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Most of us who have had family members who had cancer have found cooking to be a major challenge. Most kinds of chemotherapy cause nausea and vomiting. Gastrointestinal distress usually is not a complication of radiation therapy, but radiation to the head and even to the chest can result in mucositis, painful sores in the lining of the mouth and on the tongue that make eating painful.
Making the situation even more complicated is the fact that cancer treatment alters taste perception.
And well meaning attempts to entice a cancer patient to eat by cooking his or her favorite foods when there is gastrointestinal upset can create a body memory that cancels out all the positive associations with the food. (As a general rule, it is never a good idea to cook someone's favorite foods on days they have stomach upset.)
At the same time cancer treatment discourages eating, cancer itself can alter the metabolism so that the body starts wasting glucose and making up the difference by converting the amino acids in the proteins in the muscles and white blood cells into sugar. Wasting disease can cause even more damage than metastatic tumors do, to the profound distress of the patient and the horrified frustration of family members and friends trying to take care of them.
What can people who provide care to cancer patients do to adjust cooking to their condition?
- Don't worry about feeding lots of "miracle foods." Even if there were a particular food that cured cancer, and there isn't, eating when you feel worn out from the disease or dyspeptic from treatment would create an aversion to it. And as a corollary:
- Try to provide a variety of foods. Variety of textures, tastes, shapes, sizes, smells, and colors increases appetite. Be careful with bitter flavors. Even if the person you are cooking for likes them, the sensation of bitterness on the tongue causes the release of acid in the stomach.
- Make food tasty by adding a little sweetness (such as a touch of sugar or maple syrup), a little saltiness (in liquids, salt crystals can irritate the lining of the mouth), a little umami flavor (from a protein food, tomatoes if they can be tolerated, or kombu), and a little acid (from a squeeze of lemon juice). Sometimes when cancer patients can taste one kind of flavor, they can still taste the others. Including all flavors in every bite makes eating more pleasant.
- Minimize mouth pain by avoiding hard or crusty foods. Moistness makes food more tolerable. Bread pudding is more likely to be tolerated than crusty bread, cracker crumbs are more likely to be tolerated than whole crackers, and soups and stews, appropriately seasoned, are easier to eat than roasts and roasted vegetables or fried foods.
- When digestive upset is a problem, stick to bland foods, preferably foods that aren't eaten very often. The brain associates nausea, vomiting, and diarrhea with the food eaten immediately before the symptom.
I'd like to take credit for this recipe myself, but Rebecca Katz's preparation tastes so much better than my own I'm sharing it here.