Pre-surgery treatment diet
Discovering cancer for the for first time is traumatic, but please be assured that you are not alone - many patients have been through the very same experience. The care you will receive from the NHS will be nothing less than the very best.
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Prior to diagnosis, the early symptoms of oesophageal and stomach cancer vary to a wide extent, but mild bloating and or phlegm after meals, and occasional acid reflux with a burning sensation in the lower oesophagus or heartburn are common. Over a period of months food can become increasingly hard to swallow. Most usually this is the time when people visit their GP and should then be referred for further tests without delay. The earlier the diagnosis, the sooner treatment and recovery can take place.
Within days of diagnosis, a specialist dietitian at the hospital will be in touch to review and assess the person’s individual circumstances, offering advice and practical support as needed. It is vitally important to listen carefully and follow their advice. We know from our own experience that it helps to remain calm and focused on everything that ‘can be done’ to get well.
Here are a few things you can do:
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Keep a daily diary of what you eat. This will help you decide which meal options you prefer and find easier to eat; it will help you to plan ahead and ensure that you eat regularly and enough.
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Keep a weekly record of your weight. There is no need to record a daily weight. Be mentally prepared for weight loss - it is quite normal to lose weight throughout treatment. Keeping a record helps tie together your dietary diary with foods that work well for you.
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If possible, aim to maintain a recommended weight and improve your fitness ahead of and during treatment; this helps to reduce surgical risk, sustain energy levels and offset weight lost during chemotherapy and or radiotherapy, and importantly post-surgery.
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Also, keep a daily diary of exercises you do. It’s important to remain active however small or insignificant it may seem. Activity could range from doing a little housework, gentle exercises in front of the TV, or a short walk around the garden or to the local shop, to longer daily walks or other more strenuous exercise. Being active and eating wisely are helpful components of a quicker, trouble-free recovery.
If you are able to swallow normal food
Aim to carry on with your normal routine as best you can. Throughout pre-operative treatment such as chemotherapy and or radiotherapy, enjoy your food! Choose the foods you especially like, because chemotherapy tends to reduce appetite and change the taste of some foods.
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At this stage, do not worry about a ‘slimline’ or low fat/low carbohydrate diet. Try to maintain a suitable weight by eating what you really like. It might feel counter-intuitive to eat whatever you like, including full-fat, high-protein foods with carbohydrates, but this is only a short-term phase, just a matter of a few weeks during treatment that can otherwise cause considerable weight loss. Recovery will be a little easier in the long run if you are better prepared for it now.
If you have difficulty swallowing food
Do not panic! Stay calm because there are solutions to help you get through this difficult time. Follow the advice of your Consultant and Dietitian. Whether liquid food is temporarily needed through a feeding tube or soft foods taken orally, in the majority of cases it is a temporary phase, typically lasting only a few weeks.
Standard treatments such as chemotherapy and radiotherapy work effectively to reduce tumour size, in most cases dramatically improving swallowing in a matter of only a few weeks.
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If you need to be on a liquid-only diet, you should be under the care of your Dietitian. For most people on a liquid diet, the calorie goal can vary widely and be up to 2,500 calories/day with a strong focus on a high protein diet, but patients should always seek their dietitian’s advice.
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If swallowing liquid food is difficult, a temporary ‘feeding tube’ may need to be surgically inserted to achieve sufficient nourishment. If this is necessary, your Consultant in charge and Specialist Nurse Practitioner will arrange it for you. In these circumstances the medical team will supply all liquid feeds to be taken at home, with guidance and support to make sure it works well.
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Pureed foods are simple to make at home or a wide variety can be purchased online through specialist suppliers. Pureed foods have a smooth consistency best achieved using a blender.
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Fork mashable foods are those that can easily be broken down with the back of a fork, meaning they are easier to chew and swallow.
Being on a pureed or fork mashable diet can feel monotonous after a while, but it is important to be persistent. Choose a variety of flavours from fresh produce that you like, season it well and establish a routine that suits you best. Making up batches of different meals once a week for the freezer is a convenient and cost-effective way to plan ahead. But whatever you do, stay positive and opt for nourishing foods that taste good and are high in protein, fats and carbohydrates.
The section on Meal Ideas provide some suggestions for drinks, pureed foods and fork mashable foods.
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The Eating well with swallowing difficulties booklet has loads of recipes and specifies which texture each meal is suitable for.
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Once your treatment plan has been completed, whether it entailed chemotherapy and/or radiotherapy, with or without surgery, your ability to eat and swallow foods should have improved, enabling you to eat more normally again. However, the transition back to ‘normal’ foods varies for every individual.