This article is the first in a two-part series about nutrition for multiple myeloma patients. This article provides an introduction to nutrition for cancer patients as well as tips for getting the right nutrition. The second article describes sources and amounts of nutrients that are important for myeloma patients.

Healthy eating can help people with multiple myeloma heal faster, feel more energetic, respond better to treatment, and protect a vulnerable immune system. But treatments like chemotherapy and stem cell transplants can sap appetites, leading to malnutrition and vitamin deficiencies.

However, as a multiple myeloma patient, you can manage your nutrition by following the principles of a balanced diet that you are probably already familiar with, such as eating plenty of colorful fruits and vegetables, getting enough protein, avoiding fried foods, and getting unsaturated fats from sources like fish, nuts, and seeds. You can also meet with a registered dietician during treatment, who will work with you to choose a diet that will help you feel the best you can.

Eating well and getting regular exercise are good ways to prepare for treatment. Once treatment starts, there are many strategies you can use to make up for nutritional deficiencies and to overcome side effects that reduce your appetite.

Strategies For Eating Well During Treatment

“The biggest problem I encounter with myeloma patients is poor intake of protein and calories due to effects of disease progression and treatment,” wrote a University of Arkansas cancer center dietician on the university’s Myeloma Institute website.

Eating snacks and frequent small meals every two or three hours can help increase calorie and protein intake. If you find that you need to gain weight, try adding grated cheese on top of meals, adding powdered milk to cream soups and casseroles, choosing the full-fat versions of dairy products and dressings, or supplementing your diet with nutritional drinks and shakes.

Nausea and vomiting are common side effects of chemotherapy. If you are feeling nauseous, try eating small meals, avoiding strong smells, and eating cold instead of hot foods. Bland, dry foods like crackers and toast and clear liquids like broths, juices, and water may be appealing.

Some treatments can cause sore throats or mouths, or reduced saliva and a dry mouth. Soft, bland foods can help. Soups, milk, pudding, and ice cream are good examples. Avoiding spicy, salty, or tart foods like citrus fruits and avoiding alcohol can also help. Dry and sore mouths are prone to cavities and infections, your doctor may recommend a rinse or brushing after meals to keep your mouth clean.

Another common side effect after stem cell transplantation is an altered sense of taste or smell. Try rinsing your mouth before eating, using different herbs and spices, or adding more salt or sugar to your food. If you do not have a sore throat or mouth, you can try tart, citrus flavors. If you are bothered by a metallic taste in your mouth, try sucking on sugar-free lemon drops or mints and using plastic utensils at meals (see a related Beacon forum discussion for more tips).

Even side effects such as diarrhea, constipation, and fatigue can be managed in part by diet.

Avoiding Infections

In addition to getting enough nutrition, people undergoing multiple myeloma treatment will also need to eat well to help protect their weakened immune systems.

“Decreased red blood cell and white blood cell counts are common side effects of chemotherapy. While patients are aware of this, they often overlook the fact that poor nutrition can also play a role,” wrote the University of Arkansas dietician.

If you have low white blood cell counts, avoid raw foods such as raw seafood, salads, and soft cheeses like Brie or Camembert. Wash your hands often and keep your kitchen especially clean. Doctors or nurses can provide advice on how to keep the home safe while you are vulnerable to infection.

Vitamin Supplements

You may become interested in taking supplements during your myeloma treatment, especially as more studies emerge showing the importance of different vitamins to cancer healing. A few recent studies have suggested that fixing vitamin D deficiency in people with multiple myeloma may lead to better prognoses, and that vitamin D supplementation can reduce bone complications and correct hypercalcemia.

However, excesses of vitamins may interfere with cancer therapies. In particular, vitamin C, green tea, and other antioxidants may interfere with Velcade (bortezomib). In addition, taking more than 100 percent of the recommended daily value of any given vitamin may increase cancer risk. Patients should always consult their doctors before making any changes to their diet, including taking supplements.

Eating well during multiple myeloma and its treatment takes care and planning, but provides patients with an effective, actionable way to feel healthier and respond better to therapy.

For more information, see articles on nutrition by the Leukaemia Foundation (pdf) and the American Cancer Society. Also check out Part 2 of the Beacon nutrition series.