Diet and Cancer

The most common nutritional problems for mesothelioma cancer patients include consuming too little protein and too few calories. Both protein and calories are essential to aid recovery, support immunity and fight fatigue.

Begin with a balanced, healthy diet. A balanced mesothelioma diet can help you feel better, maintain weight and energy, fight off infection, manage side effects of cancer treatment and recover more quickly.

Before dietary changes are made, all patients should consult with their mesothelioma doctor.

Top Diet Tips for Cancer Patients

  1. Eat 5-6 small meals or snacks every 2 or 3 hours instead of 3 large meals a day.
  2. Eat nutrient-dense foods such as full-fat Greek yogurt, eggs, salmon and homemade milkshakes using whole milk, fruit and protein powder.
  3. If cooking smells bother you, avoid kitchens during cooking. Also try colder foods such as sandwiches or cheese with crackers.
  4. Taste changes are common, especially with chemotherapy. Try sweet, sour, salty and bitter flavors to identify what your taste buds can handle.
  5. A mouthwash of 1 qt. water, ¾ teaspoon salt and 1 teaspoon baking soda clears taste buds and relieves dry mouth.
  6. If you’re not eating every 3 hours, set a timer. It’s easy going half a day without eating or drinking.
  7. Stay hydrated. Water is great, but milk, 100% fruit or vegetable juices, and soups will hydrate and provide nutrients.
Tejal Parekh
Registered & Licensed Dietitian

Foods to Aid Recovery

Some foods contain nutrients that may support recovery after mesothelioma treatment. Though more research is needed. Also, some foods can have negative interactions with mesothelioma drugs such as chemotherapy. Speak to your doctor about possible interactions.

While antioxidants are generally considered part of a healthy diet, many chemotherapy drugs use free radicals to attack cancer cells. Patients receiving chemotherapy may be advised to avoid foods and supplements high in antioxidants.

Speak with your doctor about adding the following foods to your diet.

  • Omega-3 Fats in Fish: May reduce harmful weight loss and inhibit metastasis.
  • Fiber-Rich Foods: Vegetables, fruit, beans, potatoes and nuts can balance insulin levels, possibly minimizing cancer cell growth.
  • Spices: Turmeric, basil, oregano, rosemary, mint, dill and others may have anti-cancer and anti-inflammatory benefits.
  • Natural Sources of Coenzyme Q: The nutrient in beef, chicken, pork, trout, herring, sardines, soybeans, lentils and peanuts may protect the heart from chemo damage.
  • Green Tea (Brewed from Loose Leaf or Tea Bag): Rich in antioxidants.
  • Other Herbal Teas: Chamomile, ginger, mint and hibiscus may have anti-cancer properties.
  • Medicinal Teas: Essiac tea or moringa leaf are antioxidant-rich and may have anti-cancer actions in the body, though more research is needed to assess potential benefits.

Nutritional and herbal therapies usually are not as well researched as mainstream medications, which makes it even harder to predict what problems they may cause when combined with chemotherapy. Even traditional supplements doctors may recommend for some people can have negative interactions for mesothelioma patients. For example,  vitamin B6 supplements can interact negatively with cisplatin.

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Vitamins, Minerals, Herbs and Other Dietary Supplements

Your doctor or dietitian will let you know if they advise the use of dietary supplements. Some mesothelioma patients may benefit from a vitamin supplement if, for example, they have a nutrient deficiency.

However, you should avoid most dietary supplements during cancer treatment because they can interfere with the effectiveness of cancer therapies. If you want to take any over-the-counter supplements or medications, ask your oncologist first.

Meal Planning

Meal planning can alleviate some of the stress associated with food shopping and meal prepping when crafting your mesothelioma diet.

When food shopping, stock up on the patient’s favorite foods and items important for meeting their nutritional needs. This can reduce the need to shop often.

Planning Healthy Portions

The U.S. Department of Agriculture retired the Food Guide Pyramid years ago and replaced it with My Plate. However, My Plate isn’t designed to give people with cancer information about their specific nutrition needs before, during and after treatment.

Health Eating Plate
A diet to follow for mesothelioma patients

The Harvard School of Public Health created the Healthy Eating Plate — a better starting place for designing a healthy diet for people with mesothelioma.

The effects of cancer and treatment can make it difficult to eat. You’ll need to adjust the Healthy Eating Plate guidelines during cancer therapy to find the best mesothelioma diet for you.

For most mesothelioma patients, it’s helpful to increase the protein portion of the plate and decrease whole grains a bit. Replace green vegetables, salads and other lower-calorie foods with starchy vegetables such as potatoes and sweet potatoes. In some cases, you may need to add a high-protein, high-calorie liquid nutrition supplement.

Rarely, mesothelioma may also cause hypoglycemia, a form of low blood sugar that can be controlled through medication and diet. In 2021, a case study was reported on a 77-year-old man who developed nonislet cell tumor hypoglycemia (NICTH) associated with malignant mesothelioma. Mesothelioma is responsible for 8% of NICTH cases.

Tips to Get More from Your Meals

  • Eat multiple small meals throughout the day instead of three large ones.
  • Snack whenever you are hungry, even if it is not mealtime, and enjoy the foods that appeal to you at the time.
  • Drink liquids after meals or as snacks, not before or during mealtime. Liquid can fill you up before you have the chance to consume the whole, nutrient-dense foods on your plate.
  • Include a portion of protein, such as poultry, fish, eggs, beans or peanut butter, at each meal.
  • Juice fresh fruits and vegetables to obtain their nutrients without filling up. If you don’t own a juicer, you can create juice with a blender and cheesecloth. Blend fruit or vegetables with filtered water, then strain with a cheesecloth, which is available at most grocery stores.
  • Consume your favorite foods any time of day. If you love breakfast foods, it’s OK to eat them for lunch or dinner.
  • Create a joyful or relaxing setting by enjoying your food in the company of friends or family.

Tips to Add Protein

  • Eat protein-rich foods regularly, such as chicken, fish, lean beef and pork, Greek yogurt, beans, nuts, spinach, cheese, eggs and soy foods such as tofu or tempeh.
  • Add cheese to omelets, sandwiches, soups, salads and casseroles.
  • Increase protein in milk by blending one packet of dry milk powder into one quart of whole milk.
  • Powdered milk can also be added to milkshakes, cream-based soups and mashed potatoes.
  • Add cooked meats to omelets, soups and salads.
  • Snack on cheese, nut butters, roasted nuts or sliced meats.
  • Blend nut butters or ice cream into smoothies and milkshakes and add vanilla or plain whey protein powder for a more balanced snack or meal.
  • Choose desserts made with eggs such as cheesecake, custard and pudding.

Tips to Add Calories

  • Avoid foods labeled as low-fat, non-fat and low-calorie. For example, choose whole milk in place of reduced fat.
  • Opt for high-calorie drinks such as milkshakes with added ice cream or fruit nectars.
  • Cook with butter and oil, and add them to meals when possible. For example, top vegetables and bread with butter, or toss oil into rice, pasta and casseroles.
  • Add avocado to sandwiches and salads. Eat guacamole with tortilla chips.
  • Smear cream cheese onto bagels, sandwiches or crackers.
  • Toss salads with high-calorie dressings.
  • Top vegetables with creamy or cheesy sauces.
  • Add Greek yogurt, heavy cream or sour cream to dessert recipes, sauces and soups.
  • If sweet flavors are appealing, add whipped cream or chocolate sauce to pancakes, waffles, French toast, ice cream and cakes.

Prepare meals in advance and freeze them in meal-sized portions that are easy to heat. If you want help with planning your meals or preparing a grocery list, talk with a dietitian.

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Understanding Nutrition During Treatment

Mesothelioma treatment can affect your ability to eat as you normally do. You can take proactive measures to meet nutritional needs for each type of treatment.

Surgery

Certain surgeries can complicate eating. Some peritoneal mesothelioma patients may receive nutrition intravenously for a short period of time after abdominal surgery.

If you are underweight, you may need to gain weight before surgery. A healthy weight prior to mesothelioma surgery can improve wound healing, reduce infection risk and aid recovery.

Proper nutrition after your surgery will also replace blood loss and increase your level of energy. Post-operative care and nutrition are important considerations for patients returning to normal health.

Chemotherapy

Chemotherapy affects chewing and digestion because the treatment kills cells in the mouth, hair follicles and digestive tract.

If mouth sores develop from the treatment, cool or lukewarm, soft foods may reduce chewing.

Some patients receiving cisplatin experience extreme cold sensitivity. If this happens, avoid handling or eating cold or frozen foods.

Chemotherapy also may cause nausea, decrease appetite or change the way food tastes. Alterations to your diet and eating habits can help you cope with these side effects. For example, if food tastes metallic, eating with plastic or wooden utensils can help.

Radiation Therapy

Receiving radiation therapy around the chest can impact swallowing. It is rare for peritoneal mesothelioma patients to receive radiation around the abdomen, but this can cause digestive issues such as nausea, vomiting, cramps, bloating and diarrhea.

Immunotherapy

Immunotherapy unleashes the immune system to recognize and destroy cancer. Because the treatment removes the usual brakes on immune cells, they can attack normal tissue, too.

Side effects of immunotherapy may include diarrhea, vomiting, trouble breathing, cough, rashes, vision changes. They require immediate attention by your oncologist, who may use steroids and other medications to tamp down immune attack on healthy tissue.

Pain Medications

Certain pain medications can decrease appetite, cause nausea and contribute to constipation. Increasing dietary fiber and water can help lessen constipation.

Always drink plenty of water when increasing fiber because without adequate fluids, constipation may worsen.

Eating enough during treatment is always the goal but often times easier said than done. I find making small changes can make a big impact on your nutrition plan.

Tejal Parekh
Registered & Licensed Dietitian

Food Safety and Mesothelioma

For people undergoing mesothelioma treatment, food safety is crucial. Cancer therapies, such as radiation and chemotherapy, often weaken the immune system. And a weakened immune system may not properly fight bacteria, parasites or other potentially dangerous organisms in food.

The U.S. Department of Health & Human Services outlines four important steps to ensure food safety: Clean, separate, cook and chill. Avoid raw or undercooked meat, poultry, seafood and eggs. Unpasteurized or raw milk and cheeses should also be avoided. 

Food borne illnesses or “food poisoning” can cause serious adverse effects. Food poisoning side effects can include:

  • Abdominal cramps
  • Dehydration
  • Diarrhea
  • Dizziness
  • Fever
  • Flu-like illness
  • Lethargy
  • Loss of appetite
  • Muscle aches
  • Nausea
  • Upset stomach
  • Vomiting
  • Weakness

Paying attention to reports of food recalls and food-related disease outbreaks can also help prevent health complications. Avoid any contact or consumption of suspected foods.

The U.S. Department of Agriculture’s Food Safety and Inspection Service, for example, issued a public health alert in December 2022 for ground beef that tested positive for E. Coli. That same month, Kraft Heinz Foods Company recalled approximately 2,400 pounds of ready-to-eat ham and cheese loaf because of possible cross-contamination with under-processed products.

Immune Function Matters

When thinking about food safety for mesothelioma patients, doctors and dietitians pay attention to a type of white blood cell called a neutrophil.

Neutrophils are part of the immune system. They help your body fight off infections. When their levels are abnormally low, this is referred to as neutropenia.

When you don’t have enough of these cells, you have a high risk of bacterial infections from the food you eat, the counters you touch or any other item that may contain illness-causing bacteria.

Doctors track neutrophil numbers with blood tests during mesothelioma treatment. Although any number below 1,500 neutrophil cells per microliter is considered neutropenia in an adult, most health care providers do not consider neutrophil counts between 1,000 and 1,500 a cause for alarm.

However, when counts drop below 1,000, and especially when they drop below 500, infection risk increases. At these levels, even normal bacteria from your mouth and digestive tract can cause serious infections.

Common Questions About Nutrition & Mesothelioma

What is the best diet for mesothelioma patients?

Mesothelioma doctors recommend that cancer patients eat foods rich in nutrients such as eggs, fruit and salmon. Also, patients should have a diet high in protein with starchy vegetables and plenty of water to counter the effects of mesothelioma treatment.

How do you cure mesothelioma with diet?

While there is not currently a mesothelioma cure, a healthy diet can offset the adverse effects of cancer therapy and improve the outcome of treatment. Eating enough of the right foods can make treatment recovery more manageable and improve prognosis.

What diet helps prevent mesothelioma?

Healthy habits like diet and exercise are important for lowering the risks of mesothelioma and other cancers. A healthy eating pattern will control your weight through a variety of fruits, vegetables, fiber sources and low-calorie foods. Limiting your intake of red meats, sugar-sweetened beverages and highly processed foods will also lower your risk of cancer.

Does mesothelioma cause weight loss?

Unexplained weight loss is one of the signs of advanced mesothelioma. Weight loss can also be due to a lack of appetite or persistent nausea, which are symptoms of peritoneal mesothelioma.

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