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Planning Meals and Managing Cancer Side Effects

  • At every meal, you should strike a healthy balance of foods by planning your plate into these sections:

    • 1/2 vegetables and/or fruits
    • 1/4 protein
    • 1/4 whole grains
    • A small amount of healthy fats
    • Plenty of water

    Below are tips on how to plan for each part of your plate for optimal nutrition.

    Fruits and vegetables

    Fruits and vegetables contain phytonutrients, which are natural compounds found in plant-based foods. They are essentially the plant’s immune system and offer protection to you in a variety of ways.

    They act as antioxidants, boost immunity, form anti-inflammatory pathways, discourage tumors from being able to create their own blood supply, promote apoptosis (cancer cell death), and help your body to detoxify naturally.

    Try to eat 5-10 servings of fruits and vegetables per day. One serving is equal to:

    • 1 cup of leafy greens, berries, or melon chunks;
    • 1/2 cup for all other cut, cooked, or sliced fruit or vegetable;
    • 1 medium-sized fruit or vegetable (e.g., apple or orange);
    • 1/4 cup dried fruit;
    • 3/4 cup or 6 ounces of 100% juice or fresh juice.

    When possible, choose local and in-season produce. Consider choosing organic fruits and vegetables on the Dirty Dozen List.

    Find out more about the best ways to choose and prepare fruits and vegetables.

    Whole grains

    Whole grains contain the entire grain kernel, including the bran, germ and endosperm. Unlike refined grains, they contain fiber, phytonutrients as well as other vitamins and minerals that are important for supporting your immune system during and after cancer treatment.

    Aim to eat 25-35 grams of fiber per day by following these tips:

    • Switch to whole-wheat pastas, bread, and crackers.
    • Choose brown rice instead of white.
    • Experiment with different grains such as quinoa, bulgur, and barley.
    • Choose whole grains and limit your intake of white flour and sugar.
    • Eat the skin of potatoes and fruit.
    • Choose whole-grain breakfast cereals.
    • Add wheat germ to cereal or yogurt.
    • Look for the terms “100% whole” or “100% whole grain” in the ingredient list.
    • Look for at least 5 grams of fiber per serving on the food label.


    Protein is necessary for the growth and repair of all the cells in your body, including red blood cells, white blood cells, muscles, and hormones. Protein is made up of amino acids, some of which cannot be made by your body. When selecting a protein, choose lean, high-quality sources.

    Protein-rich foods include:

    • Fish*
    • Poultry*
    • Lean red meat*
    • Low-fat or non-fat dairy (milk, yogurt, cheese)
    • Eggs*
    • Soy foods like tofu, edamame, and tempeh*
    • Nuts and nut butters
    • Beans and legumes
    • When possible, choose organic, free-range, grass-fed, and wild options

    Find out more about the healthiest cooking techniques.


    A diet that is low in saturated and trans fats and high in omega-3, monounsaturated fats from plant oils, nuts, seeds, and fish is recommended for everyone, and may be particularly important for cancer survivors. Aim to decrease your consumption of foods that are high in saturated and trans fats, which are unhealthy and can be taxing to your heart and circulation. Instead, choose foods that are high in healthy unsaturated and omega-3 fats.

    Healthy fats include:

    • Fish (salmon, flounder, herring, sardines)
    • Olive oil, canola oil, flax oil, and coconut oil
    • Nuts and natural nut butters
    • Ground flax seed
    • Chia seeds
    • Wheat germ
    • Avocado
    • Olives

    Unhealthy fats include:

    • Whole milk products
    • Butter and margarine
    • High fat red meat (except grass-fed)
    • Processed meats (like bacon, hot dogs)
    • French fries and other deep-fried foods
    • Partially hydrogenated oils in pastries, crackers, processed foods


    Fluids are important for your overall health because the adult body is about 60 percent water. If you're not getting enough fluids, you can become dehydrated, which can slow your metabolism and harm your body’s ability to eliminate toxins.

    Fluids are considered anything that is liquid when kept at room temperature, excluding caffeinated and alcoholic beverages.

    Examples of healthy fluids include:

    • Water, seltzer water, flavored water (try adding lemon or lime)
    • Coconut water
    • 100 percent fruit juice
    • Low fat or non-fat milk (dairy, soy, almond, coconut, or rice)
    • Smoothies
    • Bottled liquid nutrition supplements
    • Soup and broths
    • Ice cream, sorbet, sherbet (dairy, soy, almond, coconut, or rice)
    • Pudding
    • 100% juice popsicles
    • Italian ice
    • Crushed ice, ice cubes (one cube contains one ounce of water)
    • Herbal teas (lemon, apple, berry, mint)
    • Decaffeinated coffee and tea

    The amount of fluid you need may change from day to day. The general recommendation of eight 8-ounce glasses works for some people, but it may not be enough for others. For a more precise answer, ask a Registered Dietitian.

    Vitamins and supplements

    Before beginning a vitamin or alternative diet regimen, it's important to meet with a nutritionist. Our nutritionists will review, research, and discuss your questions or concerns related to vitamins, herbs, and other supplements or special diets in the context of your current medical treatment plan, and make recommendations based on the most up-to-date research available.

    We will address potential safety concerns that may arise if you are taking supplements while undergoing chemotherapy or radiation, or taking certain medications.

    Managing side effects

    You may experience side effects during your cancer treatment. Our nutrition team offers advice on how to help you manage them and minimize their impact on your quality of life.


    Tips for minimizing nausea:

    • Eat six to eight small meals a day, instead of three large meals.
    • Try bland, soft, easy-to-digest foods. It may be best not to eat your favorite foods when you are nauseated.
    • Keep up with your fluid intake. Sip clear liquids such as ginger tea, ginger ale, or lemonade frequently to prevent dehydration.
    • Try using ginger, lemon, lavender or peppermint in foods and fluids, or topically in lotions, bath soaps, or aromatherapy.

    Sometimes just thinking about treatment may make you nauseous. This is called anticipatory nausea, which you can decrease with relaxation techniques.

    Dana-Farber’s Zakim Center for Integrative Therapies offers services which may help decrease your nausea, such as Reiki and acupuncture. Additionally, your care provider can prescribe medication that will help minimize nausea.

    Lack of appetite

    Tips for helping lack of appetite:

    • Eat small meals and snacks every couple of hours throughout the day.
    • Use a small plate instead of a full-size dinner plate.
    • Add calories to foods by adding salad dressings, nuts, seeds, avocados, and olives.
    • Bring high-calorie snacks when away from home (especially doctors' appointments).
    • Keep fluids to a minimum at mealtimes, but don't forget to drink between meals.
    • Eat well during times when your appetite is better.
    • Eat with others. The social aspect of eating is important and can help you get back on track.

    Unintentional weight loss

    Cancer treatment can leave you with lack of appetite due to nausea, difficulty swallowing, and fatigue, and this can lead to weight loss. During treatment, it's especially important that you eat more to help your body heal and keep your immune system strong.

    Tips for increasing calories from healthful foods:

    • Eat small meals and snacks every couple of hours throughout the day.
    • Use olive or canola oil when stir frying or as a dip for bread. Add oil to pasta, rice, in cake or bread mixes, and as salad dressing.
    • Add calories to fruits by baking them in layers with granola; dipping them in nut butters; or baking them in pies and turnovers. You can also add them to milkshakes or commercial nutritional supplements.
    • Sip on higher-calorie fluids such as smoothies, 100% fruit/vegetable juices and commercial nutritional supplements.
    • Eat nuts and seeds for snacks. Add chopped or ground nuts to bread, baked goods, salads, pancakes, cereal, and ice cream.
    • Use peanut, almond, or cashew butter on grains, baked goods, fruit, or veggies.
    • Use bean dips or hummus as a veggie dip. Add beans to nachos or baked potatoes, or in dips for pita bread or tortilla chips.

    Undesired weight gain

    Fatigue, decreased physical activity, eating to cope with nausea, and stress can all contribute to unintentional weight gain. However, you can lose weight during and after cancer treatment in a healthy way while still meeting your nutritional needs.

    Tips for promoting healthy weight loss:

    • Keep it slow and steady. A safe amount of weight to lose is 1 to 2 pounds per week. Losing weight gradually is the best way to shed fat without losing muscle. You can do this by eating 500 fewer calories a day, burning 500 more calories per day, or doing a combination of both.
    • Fill up on nourishing, lower-calorie foods. Trim portions of "unfriendly fats" found in foods like pastries, red meat, fried foods, and full-fat dairy foods. At the same time, boost your intake of lower-calorie foods like fruits, vegetables, and whole grains, which are rich in anti-cancer phytonutrients.
    • Adjust your portions. Use a smaller plate, which will make a smaller portion look bigger. After you serve yourself, put any leftovers in the fridge right away to avoid the temptation to get seconds. Ask your restaurant server for a box so you can take half of your meal home.
    • Balance your plate. Aim for generous portions of fruits and vegetables for filling fiber and cancer-fighting phytonutrients. Pair protein sources with your starches for long-lasting energy. "Friendly fats," such as nuts, avocado, and vegetable oils, are a heart-healthy addition in small amounts.
    • Add physical activity if you can. Aim for 30 minutes of moderate physical activity, such as walking, six days per week, if your doctor permits it.
    • Keep your dietitian and doctor in the loop. If you are struggling to lose weight, your dietitian can help you adjust your meal and exercise plan. If you are gaining or losing more than 2 pounds per week unintentionally, let your doctor know.
    • Eat mindfully. Mindful eating is being present for the sensations of tasting, swallowing, and breathing while eating. Scientists are evaluating the complex role of the mind-body connection in eating behavior. Multitasking (watching TV, reading email) while eating can interfere with critical signals from the digestive system to the brain, leading to overeating.

    Safe, smart swaps to reduce your calorie intake

    These are just a few ways to trim calories. Mix and match and choose what works best for you:

    Instead of Choose
    Fruit juice Whole fruit
    Baked or fried potato Steamed green vegetables or carrots
    Flavored yogurt Plain yogurt with fresh or frozen fruit
    Mayonnaise Mustard
    Creamy salad dressings Vinaigrette or balsamic vinegar
    Creamy soups Tomato- or broth-based soups
    A large bagel 2 slices of whole grain toast
    1 cup mac and cheese or alfredo pasta 1 cup pasta with marinara sauce
    Whole or 2% milk 1% or skim milk
    70% or 85% lean ground beef 90 or 93% lean ground beef or turkey
    T-bone steak, porterhouse steak, top loin steak, prime rib, "prime" cuts Eye of round roast or steak, round steak, chuck shoulder roast or steak, top sirloin steak, tenderloin steak/filet mignon, "choice" or "select" cuts
    Fried, breaded, or battered meat, poultry, or seafood entrée Baked, grilled, or broiled entrée

    Bowel irregularities

    Tips for battling constipation:

    • Drink warm prune juice or tea.
    • Get plenty of water and fluids. Aim for at least eight to 10 glasses per day.
    • Eat regular meals at same time daily.
    • Increase fiber intake by choosing whole-grain crackers, cereals and breads, oatmeal, legumes (beans), fresh or frozen fruits and vegetables.

    Tips for battling diarrhea:

    • Eat small meals or snacks that are bland and low in fat.
    • Drink plenty of fluids such as broths and diluted juices.
    • Drink fluids between meals rather than with meals. Choose non-carbonated, non-caffeinated, and clear fluids such as sports drinks and teas.
    • Limit milk and milk products, as they can worsen diarrhea symptoms. Substitute with Lactaid, soy milk, rice milk, almond milk or other dairy substitutes.
    • Avoid very hot or very cold food items; eat foods at room temperature.

    Other common side effects include lack of energy, difficulty swallowing, and sleep disturbances. Our nutritionists are experienced in treating these issues and can help tailor a plan to manage them for you.