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How treatment causes diet problems

Cancer treatments can affect your appetite and cause problems with eating, drinking, and digestion.

Treatments

The treatments most likely to cause problems with eating, drinking and digestion are:

  • chemotherapy
  • radiotherapy
  • chemoradiotherapy
  • surgery to the digestive system
  • targeted cancer drugs
  • immunotherapy
  • bone marrow and stem cell transplants

Some treatment side effects are difficult to control. But doctors can manage most side effects, and there are things you can do to help you cope. You might have to take medicines to stop you feeling sick. Or have extra nutrients in high calorie and protein drinks.

In some situations, you might need drip or tube feeds.

Chemotherapy

Chemotherapy can kill healthy cells as well as cancer cells. This is what causes most of its side effects.

Different chemotherapy drugs cause different problems. Side effects that are most likely to cause problems with your eating, drinking and digestion are:

  • loss of appetite (anorexia)
  • feeling and being sick
  • diarrhoea and constipation
  • infections (with a fever you can lose your appetite, burn more calories and sweat more causing dehydration and weight loss)
  • mouth problems (changes in taste, ulcers, a sore and dry mouth, painful swallowing)

Radiotherapy

Radiotherapy damages healthy cells as well as the cancer cells.

Radiotherapy can cause short-term diet problems. This will depend on which part of your body have treatment. For example, radiotherapy to the head and neck can cause:

  • loss of appetite (anorexia)
  • taste changes
  • mouth ulcers
  • difficulty swallowing
  • painful swallowing
  • dry mouth
  • sore and inflamed gums
  • teeth problems

If you have treatment to your stomach or tummy (abdomen), you might have the following side effects:

  • diarrhoea
  • feeling and being sick
  • pain
  • inflammation in the bowel
  • blockages in the bowel making it difficult to absorb nutrients (long term side effect)

Radiotherapy can also cause tiredness. This can affect your appetite and put you off your food.

You might not feel like cooking when you’re very tired. This can stop you from eating balanced meals and cause weight loss.

Surgery

After any surgery, you may not feel like eating much for a while. Try to eat foods high in calories and in protein. It can help with healing and fighting infection.

You are more at risk of getting an infection if you are malnourished before surgery. It also takes more time to recover from your operation.

You might need tube or drip feeding to build you up if you are very malnourished. This can be before surgery or afterwards to help you recover.

Surgery to your digestive system often causes longer lasting problems with diet. The problems you have will depend on what you had surgery for:

  • swallowing problems after surgery to the food pipe or gullet (oesophagus) or voice box (larynx)
  • diarrhoea can be a problem after bowel, stomach or pancreatic surgery

Targeted cancer drugs

There are different types of targeted cancer drugs. They are drugs that work by ‘targeting’ those differences that help a cancer cell to survive and grow.

Targeted cancer drugs can cause side effects. The side effects that are most likely to cause diet problems are:

  • feeling and being sick
  • loss of appetite (anorexia)
  • diarrhoea
  • fever
  • tiredness

Immunotherapy

There are different types of immunotherapies. Immunotherapy uses our immune system to fight cancer. It works by helping the immune system to recognise and attack cancer cells.

Some of the side effects of immunotherapy that can cause diet problems are:

  • diarrhoea
  • inflammation of the small and large bowel (enterocolitis)
  • tummy (abdominal) pain
  • sore mouth
  • fever
  • feeling and being sick

Bone marrow and stem cell transplants

You have a bone marrow or stem cell transplant for several types of cancers. You have the transplant after very high doses of chemotherapy. You might have targeted drugs with the chemotherapy.

You may also have radiotherapy to your whole body. This is called total body irradiation or TBI.

The radiotherapy and chemotherapy have a good chance of killing the cancer cells. But it also kills the stem cells in your bone marrow.

Side effects

Treatments that can cause side effects during a stem cell or bone marrow transplant are:

  • high dose chemotherapy
  • targeted drugs if you have them

You might have extra side effects if you also have whole body radiotherapy as part of the treatment. The main side effects that can cause problems with diet are:

  • feeling and being sick
  • diarrhoea
  • sore mouth and sore throat
  • difficulty eating and drinking
  • loss of appetite
  • feeling tired and run down
  • infection

Graft versus host disease (GvHD)

Graft versus host disease (GvHD) can happen during a stem cell or bone marrow transplant. This is when the transplant is from a relative or an unrelated donor. The immune cells in the donors stem or bone marrow cells attack your body cells. This can cause:

  • severe diarrhoea
  • loss of appetite
  • feeling and being sick
  • tummy (abdominal) cramps
  • difficulty swallowing
  • painful swallowing
  • weight loss

Enteral nutrition and intravenous drips

Some people with diet problems during a stem cell or bone marrow transplant can have:

  • food through a tube into their stomach (enteral nutrition)
  • intravenous (drip) feeds called parenteral nutrition (PN)
Last reviewed: 
03 Mar 2020
Next review due: 
03 Mar 2023
  • Nutrition and Cancer
    Edited by Clare Shaw
    Wiley-Blackwell, 2011

  • Cancer: Principles and Practice of Oncology (11th edition)

    VT DeVita , TS Lawrence, SA Rosenberg

    Lippincott, Williams and Wilkins, 2019

  • The role of parenteral and enteral/oral nutritional support in patients with cancer

    A Jatoi and others

    UpToDate website

    Accessed March 2020

  • Nutrition in Cancer Patients

    P Ravasco

    Journal of Clinical Medicine. 2019 August; 8(8): 1211.

  • Management of toxicities from immunotherapy: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

    J Haanen and others

    Annals of Oncology 28 (Supplement 4): i119–i142, 2017

  • Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy

    T Lawrie and others

    Cochrane Database of Systematic Reviews 2017, Issue 2. Art. No.: CD012529.

  • The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. If you need additional references for this information please contact patientinformation@cancer.org.uk with details of the particular issue you are interested in.

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