How do I make the best food choices throughout cancer treatment?

When you are faced with esophageal cancer, nutrition can be an important part of your journey. Eating a well-balanced diet during and after cancer treatment can help you feel better, maintain your strength, and speed your recovery.

The esophagus is a tube that connects the back of your throat to your stomach. Cancer of the esophagus can sometimes narrow your esophagus which may make it difficult to swallow or eat properly. Try following these tips to help you best manage your nutrition during treatment.

Know your risk. Esophageal cancer and treatment increase the risk for nutrition issues, including malnutrition. Malnutrition occurs when a person is not receiving or absorbing proper nutrition and the right amount of calories and nutrients needed for healthy bodily function. Malnutrition increases the risk for health complications, hospitalizations, and poor quality of life. Tell your healthcare team immediately about any new or worsening side effects or weight loss. For more on esophageal cancer, visit our recommended resource.

Receive ongoing nutrition support. You may need ongoing support from a registered dietitian in your area, especially if you experience ongoing weight loss or severe side effects such as loss of appetite, nausea, vomiting, or diarrhea. Ask your healthcare team for a referral to local registered dietitian who specializes in helping cancer patients. You can also ask your health insurance provider for a referral or use the Find an Expert tool provided by the Academy of Nutrition and Dietetics (AND). (You may also schedule a time to talk to one of our registered dietitians for general education and guidance. You will benefit most from having a registered dietitian as a member of your healthcare team.)

Maintain a healthy weight. Unintentional weight loss is a common problem while undergoing treatment for esophageal cancer. This is because of many side effects that may make eating difficult. Depending on the location of the tumor, you may find it difficult to swallow or painful to eat. If you notice that you are losing 1-2 pounds a week consistently, talk with your healthcare team or a PearlPoint registered dietitian about what you can do to increase your calorie intake and prevent further weight loss.

Eat small, frequent meals throughout the day. Eating frequent small meals will ensure your body is getting adequate calories, protein, and nutrients to endure treatment. Smaller meals may also help to minimize treatment-related side effects such as heartburn, reflux, or feeling full too quickly. Try eating 5-6 “mini” meals a day, about every 3 hours.

Choose foods that are easy to chew and swallow. Depending on the cancer itself or your treatment, you may find it difficult or even painful to swallow. Choosing soft foods may make this easier. Also, be sure to eat slowly and chew thoroughly.

Choose protein-rich foods. Protein helps the body to repair cells and tissues. It also aids in the recovery and maintenance of the immune system. Include a lean protein at all meals and snacks. Good sources of lean protein include:

  • Lean meats such as chicken, fish, or turkey
  • Eggs
  • Low-fat dairy products such as milk, yogurt, and cheese or dairy substitutes
  • Nut butters
  • Beans
  • Soy foods

Include whole grains. Whole grains provide a good source of carbohydrate and fiber, which help sustain energy levels. Good sources of whole grains include:

  • Oatmeal
  • Whole wheat breads
  • Brown rice
  • Whole grain pastas

Eat a variety of fruits and vegetables every day. Fruits and vegetables offer the body antioxidants which can help fight cancer. Choose a variety of colorful fruits and vegetables to get the greatest benefit. Try to eat a minimum of 5 servings of whole fruits and vegetables daily. Because cancer of the esophagus can make eating fruits and vegetables more difficult, choose those without skins and seeds. Soft, cooked vegetables are also more easily tolerated.

Choose sources of healthy fat. Healthy fats include olive oil, avocados, nuts, and seeds. Avoid fried, greasy, and fatty foods, Choose baked, broiled, or grilled foods instead.

Limit sweets and added sugars. Foods high in added sugars like desserts and sweets provide little nutritional benefit and often take the place of other nutritious foods.

Stay hydrated. Drinking enough fluids during cancer treatment is important for preventing dehydration. Aim to drink 64 ounces of fluid daily. Avoid drinking large amounts of caffeinated beverages as too much caffeine can lead to dehydration. If you are having difficulty swallowing, drinking with your meals may help to soften your food, making it easier to swallow.

Use good mouth care. Chemotherapy and radiation therapy can irritate the lining of the mouth, throat, and esophagus. This irritation can make eating and swallowing difficult. Treatments can also decrease how much saliva you have, which can make teeth decay faster than normal. Good mouth care is very important if you have mouth soreness. Brush your teeth after eating and floss daily.

Sit up after eating. Wait at least 1 hour before lying down. Lying down after eating can result in symptoms of heartburn. Heartburn, gas, bloating, and belching are common side effects of esophageal cancer. Ask a registered dietitian for guidance on which foods to avoid when you have heartburn, gas, bloating, and belching.

Practice good food safety. Wash hands often while preparing food. Use separate cutting boards for raw meat and raw vegetables as well as separate knives. Be sure to cook all foods to their proper temperature and refrigerate leftovers right away. Read more about Food Safety.

Talk to your healthcare team before taking any vitamins or supplements. Some medications and cancer treatments may interact with vitamins and supplements. Choose food first as the primary source for nutrients.

Drink alcohol in moderation, if at all. Alcohol may contribute to dehydration, can impair the immune system, and provides no beneficial nutrients.

Understand the need for nutrition support. If you are not able to eat enough by mouth or are recovering from surgery, a feeding tube may be necessary to help you meet your nutrition needs. It is not uncommon for individuals undergoing therapy for esophageal cancer to have a feeding tube for a temporary time period. Your healthcare team will assess your individual needs to determine if and what kind of nutrition support is right for you.

Most importantly, know that your cancer journey is unique to you and your treatment.

Recommended Resource for Esophageal Cancer

  • Esophageal Cancer Awareness Association
    Phone: (800) 601-0613
    The Esophageal Cancer Awareness Association (ECAA) is dedicated to helping patients, caregivers, survivors, family members, and anyone at-risk of the disease. Their website offers easy-to-read information on esophageal cancer, including descriptions of the disease, its diagnosis, staging, treatments, and other factors.

For more resources, visit our Recommended Resources page.