Chemotherapy

[NeroW]

Hi everyone!

Not as light-hearted as most of my usual posts , but I wondered if you'd share some of your experiences.

Someone close to me is starting chemo this week. I read that one of the side effects of chemo was that you might lose your appetite.

I'd like to try and help in my own way. He already has enough people to help him with yardwork and household chores if he gets tired, but what about in the kitchen?

Are there any particular dishes you've prepared for someone in chemotherapy that they enjoyed? He has already asked me for creme brulee.

If you have experiences with this, I'd like to hear from you, either via PM or this thread.

Thanks.

[niv]

My experience with this is that, within a few days of the chemo, there is very little you can make that would be palatable. If I remember correctly, strong flavors are especially a problem. This cycles, however, and sometimes people can get weird food cravings after several days (or weeks) have passed. Gotta go with the flow.

[chardgirl]

I did the chemo dance 4 years ago, and the meds they gave me to counteract the chemo side effects made me more hungry! I can only speak from my own experience and different chemo drugs have different side effects, but comfort food, however your friend defines it, is the best thing to prepare. He might be tired, I very much enjoyed it when my friends did dishes and babysitting! Sounds like you're headed towards making some creme brulee. He's a lucky patient.

[Chad]

My brother just went through this. He's finishing up his radiation now. Hodgkins lymphoma. I think the type of cancer and the aggressiveness of the chemo make a huge difference in the patient's appetite and ability to eat. They put my brother on an extremely aggressive chemo schedule called the Stanford Five. It's fast but brutal. They rotate meds each week as you cycle through the therapy. He went from about 210 to 160-something during the course of it. The tumors pressing on his stomach made eating difficult anyway, so the nausea-induced lack of appetite only made things worse.

With that said, there were a lot of high-protein shakes involved, just to keep his weight and strength up. He was really only able to keep down one meal a day at best, though he did have occassional food cravings. One day it was a Big Mac -- that, and only that, was what he wanted. The thought of anything else made him ill. Go figure.

So, whatever the patient feels like eating is what you need to feed him. Be aware that the chemo drugs can make him very sensitive to strong tastes and smells. My brother had to give up coffee because the smell of it made him sick. Same thing with any spicy foods, which he dearly loves. You might check with the oncologist to see if the chemo regimine has any food no-nos associated with it. And stock up on high-protein weight gain shakes like bodybuilders drink.

This is only from my limited experience, so take it for what it's worth.

Chad

[blueapron]

Sorry to hear,

It does go in cycles for my mother and I came to find that it was truly the love you put into the dishes that made the difference. I had a hard time getting her to eat sometimes but that is to be expected. Cook their favorites and dont try to introduce too many new dishes or flavors. Mild bland food was what she needed at first because of the nausea from the chemo. American cancer society website has a thing about nutrition for patients. His immune system is so weak now that veggies like crucifers(broccolli) and tomatos give essential immune support. Think comfort food that has good nutrients.

Oh yea i forgot about the protien shakes thing-she loves the high protien Ensure drinks and the oncologist even had coupons for them in the waitng room.

Edited May 18, 2004 by blueapron (log)

[niv]

different chemo drugs have different side effects

You bring up a good point. Chemo is a generic name related to a host of different drugs. I imagine there are no good rules of thumb as to food reactions other than it sucks.

[enrevanche]

Follow his lead-- ask him what he wants and has a taste for, and cook it for him.

When my wife went through chemo a few years ago (she made a full recovery, thank God) she couldn't stand strong odors or flavors and found anything with much fat/grease in it revolting. We ate a lot of rice, lightly dressed pastas, soups, nibbled at cheeses and lightly cooked veggies. I basically made her anything she thought she could handle and felt like eating... so ask, and keep asking.

(Just IMed my wife, and she also suggests fruit salads with mellow flavors like banana, melon, etc. Also she enjoyed yogurt, smoothies, pudding, non-sugared cereal...also things like cold cucumber soup or three-bean salad. Key seems to be soft, subtle flavors, easy to chew.)

When my aunt went through chemo, she craved my peanut-butter cookies. Some days they were the only thing she felt like eating. I made batch after batch.

The side effects of chemo are much less horrifying these days than they used to be. Some people don't handle the anti-nausea drugs (e.g. compazine) all that well, however. In my wife's case, a few puffs of marijuana worked ten times better than compazine, without compazine's own troubling side effects. Without getting into the whole medical marijuana debate, I'll just say that depending on your friend's situation and how well he tolerates the anti-nausea meds, the discreet provision of a small bag of dope might be the nicest thing you could do for him.

[Mulcahy]

I think it very much depends on the patient and the types of chemotherapy. Two of my loved ones went through chemo and radiation and they reacted differently. Some people complain, on particular drugs, that everything tastes metallic and therefore don't want to eat. Others just lose their appetite entirely.

In my experience chemo patients need to be loaded with calories. Protein shakes are a good idea, so are Boost or Ensure. Cook things that you can hide calories in, because large portions are daunting in general. In other words, if you make grilled cheese (one loved one's favorite through chemo) add as much butter as possible. Veggies are important, but what is most important is getting enough food into the patient, and in some cases it becomes very difficult. As others have suggested anything bland is good (yogurts, pudding, etc.).

If you could let us know which drugs in particular yor friend will be taking, you might get even more targeted advice.

Good luck!

[GG Mora]

Everyone else has already given such good advice that mostly coincides with my experiences and observations. The avoidance of strong flavors & smells seems to be key. HOWEVER...the patient's appetite may also be informed by emotional issues and external influences that contradict the edicts of a chemo-addled body. I've found this to be particularly true in the terminal stages*, which I sense and hope is not where your "patient" is at.

When my longtime business partner was going through chemo, I cooked and brought him food as much as I could. He favored things like plain roast chicken, mac and cheese, meatloaf, mashed potatoes. A large vat of cold vichyssoise was, as I recall, the most welcome delivery during the hot sticky days of August. Suddenly one day, though, the smell of onions cooking got his appetite up and he wanted grilled onions on everything. So I made a large vat of caramelized onions, which he proceeded to put on everything for about 5 days until the smell of onions made him retch. Chemo is like that.

*About 4 days before my mother passed away after an ugly battle with leukemia, she asked if someone would please make her a whiskey sour, because she really just wanted a whiskey sour. Never mind that she had never been a whiskey drinker, and that she probably had no stomach lining left (if even a stomach). I made a huge pitcher of whiskey sours and me and my brother and sisters and Dad sat around the edges of her bed and had a cocktail party.

[bleudauvergne]

I'm so sorry to hear what some others have been and are going through. My thoughts are with you guys. It's true, it does depend on what kind of chemo it is.

Yes, do the creme brulee, if that's what your friend is asking for. And ask him how brullee'd he wants the top.

When my dad fought his battle, I cooked for the helpers. I could not cook long simmering comfort foods in the house. A neighbor was really gracious and turned her kitchen over to me so I cooked and brought the finished dishes back home for people to eat. One thing I was able to do at home was I made Jaiozi (Chinese dumplings) for everyone and little itty bitty jiaozi with very little filling and lots of skin just enough for him to feel the warm soft dumpling skin and swallow it for him. He was craving tart flavors and the vinegar hit the spot. Also fresh squeezed orange juice and fresh made lemonade. He appreciated the fresh squeezed citrus juices.

I suggest cooking for the helpers most of all, do it off site, and bring things ready to heat up and eat. The helpers are not going to be taking care of themselves much.

Do your best.

[lala]

As others have said, it's highly individual how each person reacts to chemo, and it does depend on what other drugs they're taking to deal with the side effects.

Both my Mom and best friend have gone through extensive chemo in the last two years, with differring side affects. (And my Dad had months of Radiation for his cancer last year, couldn't eat his usual oatmeal or veggies. It's been a fun few years.) Mom could eat most things, but had to cut back on her usual full flavorings (no garlic or lemon). Her teeth loosened due to the radiation (brain tumors), so it hurt to eat, so soft foods were good. My friend couldn't tolerate any strong flavors and aromas (goodbye fish!), and could not eat any vegetables. She's been off chemo for 5 months, and is just getting back into eating salads. Mom didn't lose her appetite, Friend did.

As each person is individual, so is their reaction depending on what day it is in relation to the chemo treatment. Be prepared with bland foods on the day of, and a few days after. Each of them tolerated creamy, lightly sweet things like custard. Bread pudding is a good way to get bulk and protein. Jello. Ensure. Toast and warm milk. Creamy, blended soups (add tofu for protien). Chicken with no sauce. Rice, either with a little butter and salt and pepper, or with hot milk and sugar. Regular muffins without bran. Mashed potatoes.

Then, it's just a matter of getting to know what works, and what doesn't. Ask for information from his doctor, or the cancer nutrition center to see what their particular treatment may do.

I'm sorry that your friend is going through this, but it sounds like he has a good support system, including you. Please know that it may be rough not only for him, but for you (it's hell to watch someone you love go through this), so be sure to treat yourself well, too. Please post again if you have any more questions.

[blueapron]

Such a sad topic, but it reaffirms one of my favorite reasons for being a cook/chef and that is that food brings people together and provides awesome memories.

The whiskey sour story almost made me cry.

[alacarte]

I'm encouraged by all the tales of chemo survivors. I'm so sorry for those who lost loved ones.

For my MIL, she craved bread, any kind of bread, and still does to this day (her chemo was 20 yrs ago). Her main avoidance was to oil and butter, anything too greasy made her nauseous.

Edited May 18, 2004 by alacarte (log)

[hillvalley]

I spent a summer helping a friend go through chemo and like you was on kitchen duty. When she couldn't eat we did a lot of chicken broth and added whatever carb or veggie she could handle.

The cravings were fun at times, milkshakes, sushi, steak (she was a vegetarian.)

This is not food related but still worth sharing. We had her friend each donate a gift (we let them decide how big or small). Then, when she got home from chemo she had a present to open. Sometimes it was a poem, or a new needlepoint project or a box of crayons and a new coloring book. Yes, she was in her mid-30's. This gave people a chance to feel like they were helping without her having to deal with people. And she had something to look forward to during her treatments.

The latest EGCI course, Cooking with Disabilities, goes up tomorrow. There are sections about eating through nausea, when you have no appetite or are on medication. It might be helpful.

Feel free to vent when you need to. Taking care of a loved one going through chemo is hard on everyone.

[hathor]

*About 4 days before my mother passed away after an ugly battle with leukemia, she asked if someone would please make her a whiskey sour, because she really just wanted a whiskey sour.

Funny...my husband's father only wanted a Manhattan.

When I was going thru my chemo 'thang...someone recommend Synergy to me for energy, hair and nail health, and overall feeling better kind of stuff. Even though my bout was a few years ago, I still drink the stuff. I'm referring to the Pure Synergy product. Here is a link.. It tastes pretty 'green', hence the name pond scum, but once I got used to it, I really felt it made a difference. Best of luck to your friend. I'm sure having such caring friends will make a huge difference as well.

[Toliver]

I agree with what's been said. My mom couldn't stand the smell of certain foods when she was going through chemo. What little she could eat (and keep down) was bland foods. Of course, that was 20 years ago and I am sure the meds have changed since then so perhaps your friend may have some sort of appetite. To play it safe, try not to cook foods at his house. Reheat it, yes, but don't cook it there due to the odors and the possibility he won't be able to tolerate them.

Be prepared to roll with the punches, so to speak. One day your friend may not want to even hear mention of food and the next he may want to eat everything in sight.

And what a blessing you are, NeroW. Here you are taking cooking classes and now a door has opened for you to use your skills to help a friend. Sometimes our paths through life are unlit...How fortunate that yours, for a time, has been illuminated.

Here is the "nutrition during chemo" section of the American Cancer Society's web site. Some of the sections have a lot of sub-sections covering a wide range of concerns from "When treatment causes eating problems" to "side effects of treatment". I hope this will help you.

[Fresser]

I recommend spicy, fatty foods such as spareribs, Chinese whatnot, et cetera.

Battling cancer is a war, and the body needs lots of ammunition in the form of food. Since chemo patients often lose their appetite, highly fatty foods bring a lot of calories in to the party, even in small portions.

Also, spicy food can counteract the effect of chemo on the patient's tastebuds.

[Ovenfrenzy]

I went through chemo for Hodgkin's a couple of years ago, and craved lots of carbs and fat. Comfort food. I couldn't get enough of dishes like cheddar mashed potatoes, macaroni and cheese, buttered bread. Once my mother-in-law made me a simple pot roast of beef and it was so wonderful and tasted of healing qualities.

I would avoid any smoked foods. I grilled a steak over some hickory chips during treatment and was up all night with the most horrid acid indigestion.

Best of luck to your friend.

[McDuff]

I would avoid any smoked foods. I grilled a steak over some hickory chips during treatment and was up all night with the most horrid acid indigestion.

My wife is 6 years down the road from an autologous bmt for non-Hodgkins lymphoma and suffers daily from acid reflux and indigestion. She can eat almost anything, but abhors the smell of boiling vinegar and can't stand the feel or look of raw meat. She seemed to be able to tolerate almost anything when on chemo, but was noodgy about the raw vegetable thing and really followed the recommendation to stay away from buffets, especially after we saw an old man flick a booger into egg foo yung at a local Chinese buffet.

[Paula Jonvik]

So sorry to hear... but keep a positive attitude... and cheers to the eGullet community for the outpouring of compassion!

I have had several folk around me take all types of chemo but the really important thing it I took away from the experiences was that cooking in METAL pots made things taste metalic to them.

Avoid aluminum at all costs and try to use glass...

Good luck to you and yours.

[hillvalley]

When my dad fought his battle, I cooked for the helpers. I could not cook long simmering comfort foods in the house.

This is a really good point. When my grandfather had chemo he would crave certain foods, but the smell of it cooking made his stomach sick. My grandmother cooked a lot of meals at her neighbors kitchen down the hall.

[balmagowry]

There's not a lot I can add to what's already been said here, except to confirm the degree to which the side-effects of chemo can be an utter crap-shoot, from day to day, from session to session, from drug to drug, in the same patient. My mother died of her eighth cancer but successfully thumbed her nose at the first seven. She didn't have chemo for all of them, but when she did you just never knew what she was going to crave or to be able to choke down. Whatever it was - I was there with it, and only too glad to get the calories into her any way I could. During her final illness (some serious chemo that time, including cisplatin injected directly into the lung) there were ups and downs - a bad period when she just wasn't interested in eating at all; and she so loathed things like Ensure that when she was loopy on pain meds I had to trick her or blackmail her into taking even a few sips. (Fortunately for the sanity of all concerned she came out of that for the last week or two, and I had the satisfaction of seeing her eat - and really enjoy - two hearty meals on her last day.) Funny, her palate didn't change much, even during her most extreme reactions - but her appetite did. She wasn't big on sweets as a rule, but she did love bittersweet chocolate. I thought I'd gone to heaven when I discovered the Godiva dark chocolate ice creams - not only did she love them, but their flavor was so mousse-like that at her own suggestion I gave her heavy cream to pour over them. Calorie after calorie after lovely calorie.

Here's another thing to be prepared for if it's a really fierce chemo regimen: an extremely capricious appetite. I live five minutes from the hospital, and at one point when she hadn't been eating much for a while I was thrilled when she called me and said she really really wanted a tuna sandwich. Ace hospital caterer, I whirled round and dished up a tempting batch, put it in a neat little vat, and came hotfoot to the hospital with bread and lettuce in separate containers etc so I could put it all together fresh on the spot. By the time I got there... she wasn't interested any more. There's nothing harder than putting a good face on that.

Them's my words of wisdom for what they're worth. I'll be thinking of you and your friend.

GG - I love your whiskey sour story. Yeah, it makes a catch in the throat, but the cocktail party is right up my alley. Over the years I made it a habit to bring in vodka whenever my mother was in the hospital (and when it was safe for her to have it - I ain't STOOPID), and we'd have a couple of drinks together and whatever dinner I'd brought in, watch the news together or just chat, most companionable. Until that last time, her bedside was always where the party was.

[pjs]

Five years ago I did a couple of rounds of induction and the same in consolidation chemo to treat AML leukemia.

Nero, I think a large part of the problem is that even if the patient craves something they will tire of it quickly, as I did. So, different favorites to eat in small portions would be my advice in hindsight. Scrambled eggs always worked, but those ridiculously expensive cans of Ensure would make me want to heave just reading the ingredients on the label. Try Carnation Instant Breakfast instead, preferably with whole milk--or even better real milkshakes or malts.

PJ

[JAZ]

Not too much to add, except to say that it does seem to vary from patient to patient. My sister's currently undergoing chemo, and she's doing pretty well, considering. She can't eat much at one sitting, and as others have recounted, her appetite can be capricious.

What she's most appreciated are dishes that she can freeze, to be thawed and heated when she is in the mood to eat but doesn't want to cook. Casseroles, lasagne, mac and cheese -- that sort of thing.

[Pan]

My father had stage 4 chronic lymphocytic leukemia in 1995-96. During that time, he drastically reduced his food intake and has continued on a low-intake diet ever since, in various guises, and to good effects, losing weight and feeling healthier - but none of this is a general comment on chemotherapy. However, if you haven't already done so, I recommend that you ask your friend whether nutritionists or other medical people have told your him he should eat more or less of certain foodstuffs or nutrients, etc. Also, does your friend have to force himself to drink tremendous quantitites of water for several days in each cycle, in order to flush the chemicals and dead cells out of his system? That's an important thing to know (he probably already told you if he has to do this, but I mention it anyway).

The only other general advice I'd offer is that you can help him by being positive and supportive. When my father was trying to fight off the ravages of the cancer, my mother, brother and I were scared shitless and I think all of us doubted he would survive his crisis, but we did our best never to let this on to him and to always be as positive as we could under the circumstances (not Polyanna-like behavior, of course, which would have been obviously fake and objectionable). Had I told him what I understood his chances at surviving for just another year were, I think he would have died. As it is, he beat the odds and, despite various problems and challenges, he seems to stand a decent chance to not only celebrate his 75th birthday at the end of this year but reach 80, God willing.

My heart goes out to all of you who've had chemotherapy yourselves or cared for a loved one through successful or unsuccesful treatments. I'm not up on all the latest research, but my feeling is that most chemotherapies are still more or less harsh and plagued with sometimes pretty serious side effects, not least on systems directly relevant to digestion and excretion. But what is, is, and the best that a patient and his loved ones can do is to genuinely make the best out of it, whenever that's possible.

We're your online friends, so please come to us any time you need a little support, because this won't be easy for you, but it's one of the most important things you can do in life.