1. Avoid Risk. Pay attention to the list your doctors give you of what you can't eat. It took me some time to realize that this list resembles the list of things to avoid when pregnant: unwashed fruits and vegetables, raw and undercooked meat, raw milk products, salad bars, among others. Rather like in pregnancy, your body is undergoing a chemical change during chemo, and with a compromised immune system you have to be careful not to expose yourself to unwanted pathogens.
2. Manage Nausea. No duh! But this involves not just the amazing drugs you can now get as part of your treatment; it can also involve some homemade remedies, which offer a nice break from all the medications you will be on.
For me, that old standby, ginger, really did work. One of my favorite cookbooks to use was The Cancer Fighting Kitchen by Rebecca Katz with Mat Edelson. I found the ginger syrup recipe quite the tonic, along with her Magic Mineral Broth (recipe below). I would say these were staples. In fact, that broth (don't let the secret ingredient — seaweed — scare you) is still standard repertoire in my cooking, long after the end of treatment.
3. Beat Metal Mouth. Depending on which chemotherapy regimen you are on, you may find yourself with extreme dry mouth and also a metallic taste in your mouth. If you eat with metal flatware, the metallic taste will be worse. Time to get out the plastic forks. This doesn't last forever, but it really makes a difference.
4. Focus On Flavor. Does it taste good? If it does, eat it. If it doesn't, don't. Could this be more obvious? Well, you will be surprised at how much you will resist this seemingly simple bit of advice. "Oh, but I must eat X because of its anti-cancer fighting properties," you'll say. When you are in the throes of treatment, you don't really have to worry about that because, well, you already have cancer, and you are fighting the cancer by going through treatment!
Eating should be a pleasure, and we tend to lose sight of that fact. In fact, eating should be as much about pleasure as it is about health. So don't destroy the pleasure by now forcing yourself to eat something that doesn't smell or taste good to you.
I continued to eat yogurt during my treatment because I thought it was good for me. The texture was unbearable, and my gag reflex would kick in, but I soldiered on. Now I can't eat yogurt without loading it with granola or fruit to distance myself from that unpleasant memory that I associate with its texture.
And let's go back to the pregnancy analogy. When I was pregnant, I could not drink tea because it tasted bad to me, and that is exactly what happened during chemo, so I stopped. I'm glad I did, because now I have no bad associations at all when it comes to my tea habit/addiction.
My apologies if you were expecting something more profound from a veteran of chemotherapy. The good news is that as far as food and chemotherapy goes, it is not as complicated a problem as it could be. But while it is not complicated, it is hard to get right. Everyone reacts a little differently, so there is trial and error involved. I ate a lot of peanut butter and chicken and drank protein-fortified smoothies. That's what worked for me. What works for you will be different but attainable, and that is even better news, because you will have plenty of other stuff to deal with during your treatment.
So, will a cancer cookbook or even an app help you through this period? Well, usually the recipes are common sense, nutritious foods that you might have been cooking already and will certainly want to continue to cook. What a cookbook can do is help you organize.
A new book that just crossed my desk, Cooking through Cancer, has a table of contents ordered by ailment: Sore Mouth, Nausea & Vomiting, Constipation, etc. This seems particularly useful when you are juggling so much else in managing your treatment, and the recipes look good, too.
There are a range of books to choose from, but actually the best thing you can do with a cancer cookbook is give one to your caregiver or whoever else is preparing meals for you while you are focusing on healing! Don't be embarrassed to do so. People want to help you, and if this is the help you need from them, go ahead — it sure beats a pink teddy bear. Bon appetit!
Recipe: Magic Mineral Broth
Reprinted with permission from The Cancer-Fighting Kitchen: Nourishing, Big-Flavor Recipes for Cancer Treatment and Recovery by Rebecca Katz with Mat Edelson, copyright 2009. Published by Celestial Arts, an imprint of Ten Speed Press and the Crown Publishing Group. Photo Credit: Leo Gong.
6 unpeeled carrots, cut into thirds
2 unpeeled yellow onions, cut into chunks
1 leek, white and green parts, cut into thirds
1 bunch celery, including the heart, cut into thirds
4 unpeeled red potatoes, quartered
2 unpeeled Japanese or regular sweet potatoes, quartered
1 unpeeled garnet yam, quartered
5 unpeeled cloves garlic, halved
1/2 bunch fresh flat-leaf parsley
1 eight-inch strip of kombu (dried strips of seaweed)
12 black peppercorns
4 whole allspice or juniper berries
2 bay leaves
8 quarts cold, filtered water
1 teaspoon sea salt
Rinse all of the vegetables well, including the kombu. In a 12-quart or larger stockpot, combine the carrots, onions, leek, celery, potatoes, sweet potatoes, yam, garlic, parsley, kombu, peppercorns, allspice berries and bay leaves. Fill the pot with the water to 2 inches below the rim, cover, and bring to a boil.
Remove the lid, decrease the heat to low, and simmer, uncovered, for at least two hours. As the broth simmers, some of the water will evaporate; add more if the vegetables begin to peek out. Simmer until the full richness of the vegetables can be tasted.
Strain the broth through a large, coarse-mesh sieve (remember to use a heat-resistant container underneath), then add salt to taste. Let cool to room temperature before refrigerating or freezing.
Madhulika Sikka is executive editor of NPR News and author of the forthcoming book, A Breast Cancer Alphabet.