It’s important to give your body the nutrients it needs during CML treatment. Some habits can help with side effects like low appetite, too.
Cancer treatment, including treatment for chronic myeloid leukemia (CML), can change the way you feel. It may leave you with severe fatigue and take a toll on your immune system.
Nutrition guidance for CML includes handling food safely and eating foods like protein, whole grains, fruit, and vegetables that help your body get the nutrients you need.
Making sure you are getting enough calories and nutrients is one way you can feel better before, during, and after CML treatments.
Why is nutrition important for CML?
Many people find that cancer treatment makes it hard to eat foods they once enjoyed.
Coping with nausea, loss of appetite, digestive changes, and other side effects can make maintaining proper nutrition a challenge. At the same time, the body needs energy to handle cancer treatment.
According to the
In addition, treatment for blood cancers like CML can result in lower white blood cell counts and damage to the lining of the gut.
Both of these effects increase the risk of bacterial infections. It’s important to not only eat good food, but to do so safely.
During cancer treatment, eating changes are common.
According to recommendations from an expert group from the European Society for Clinical Nutrition and Metabolism, these changes can lead to malnutrition and cause excessive weight loss and loss of lean body mass.
It’s important to try to get enough protein, carbohydrates, and fats to maintain your weight. A balanced diet, including plenty of water to keep you hydrated, can help prevent weight changes.
The Leukemia and Lymphoma Society (LLS) offers these general guidelines for foods to eat:
- a variety of vegetables, including legumes
- whole fruits
- whole grains
- fat-free or low fat dairy
- a variety of proteins, such as seafood, lean meats, poultry, beans, soy, and eggs
- healthy oils, like olive oil
- water, tea, or coffee for hydration (if you experience diarrhea or acid reflux, drink decaffeinated tea or coffee)
- canned fruit
- tender beef cuts
- hard and mild cheeses
- chicken or turkey without skin
- broiled or poached fish
- nut butters
- plain yogurt
- well-cooked vegetables
If you experience constipation or weight gain, eating foods high in fiber may help. High fiber foods include:
- bran muffins
- dried fruits
- whole grain cereals
- sweet potatoes
If you experience diarrhea, eating foods low in fiber may help. Low fiber foods include:
- refined cereals, like cream of rice and instant oatmeal
- vegetable juice
- string beans
A dietitian can help you find the best foods for you and your specific situation, especially when you feel different because of CML treatment or are in the later stages of recovery.
If you have low neutrophil levels, aim to follow food safety practices that prevent exposure to bacteria and other harmful organisms in food.
The LLS recommends that people who are immunocompromised follow safe food handling practices. This involves avoiding:
- all uncooked vegetables
- most uncooked fruits, except those with a thick peel, like bananas or citrus fruit
- raw or rare meat
- uncooked fish
- uncooked or undercooked eggs
- most foods from salad bars and deli counters
- soft, mold-ripened, and blue-veined cheeses, like brie and blue cheese, including Camembert, Gorgonzola, Roquefort, and Stilton
- well water that hasn’t been boiled for at least 1 minute
- unpasteurized dairy products
Some people may have heard of a specific “neutropenic diet.” According to the LLS, there’s never been a universal list of foods to include or avoid on this diet, and there’s no evidence the diet actually benefits people.
Researchers in a 2019 review of six studies concluded there was no evidence to support a neutropenic diet for people with cancer, although it’s important to follow safe food handling practices.
If you’re experiencing neutropenia, it’s important to avoid raw or undercooked foods to reduce the risk of infection.
- high fiber foods
- high sugar foods
- greasy or fatty foods
- milk products
- spicy foods
- sugar-free products sweetened with xylitol or sorbitol
You may also want to avoid certain dietary supplements, such as St. John’s wort, as they may interfere with some medications. You can discuss these with your doctor in regard to your specific treatment.
Your CML treatment may reduce your appetite and cause side effects, such as nausea and mouth sores. This can make it difficult to eat.
Here are some tips from the
- Eat frequently. Opt for four to six smaller meals a day instead of two or three big meals.
- Drink nutrient-rich liquids, such as soups, juices, and shakes, if you have trouble swallowing solid food.
- Sip on water, ginger ale, and other clear liquids to prevent dehydration and ease nausea.
- Add more calories by blending foods and soups with high calorie liquids, such as cream and gravy.
- Cook foods until they are tender, or choose soft foods.
- Try different recipes and experiment with ingredients if treatment has altered your taste.
- Ask for help with grocery shopping and food preparation.
A dietitian trained in working with people with cancer may also be able to offer advice on boosting nutrition and making eating easier while on treatment.
Handling food properly is always important. It’s even more so during cancer treatment because your immune system may be compromised.
The following important food safety tips from the LLS can help you safely prepare and eat foods, and lower your risk of infection or illness caused by food.
- Check expiration dates on foods before eating.
- Refrigerate all cooked or perishable food within 2 hours of preparing or purchasing.
- Eat leftovers within 3 days.
Food preparation and cooking
- Wash your hands often, particularly before, during, and after food preparation.
- Rinse all fruits and vegetables before peeling or eating.
- Remove bruised or damaged areas on fruits and vegetables.
- Discard the outer leaves of cabbage or lettuce.
- Do not use dishes or utensils for eating or serving that touched raw meat, poultry, or fish.
- Avoid thawing frozen meat on the counter. Use the microwave or fridge instead.
- Use a meat thermometer to ensure that meat, poultry, and fish are properly cooked.
- Keep counters, cutting boards, dishes, utensils, and sinks clean.
- Wash dish towels regularly.
- Wash and rinse sponges and dishcloths frequently to remove bacteria.
- Wash all surfaces that have come in contact with raw meat, fish, or poultry.
The Partnership for Food Safety also recommends separating foods to avoid cross-contamination.
Although food is not a treatment for cancer, eating nutritious foods can help you feel better and give you the strength needed for treatment and recovery.
Speak with a doctor or dietitian about any special instructions or considerations specific to your CML and nutrition needs.