20 JUNE 2010
As I write this, I have had four out of six sessions of FEC chemotherapy. This advice is based on my own experience of trying to manage nausea.
Nothing I suggest is harmful or woo-woo. If you’re struggling with nausea during chemotherapy, these might be worth trying.
Chemotherapy and appetite
Chemotherapy completely messes up appetite; you don’t go through normal cycles of hunger and satiation. Instead, when you would otherwise feel hungry, you actually feel nauseous. The more you put off eating, the worse the nausea gets. Eating removes pre-eating nausea.
Then, dependent on what you eat, you might get nauseous half an hour after eating. The challenge is to find out what didn’t agree with your stomach.
Pre-empt hunger-turned-into-nausea by eating regularly.
In the days after chemo, abandon ‘proper’ meal times and instead eat something small – for example, a slice of toast or a piece of fruit – every 2-3 hours. Eat more if you can bear it. Don’t worry about gaining weight during chemotherapy; you can lose it later.
If you’ve left it too long before eating and can’t bear to prepare anything, have a banana. They’re nutritious and rich in calories.
If you feel nauseous AFTER eating, it’s likely something you’ve eaten, maybe too rich (oily) or, as I discovered for myself, something that contains lactose.
The issue of lactose
I discovered fairly quickly that dairy products – milk, yoghurt and cheese – made me nauseous. After trying soy-based dairy alternatives and lactose-free milk products, I managed to identify my problem was lactose.
I originally eliminated dairy from my diet and went from my 3-4 cups of milky tea per day to fruit teas. But I got bored with those after two months and bought Alpro Soya Milk. It’s fine but tastes sweet. I then found lactose-free cow milk in Tesco (links at the end); that has been fine. However, I have so long associated milky tea with feeling ill that some part of me still avoids it.
Alternatives to regular dairy
This is a collection of links to products I’ve tried plus brands recommended by a vegan acquaintance, Rain.
Vegan food contains no dairy products and is often based on soy. Rain says that if you can’t find these in your local supermarket, try health food stores.
Alpro soy milk and yoghurt @ alprosoya.co.uk (available in supermarkets)
Provamel organic soy and rice drinks, desserts, yoghurts and cream @ provamel.co.uk (available in supermarkets)
Tofutti vegan ice-cream tubs and cones, and cheeses available from goodnessdirect.co.uk
Swedish glace lactose-free ice-cream @ swedishglace.com (available in Waitrose)
Vegan chocolates and ice-cream available from goodnessdirect.co.uk
Redwood vegan cheese, sausages, slices, pate, and confectionery @ redwoodfoods.co.uk
Sojasun vegan drinks, yoghurts, meals and desserts @ sojasun.com
Vegan Sheese @ buteisland.com
Vegan Parmezano sprinkles available from naturallygoodfood.co.uk (available in some supermarkets)
Finally, Waitrose and Tesco brands for soy milk. Tesco have a large range of soya milks.
Since my first chemo session, I found that I could settle my stomach by eating a handful of dry bran flakes. A slice of toast or a bag of crisps does the same trick, although the added fat in crisps might be an issue.
My theory is that these are innocuous carbs which won’t irritate the stomach while fending off hunger that has mutated into nausea. In my first week after a chemo session, I have a bag of bran flakes next to the bed so that I can nibble on them if I wake up during the night feeling icky.
What not to eat
Avoid shop-bought orange juice or apple juice as these contain a lot of citric acid to increase shelf-life. The acid will irritate your stomach.
Don’t eat pineapple as it contains the protein-digesting enzyme bromelain, which is used in meat tenderisers. Pineapple will give you mouth sores.
Finally, because of the acid-stomach issue with chemotherapy, avoid spicy food.
I hope this helps.
13 NOVEMBER 2011
I had travel-sickness-type nausea the first week after each chemo; I was mostly fine the second and third weeks. I didn’t get it under control until my last chemo, when I had specific advice from an oncologist during a regular review.
You’ll be given a bag of extra anti-sickness pills at the start of chemo. Take the Domperidone regularly every day (as prescribed) for at least the first week. I was told that taking Domperidone regularly ensures a continuous level of the medication in the blood stream and best counteracts the nausea.