry powder
• puree or blend soups if you have difficulty swallowing
• thicken soups with pureed vegetables, cream, eggs or enriched milk.

Foundation broth

Ingredients
250 g meat on the bone (any cut)
600 mL water
30 g cereal (e.g. sago, rice or pearl barley), washed
1 stalk celery, finely chopped
1 carrot, peeled and finely chopped
1 onion, peeled and finely chopped
salt and pepper

Method
Remove the fat from the meat and cut into small pieces. Soak meat and bones in cold water for 30 minutes, then bring slowly to the boil. Add cereal once soup is
boiling. Simmer for 1 hour.

Add vegetables to soup and simmer for 30 minutes. Remove bones, and season to taste with salt and pepper.

Creamy potato and leek soup

Ingredients
1–2 tsp olive or vegetable oil
2 leeks, sliced
1 tsp cumin seeds
1 kg potatoes, peeled and chopped
5 cups vegetable or chicken stock
½ cup cream

Method
Heat oil in a large saucepan and cook leek until soft. Add cumin seeds and cook for 2 minutes. Add potato and stock to the pan and bring to the boil.

Simmer for 25–30 minutes until potatoes are tender. Puree in a blender or food processor until smooth. Stir in cream.

Vegetable soup

Ingredients
1 tbsp olive or vegetable oil
3 cups diced vegetables
2 tbsp flour
2 chicken stock cubes
3 cups water
3 tbsp tomato paste
400 g can butter beans, drained
and rinsed
½ cup milk
½ cup cream
½ cup rice

Method
Heat oil in a large saucepan and fry vegetables for 5 minutes. Add flour and stir. Add crumbled stock cubes, water, tomato paste and butter beans. Simmer for 30 minutes or until vegetables are tender.

Blend the soup in a blender or food processor until smooth. Return soup to saucepan and add milk, cream and rice. Simmer soup for 15–20 minutes until rice is cooked.

Use potatoes, carrots or whatever vegetables you have.

Marinating helps to tenderise, add flavour or change the taste of meat or tofu. The following marinades are enough for four serves of beef, pork, lamb, chicken or tofu. For best results:

• combine the marinade ingredients and whisk together before adding the meat or tofu
• marinate the meat or tofu in the fridge for at least 2 hours or overnight
• drain the marinade before cooking to prevent stewing and splattering
• cook the meat at a lower temperature than usual if the marinade contains honey or sugar – this will help stop the marinade charring.

Asian marinade

2 tbsp soy sauce
1 tbsp sesame oil
1 tbsp honey
2 tsp garlic
ground black pepper

BBQ marinade

3 tbsp tomato sauce
2 tbsp Worcestershire sauce
1 tbsp brown sugar
½ tsp mustard (optional)
1 tsp vinegar
squeeze lemon juice (optional)

Honey mint marinade

½ tsp sesame oil
1 tbsp lemon juice
½–1 tsp minced chilli
1 tbsp mint leaves, chopped
2 tsp honey

Lime marinade

1/4 cup olive oil
½ cup lime juice
2 tbsp finely chopped coriander
1 tsp sugar
1 tsp sesame oil

The University of Tasmania and Centre for Rural Health has developed a number of culturally diverse recipes, specifically for people living with cancer.

Chinese recipes. Download the PDF

Greek recipes. Download the PDF

or you can watch instructional recipe videos on YouTube:

Watch recipes

The nutritional needs of children with cancer are different to adults, as children continue to grow and develop during treatment. Work closely with your doctor and dietitian − they will monitor your child’s weight and growth closely during treatment.

Be flexible – Let your child eat when they feel like it, not just at mealtimes. Be flexible in food choices, e.g. allow your child to have the same foods often or breakfast cereal for dinner if that’s what they prefer.

Allow occasional treats – During treatment, any nourishment is better than none. Allow your child to eat fatty or sugary foods like cake, chips, chocolate and takeaway occasionally.

Eat at the table – Discourage your child from eating in front of the television as it can be distracting.

Make mealtimes fun – Focus on making mealtimes as relaxed as possible and see them as an opportunity to come together to share stories and discuss any problems. Regular family meals also give a child a sense of stability.

Being a carer can bring a sense of satisfaction, but it can also be exhausting and stressful. Trying to prepare food for someone who is having trouble eating can be especially challenging.

It is important to look after your own wellbeing, so you also need to eat well and get some exercise. Give yourself some time out and share your concerns with somebody neutral such as a counsellor or your doctor, or call Cancer Council 13 11 20. There is a wide range of support available to help you with both the practical and emotional aspects of your caring role.

Support services – Support services such as Meals on Wheels, home help or visiting nurses can help you in your caring role. You can find local services, as well as information and resources, through the Carer Gateway. Call 1800 422 737 or visit carergateway.gov.au.

Support groups and programs – Many cancer support groups and cancer education programs are open to carers as well as to people with cancer. Support groups and programs offer the chance to share experiences and ways of coping.

Carers Associations – Carers Australia works with the Carers Associations in each state and territory to provide information and services to carers. Call 1800 242 636 or visit carersaustralia.com.au.

Cancer Council – You can call Cancer Council 13 11 20 to find out more about carers’ services.