If you have ongoing problems with food and eating, talk to a dietitian. Dietitians are experts in nutrition who can give you specialist advice on how to cope with nutrition-related problems and eating difficulties throughout different phases of the disease.

A dietitian can prepare eating plans for you and give you advice about nutritional supplements. Dietitians work in all public and most private hospitals. There may be a dietitian connected to your cancer treatment centre – check with your specialist or cancer care coordinator. Dietitians Australia can also help you find an Accredited Practising Dietitian who works in your area and specialises in cancer.

If your GP refers you to a dietitian, you may be eligible for a Medicare rebate to help cover the cost. If you have private health insurance, you may be able to claim part of the cost.

Eat small meals frequently (e.g. every 2–3 hours) and have a regular eating pattern rather than waiting until you’re hungry. Keep ready-to-eat food on hand for when you are too tired to cook (e.g. tinned fruit, yoghurt, frozen meals).

Ensure that meals and snacks are nourishing and include protein such as meat, chicken, fish, dairy products, legumes (e.g. lentils, chickpeas), eggs, tofu, nuts and nut butters. Choose nourishing drinks (e.g. milk, smoothies). A dietitian may also suggest nutritional supplement drinks.

If you can’t eat a balanced diet or are losing too much weight, your doctor or dietitian may suggest nutritional supplements such as Sustagen, Ensure, Fortisip or Resource. These provide energy, protein and other nutrients that can help you maintain your strength. A dietitian can recommend the right nutritional supplement for you and let you know where to buy it and how much to use.

Nutritional supplements should be taken in addition to the foods you are able to eat and are best used as snacks between meals. Supplements are available as ready-made drinks, bars, puddings and custards, and as powders to mix with milk or water, or to sprinkle on food.

There are different ways to add extra kilojoules to your food:

• add milk powder to cereals, sauces, mashed vegetables, soup, drinks, egg dishes and desserts
• add cheese to sauces, soup, baked beans, vegetables, casseroles, salads and egg dishes
• add sugar, honey or golden syrup to cereals, porridge or drinks
• use a powdered nutritional supplement recommended by your dietitian.

It’s okay to focus on eating foods that you enjoy. Gaining or maintaining weight is more important at the moment than avoiding extra fat and sugar.

You may find your sense of taste changes after treatment. If food tastes bland, add extra flavouring such as herbs, lemon, lime, ginger, garlic, honey, chilli, pepper, Worcestershire sauce, soy sauce or pickles. Eating moist fruits such as berries or sucking boiled lollies can help if you have a bitter or metallic taste in your mouth. 

If food smells bother you, ask family or friends to do the cooking. You may also prefer cold food or food at room temperature without a strong smell.

• Talk to your doctor about taking anti-nausea medicine half an hour before meals.
• Snack on bland foods such as dry crackers or toast.
• Try to eat a little bit at regular intervals – not eating or skipping meals can make nausea worse.
• Eat and drink slowly, and chew food well.
• Avoid strong odours and cooking smells.
• Drink ginger beer, ginger ale or ginger tea, or suck on candied ginger.
• Suck peppermint or lemon-flavoured boiled lollies.
• Listen to The Thing About Cancer podcast episode on appetite loss and nausea.

1. Take small sips – don’t try to force food down. Sip small amounts of liquid as often as possible. Try flat dry ginger ale, cold flat lemonade, weak cordial, or cold apple or orange juice.
2. Introduce nourishing fluids – if the vomiting has stopped but you still feel sick, slowly introduce more nourishing fluids. Start with cold or iced drinks. Prepare milk or fruit drinks with some water so they are not too strong. You can also try diluted fluids such as clear broth or weak tea.
3. Start solid food – next, try to eat small amounts of solid foods, such as plain dry biscuits, toast or bread with honey or jam, or congee (rice porridge) with little texture. Stewed fruits and yoghurt are also good. Aim to eat small amounts of food often, rather than three large meals a day.
4. Return to a normal diet – as soon as you can, increase your food intake until you are eating a normal, balanced diet. Limit rich foods, such as fatty meats or full-cream dairy products. Your doctor or dietitian may suggest extra nourishment (such as nutritional supplements) on your good days to make up for the days you can’t eat properly.

• Drink plenty of liquids (e.g. water, fruit juice, weak cordial) to replace lost fluids.
• Avoid alcohol and limit caffeine and spicy foods as these can all make diarrhoea worse.
• Try lactose-reduced milk or soy milk if you develop a temporary intolerance to the sugar in milk (lactose). This can sometimes occur when you have diarrhoea. Small amounts of hard cheese and yoghurt are usually okay.
• Always let your treatment team know about any bowel changes. For further support and tips, you can call the National Continence Helpline on 1800 33 00 66.

If these tips don’t work, talk to your doctor about whether to take anti-diarrhoea medicine.

You should also let your doctor know if your stools are pale in colour, oily, very smelly, float and are difficult to flush, or you notice an oily film floating in the toilet. This may be a sign that you do not have enough pancreatic enzymes. You may need to start enzyme replacement therapy or adjust your dose.