Like it or not, many patients experience loss of appetite and change in taste buds during chemotherapy. As much as I’m a foodie before I fell ill, these happened to me too, and was probably why I lost 10kg after my chemotherapy treatments ended.
They’re both side effects of chemotherapy. The loss of appetite could be due to nausea, or just generally not “feeling” like eating, and also because of oral ulcers that tend to occur especially with aggressive chemotherapy.
In my case, my chemotherapy doses increased with each cycle until my fourth one. They couldn’t increase it anymore because my body wasn’t able to hold up to the strong effects. With each cycle, I got worse oral ulcers despite gargling with salt water regularly, and keeping my oral hygiene in tip-top condition. We are talking about ulcers that fill the entire mouth and tongue. It was impossible to even talk or open my mouth, let alone eat.
Taste change on the other hand, is really peculiar because medically, I don’t think there’s a clear reason for it. It could be because of damage to oral cells. However, food tasted really odd to me, they sometimes tasted bitter, or with a weird sweetness, or just… strange. Generally, nothing tasted particularly good.
It could be psychological, but I felt like puking whenever I smelt hospital food. So those days I had to be in the hospital (which was about 7 days per 3 weeks) were the days I struggled most with food.
All the above-mentioned problems, coupled with less options for food (everything has to be kept low-bacteria, that means no raw foods, including raw vegetables, and thin-skinned fruits like grapes, and no yogurt and mayonnaise – the former is made up of (good) bacteria, and the latter of raw eggs). My parents cooked every meal for me, washed everything properly and made sure they were cooked thoroughly and that I ate immediately so as to make sure they weren’t contaminated.
Now that my taste buds and appetite are more or less back to normal, I thought I’d share some tips and thoughts that I had during that period. Hopefully this is going to benefit those who are going through chemotherapy now and feeling a bit lost, or for those who are cooking for loved ones who are going through chemotherapy.
- Distract yourself during meal times. When I first got home after I was diagnosed and went through my first chemotherapy cycle, I was still in a state of distraught. So were my family. Everyone was so concerned that when I ate, everyone gathered around to “watch” me. I soon realise that this wasn’t a “good” way to eat. My trick was to either eat with someone and chat, or eat while watching a show. The idea is to get my mind off the food and make the motion of feeding myself go auto-pilot, and focus on something that’s engaging instead. The shows of choice during that time? Masterchef (weird, I know) and Kang Xi Lai Le.
- Eat multiple meals in small portions. Food became something intimidating to me during that time. When I saw too much food on the table, I’d feel like puking. It helped when my parents started serving food on very small plates for me. For instance, I may be eating just a small slab of fish and a few pieces of vegetables for lunch, but may take a small bowl of red bean soup during tea time.
- Eat slowly. I typically take about one and a half hour to finish one small bowl of porridge. But this makes eating less intimidating.
- Don’t think, just eat. Mentally, it’s hard to swallow food especially when you don’t have appetite. I didn’t even feel hungry most of the time. However, I had to logically tell myself that I HAD to eat to have the energy to fight an ongoing battle. So, I dissociate food with enjoyment, and think of it as a necessity. I reminded myself that all I had to do was to put food into my mouth, bite and swallow. Win.
- Plan your meals. Because you can’t eat as much as you used to, it’s important to pick the “better” things to eat. It is very important to have sufficient protein input every day (at least 7 servings). I get most of my protein in the form of fish, tofu, eggs and beans. On days when I REALLY can’t eat anything, I drink a can of nutrition supplement called Ensure. By the way, I still have several cans that I stocked up but never drank. If you know of anyone who needs it and particularly if they can’t afford it, please let me know and I’ll be pleased to give them out for free.
- Make your food interesting. There were certain ingredients that can instantly perk up my appetite. I’m not sure if it works for everyone, but I thought I’d share. Salted butter was a life-saver for me. I put that onto bread and into mashed potatoes, and they instantly tasted better. You can get the individually-packed ones from supermarkets to ensure hygiene. Adding a touch of lemon juice to fish also made them taste better for me. Another way to make food interesting is to change up the way you present the food. I quickly got sick of having steamed salmon, but when my dad started grilling them and putting them into burger buns, it became more appetising.
- Fruits and fruit juices work. I could never get enough of fruit juices and particularly coconut. The coconut also offers a good source of energy and fats, which are good for the body.
- Prepare liquid food. These were my ammunition on those days when I my mouth was full of ulcers. My best girlfriends showered me with lots of baby foods that really worked out well because they’re easy to eat, nutritious, and are soothing on the ulcers because I chill them in the fridge before eating them. They were the only things I ate during those days I have ulcers, because it hurt a lot even when I ate tofu. You can also consider soups.
- Find ways to curb nausea. My girlfriends also supplied me with sweets and lollipops that helped to curb my nausea. One of my girls bought me organic mint tea, which I find useful to stop nausea. Whenever I feel nauseated, I also quickly lie down and breathe deeply. The doctor prescribed me medicine as well, which I only take as a last option.
- Ask for medical help. Two weeks after my last chemotherapy, I was experiencing extreme pain because of the mouth ulcers and constipation. I had a great fear towards food and eating too, firstly because it was just too painful to eat, and secondly, I knew that if I ate, I had to go to the toilet, which was super painful as well. Those were very horrible days that I still shudder whenever I think about them. I was admitted to the hospital for neutropenia, and during that stay, a pain management doctor was called in to help. I was prescribed mylocaine and morphine – which were really my magic potions. I personally don’t think we should use pain relief drugs readily, but speak to a doctor to see if he/she would advise it for your case. These drugs made my life a lot easier.
I was really very, very lucky because I have a strong cheer-leading team. My parents took turns to prepare all meals for me. It wasn’t easy and I know it’s rather stressful too, but they did this with so much joy and with a heart of service.
My brother constantly did research to find out what foods I could eat and to find ways to make food more interesting for me. He also spent time during meal times to chat with me so I could be distracted.
My girlfriends pampered me soooo much: whenever they know I like something (that I was allowed to eat), you’ll be sure that I’d be showered with it.
And a special mention for my dad and brother, who cooked san lao hor fun and mushroom risotto using ingredients that I was able to eat, just because I said I had a craving. During those times, I had no appetite all the time, and having a “craving” was very rare. But what’s more priceless was their readiness to indulge in my craving.
Finally, a word for you, if you’re going through chemotherapy and struggling with food. Don’t be depressed! Every morsel you consume is one mini victory. Take it one spoonful at a time. Try different ways to manage the issue. Get help – speak to a doctor or a nutritionist. And don’t feel bad about it – your body’s like a battlefield now and it’s normal for you to feel horrible all over. Keep your eyes on the goal. And all the best!