Why is it important?

Your nutritional needs may be even higher during your prostate cancer treatment. You will need a good supply of protein, nutrients, and liquids—not necessarily in the form of extra calories. Good nutrition promotes recovery, preserves muscle mass, and boosts your immune system. That being said, no single food or nutrient alone contains everything you need. The best strategy for meeting all your nutritional needs during treatment is to eat a healthy, well-balanced diet.

However, it’s not always easy to eat well during your treatment. Some patients suffer from side effects that prevent them from eating the healthy foods they like.

You are being offered to meet with a dietician? Say yes!

Talk to a dietician specializing in cancer care. Together, you will assess your eating habits and choose foods that are good for you. Your dietician will consider your side effects when planning your diet. If you don’t want to see a dietician, consult your urologist or family doctor.

Drugs interactions

Diet can influence some treatments for cancer such as oral chemotherapy. It is important to know if a medication should be taken before, during or after a meal, as this can influence the assimilation of the active substances it contains and, therefore, the effectiveness of the treatment.

But you also need to pay attention to what you eat/drink during your treatment. The best known example of this interaction is probably grapefruit juice. This can influence the efficacy, side effects and toxicity of many drugs, including some treatments for cancer.

In addition to grapefruit juice, other interactions with certain foods or beverages are known. The same goes for some smoking-related interactions. It is therefore important to always read the instructions for use before taking a medication and to seek advice from your doctor and pharmacist.

Finding the perfect food…

The side effects of prostate cancer treatment can make it difficult to maintain a healthy diet. The different treatments can make you nauseous, cause anemia, osteoporosis, intestinal inflammation (radiation enteritis), affect your taste, lower your interest in food, or make you gain weight that is hard to lose. Remember that most side effects will fade with time.

But what kind of diet should I follow during treatment? For the patient and his loved ones, it’s not always easy to know:

• what to eat
• how to prepare their meals
• how to sort fact from fiction when it comes to all the suggestions you get

General tips for dealing with changes in your appetite

Loss of appetite

• Prepack 3 small protein- and calorie-rich meals
• Snack between meals to increase your food intake
• Always have calorie-dense snacks on hand (cookies, nuts, chocolate, etc.)
• Spend some time on meal presentation
• Eat in a quiet environment

Feeling full quickly, early satiety

• Prepack 3 small protein-and calorie-rich meals
• Snack between meals to increase your food intake
• Avoid drinking during your meal, instead drink between meals

Fatigue

• Ask for help with meal preparation
• Have meals delivered to your home
• Read more in our section Tips for fighting fatigue

Tips for handling digestive and sensory problems

Changes in taste and smell

• Have good dental hygiene
• Try out new recipes
• Serve food cold to reduce its taste
• Season your food with spices or herbs to make them more flavourful
• Avoid smelly foods

Mouth sores or mouth pain

• Have good oral hygiene
• Avoid food that can irritate your mouth, such as, overly salty, sweet, or spicy foods
• Try changing the texture of your food: ground, pureed, liquid

Difficulty swallowing

• Try changing the texture of your food: chopped, pureed, liquid

Nausea & vomiting

• Try to recognize what time of day your feelings of nausea are most intense
• Snack between meals to increase your food intake
• Eat foods you enjoy
• Choose food and drinks that are cool or chilled
• Avoid fatty foods (fried foods, charcuteries, sauces, etc.)
• Avoid strong odours—strong smells can cause nausea

Diarrhea

• Avoid high-fibre foods (fruits, vegetables, wholegrain cereals, legumes, and pulses)
• Avoid drinking milk because of its high lactose content
• Choose foods known for their constipating effect (rice, cooked carrots, bananas, grated apples)
• Stay well-hydrated

Constipation

• Choose high-fibre foods (fruits, vegetables, wholegrain cereals, legumes, and pulses)
• Drink more liquids, minimum 1.5 L/day
• Exercise regularly whenever possible

If your symptoms are affecting your appetite, consult a dietician who will help you plan meals tailored more to your needs. In case of severe symptoms, speak to your doctor immediately.

In case of weight loss

We may think that having a diverse and well-balanced diet is important when it comes to cancer. However, when it comes to undernutrition or malnutrition, priorities change. The primary focus shifts to ensuring that the body is getting all the calories and proteins it needs to maintain a stable weight.

A balanced diet becomes secondary to eating calorie- and protein-rich dishes. The fact that these calories are coming from “less healthy” dishes is not as important as maintaining good nutrition. Good nutrition is vital in the fight against cancer and in increasing the chances of a successful treatment.

Suggestions for men dealing with significant weight loss

• Try to drink at least 1.5 liters of water per day, between meals.
• Spread your food intake throughout the day, with many small meals.
• Never skip meals.
• Take your time to eat; eat as much as you want and can.
• Eat what you crave; the important thing at this stage is to get enough energy, even if you get this energy from foods that are not necessarily healthy, such as cakes, sweets, chips, etc.
• Opt for energy-rich foods and incorporate them into your preparations and meals: fatty fish, vegetable oils for cooking vegetables, meat, and fish; add a little vegetable cream to soups, sauces, coffee, etc.
• Fat is a source of energy. So, there’s no need to consume lean or light products. Generously spread butter or margarine on bread and biscuits, and melt a piece of butter in vegetables or porridge.
• Enjoy milk chocolate without worry, eat ice cream, sweets, or pastries.
• Try to limit vegetables, fruits, and high-fiber products during meals. They quickly create a feeling of fullness.
• Add honey or sugar to your drinks and dishes.
• As snacks, treat yourself to small extras (milk, pudding, small cakes, pieces of cheese, nuts, dried fruits, savory biscuits).

If weight loss continues despite the application of these tips, check with your doctor about taking vitamin or mineral supplements to help improve your overall nutrition. Your doctor may recommend commercial nutritional supplements if you can’t meet your nutritional needs from food or drink alone.

Lots of supplements are available. They come in a number of forms and flavours, including ready-to-use beverages, powders, puddings, bars. These supplements can be used alone or add to small meals to provide more calories or protein. You can buy commercial nutritional supplements, such as Boost or Ensure, from a pharmacy or grocery store. Some supplements are made to address special needs like lactose intolerance or diabetes. Talk to a registered dietitian about commercial nutritional supplements and which one would be best to use.

In case of weight gain

Unless otherwise advised by your doctor, it is not recommended to follow a weight loss diet during treatment. It is better to wait until it is completed. However, if you are overweight and want to lose some weight, ask your doctor if you can do so during treatment. Limit weight loss to a maximum of 1–2 lbs. (0.5–1 kg) per week.

Some treatments such as hormone therapy can lead to involuntary weight gain. During treatment, the priority will be to slow down or stop this weight gain. It is not recommended to start a weight loss diet that could be dangerous.

It will be important to reduce calorie intake by favoring fruits and vegetables and limiting fatty and sugary foods. Additionally, if possible, engaging in 30 minutes of adapted physical activity daily is recommended.

Suggestions for men dealing with weight gain

• A maximum of 15–20% of your daily calorie intake should be from fat
• Instead of frying, steam your vegetables and grill or bake your fish and poultry.
• Eat one to two servings of fish a week.
• Eat fresh fruit and vegetables.
• Use herbs, garlic, onions, and spices instead of butter, salt, or creamy sauces.
• Reduce or eliminate red meats from your diet.

Tips for fighting fatigue

Meal planning, grocery shopping, food preparation, and even eating all require energy—something many of our readers may be lacking. We have provided you with various strategies to keep yourself well‑nourished when you are tired. You’ll see, it’s possible!

Cancer-related fatigue is the most common and often most distressing side effect experienced. It’s different from the fatigue that everyone has from time to time; it is usually more severe, longer lasting, and can affect your quality of life. Resting more or doing less will not make it go away.

Fuel up at regular intervals

Food gives our body energy, like fuel powers a car. Eating every few hours throughout the day gives your body a constant source of energy and helps to maintain blood sugar levels.

Maintaining muscle mass

To keep energy levels stable and reduce muscle loss, be sure to include a source of protein (fish, poultry, dairy products, nuts, legumes, eggs, or meat) with all meals and snacks.

Stay hydrated

Not drinking enough fluids increases fatigue. Most people need eight cups (2 litres) of fluid every day. Fluid is anything liquid at room temperature—including water, juice, milk, smoothies, soups, broth, sports drinks, popsicles, flavoured gelatin (Jell-O©), ice cream, or herbal tea.

Keep it simple

Eating nutritiously doesn’t need to be complicated or time-consuming. Try to eat food from at least three food groups at each meal and from a minimum of 2 food groups for each snack (see table below).

Break old habits. Don’t feel like cooking?

Why not try some store-bought dishes from the supermarket or have leftovers from the night before? You can also try eating breakfast food at night or microwaving more of your meals or snacks. Don’t be scared to do or try something new if it helps you eat.

Plan for convenience

Frozen meals, canned fish or poultry, instant oatmeal, mixed nuts or seeds, and liquid meal replacements are all quick and easy nutritious solutions. Take a look at some meal and snack ideas in the table below.

Source: Savourez santé

Getting all the nutrients your body needs will help you maintain your weight, keep your strength up, and stay active—all important factors in managing cancer-related fatigue—all while speeding up your recovery. Find out about catering or meals-on-wheels services available for patients undergoing treatment in your neighbourhood. Don’t hesitate to ask a member of your healthcare team for other strategies for dealing with fatigue.

Smoothies

Combining a few simple ingredients like milk or soymilk, nuts, and fruits in a blender makes a quick meal or snack.

Ready-made meals

When shopping for ready-made meals like frozen dinners, read the labels and try choosing protein‑rich products that are low in sodium and saturated fats. Complete your meal with a glass of milk, slice of cheese, Greek yoghurt, or a handful of nuts to increase protein content.

Liquid meal replacements

These “meals in a bottle” (such as Boost ® or Resource® 2.0) are convenient, available in a variety of flavours, and provide all the essential nutrients. They can be used either as a meal or snack alternative, or taken in small amounts with medication throughout the day. If your diet consists almost entirely of nutritional supplements, you should discuss your options with your dietician.

Advice from men like you

“When I feel good in the morning I make sure to have a hearty breakfast.”

“On days when fatigue weighs me down I don’t get very hungry at mealtimes. Instead I have several small meals throughout the day and always keep my favourite snack on hand.”

“I cook in larger amounts and freeze it into small portions for when I’m feeling fatigued and don’t feel like cooking.

“In the days following my treatment, I often feel fatigued and don’t have the will to cook. I have pre-cooked or frozen meals. It’s fast and convenient.”

“Don’t be afraid to ask for help or hire a domestic aid service to help you with meal preparation.”

“My family and loved ones are always willing to lend a helping hand when I ask them to help me with groceries or pre-cooked meals.”

It may also be helpful to consult a dietician who will take the side effects you are experiencing into consideration and personalize your diet to your needs.