We sat down with Leukaemia Foundation Supportive Care Case Manager and Dietitian Eleanor Quinn to answer your biggest questions about nutrition during blood cancer.
Nutrition plays a vital role in your overall health and wellbeing – especially during a blood cancer diagnosis and treatment.
Being malnourished can affect your overall quality of life, causing weakness, fatigue, difficulty sleeping, and pain.
We sat down with Leukaemia Foundation Supportive Care Case Manager and Dietitian Eleanor Quinn to answer your biggest questions about the relationship between nutrition and blood cancer. She shares the best foods and drinks to help support your body and well-being during treatment – and clears up some of the most common food myths along the way.
Explore what we covered with Eleanor:
- The role of nutrition and diet in blood cancer
- What to eat (and avoid) during treatment
- Common nutrition myths and mistakes
- Food safety and hygiene tips
- Getting nutrition when you’re unwell
- How to see a dietitian
- Advice for carers
Q: As a dietitian, how do you view the role of nutrition and diet when it comes to blood cancer?
A: Nutrition is another ‘piece of the pie’ when it comes to supporting the overall wellbeing of people living with blood cancer. A balanced diet can help manage symptoms, support the immune system, reduce treatment side effects, and combat fatigue.
It can also help prevent infections, improve recovery, and support the body’s ability to heal. Each person’s nutritional needs are unique, so working with a dietitian can help create an individual plan that best supports your journey through blood cancer treatment and recovery.
It’s also important to remember that nutrition matters over a lifetime. If there are a few days, weeks or months where you can’t (or don’t want to) eat an adequate diet with good variety, that’s okay!
Q: What foods, drinks and nutrients best replenish the body, aid recovery, and improve the immune system, and what should I avoid?
A: This is a big one! There is a lot of misinformation out there, and unfortunately there is no one size fits all approach, which is why it can be a good idea to get a referral to a dietitian.
Generally speaking, the best thing you can do is try to eat a variety of foods from all 5 food groups:
- Breads, cereals, rice, pasta and noodles
- Meat, fish, poultry, eggs and nuts
- Milk, yoghurt, cheese and/or alternatives (e.g. soy milk with added calcium)
- Vegetables and legumes (e.g. baked beans, chickpeas, kidney beans)
- Fruit
Foods to avoid are processed meats like salami, ham, bacon, frankfurts and canned meat, and you should limit consumption of burnt or charred meat. Try and consume a maximum of 455g of lean, cooked red meat, and avoid fad diets that are restrictive in nature as many of these fad diets suggest cutting out whole food groups.
Q: Are there any commonly held nutrition myths people have – or mistakes they make – when it comes to their diet that are incorrect and potentially dangerous?
A: Unfortunately, there’s lots. Even as a dietitian, I can find it hard to stay up to date. People can be very well-meaning and talk about what they did or ate before/during/after treatment, however it’s important to remember that what works for one may not work for another.
There is a wonderful resource online that the Cancer Council have developed called ‘iHeard’ (iHeard | Mission Against Health Misinformation | Cancer Council). Here you can ask questions and fact-check any rumours/diets/treatments that you are not sure about.
Unfortunately, there is no special diet or food that can cure cancer. It is important to note that the dieting industry is worth close to $300 billion, so it’s no wonder individuals and organisations might try to promote certain diets!
Q: As somebody with a weaker immune system, how should I approach food safety and hygiene to remain safe from infection?
A: According to the Food Safety Information Council, all Australians should follow these 4 ‘food safety basics’:
- Clean
Clean your hands and utensils/cutting boards before preparing food and cooking (and repeat after handling raw meats, or vegetables with visible soil).
Wash fruits and vegetables. - Chill
Be sure to promptly place the following in the fridge (at or below 5 degrees Celsius): meat, poultry, dairy foods, vegetables, salad ingredients.
Promptly refrigerate leftovers once they have stopped steaming (don’t leave on the bench to cool down).
Defrost frozen food in the fridge or microwave and not on the kitchen bench.
Don’t refreeze defrosted food.
If in doubt, throw it out! - Cook
Cook foods until they are steaming hot.
If you are using a microwave, stir food and ensure it is steaming hot all the way through before serving.
Keep hot food above 60 degrees Celsius until served.
Always cook packaged or frozen foods according to the packet instructions.
Never reheat food more than once. - Separate
When storing and preparing food, keep raw and cooked foods separate.
Store food in covered containers in the fridge.
Place raw meat and chicken at the bottom of the fridge to avoid any juices contaminating foods on lower shelves.
Additional precautions for immune compromised individuals:
- Consume leftovers from the fridge within 3 days.
- Never eat food past its use by date.
- If you’re not sure how long a particular food has been in your fridge, it’s best to throw it out.
- Avoid damaged/dented canned food.
- Use an esky or cooler bag with ice pack when travelling with food.
Q: If I’m unwell and don’t feel like eating, are there any other ways I can still get nutrition?
A: Treatment or cancer specific side-effects might make it hard to eat a balanced diet. For example, you may have a reduced appetite, feel full more quickly than usual, or feel nauseous (sick in the stomach). This is where it can be particularly important to see a dietitian to learn about nutrient dense foods as well as tips and tricks to make every mouthful count.
Suggestions that your dietitian may make may include:
- Eat off a smaller plate
- Don’t wait to feel hungry, try to eat every 2-3 hours.
- Try to avoid skipping meals.
- Don’t feel pressure to eat a ‘traditional meal’. If you feel like milk and cereal, or grilled cheese on toast for dinner, go for it!
- Try to avoid drinking large amounts of fluid with your meals and snacks.
- Gentle physical activity may help to stimulate your appetite.
- If you prefer fluids over solid food, have nourishing drinks high in energy and protein. For example, milk, milkshakes, smoothies, or supplement drinks like Sustagen or Ensure.
- Have pre-prepared meals and snacks for times when you don’t feel like preparing food.
Remember, if you can’t eat well or consume a wide variety of foods for a few days or weeks, don’t beat yourself up. It’s okay if there are some periods where we just do the best that we can at the time, to get through treatment and its side-effects. But please don’t feel alone and make sure you ask your treating team for help.
Q: If I want to seek personalised professional advice when it comes to nutrition and diet, how can I connect with a professional?
A: There are several ways that people can connect with a dietitian. One way would be to ask a member of your treating team to refer you a dietitian at the hospital. It is free to see a public hospital dietitian.
Another way is to have a look at the Dietitians Australia website, where you can search for a local dietitian using their ‘find a dietitian’ tool. If you need to pay to see a dietitian (referred to as a ‘private practice’ dietitian), then it is worth speaking with your GP to obtain a ‘GP Chronic Condition Management Plan’ (GPCCMP). These plans allow people to access up to 5 individual allied health services per calendar year.
Medicare will subsidise the cost of the appointment, and many dietitians will offer to bulk bill people with a GPCCMP. If they don’t offer bulk billing services and you are on a limited income, it can’t hurt to ask them and explain your circumstances. This is also something that a Leukaemia Foundation Healthcare Professional can assist you with.
Additional nutrition information from Eleanor for carers
It can be difficult to see a loved one or someone you care about losing weight and not eating. Many people show their love through food and cooking, and it can feel very disappointing when someone we love, who we have spent hours in the kitchen cooking for, doesn’t eat what we prepared them.
Please know that people with blood cancer can experience such a poor appetite, that even the thought of food might make them feel sick. If this happens, of course it’s a good idea to speak with a member of your loved one’s treating team.
Please know that your loved one isn’t deliberately not eating. They love you and appreciate you and likely feel an enormous amount of guilt that they can’t eat what you have so generously prepared for them. If people feel pressure to eat, and eating is talked about often, especially in a negative way, then this can further exacerbate a poor appetite.
Where you can be of the best help is to continue to try and enjoy meals as much as possible. Serve small portions on a small plate (they can always go back for more), keep having the conversations you might normally have about your day, discuss your highs and lows, even play music in the background.
