Foods To Eat and Avoid When You Have Advanced Gastric Cancer

Being diagnosed with stomach cancer can change, challenge — or at the very least, complicate — your approach to eating. Advanced gastric cancer may impact your appetite, swallowing, digestion and more.

Naturally, the moment when it’s hardest to enjoy food is also the moment that getting and staying nourished is more important than ever. But you don’t have to figure out the “how” alone.

General surgeon Emanuele Lo Menzo, MD, explains how to maintain a healthy eating plan during gastric cancer treatment and how your care team will address any complications that may pop up along the way.

How stomach cancer impacts eating and nutrition

No two cancers look and act exactly the same. That can make it hard to say for sure how advanced gastric cancer will impact the amount and kind of food you eat.

“It all depends on the stage of the cancer and the location,” Dr. Lo Menzo says. “Sometimes, gastric cancer is completely asymptomatic. But cancers that are toward the entrance or exit of the stomach can impact the ability of food to move through it.”

Sometimes, the problem is an obstruction — like a tumor clogging up the entrance to the stomach. Other times, the issue’s more indirect. Maybe food can get in and out of your stomach, but damage is keeping it from breaking food down effectively. Or maybe you feel full longer than you should because it’s taking longer for your stomach to empty.

Even if you aren’t dealing with damage to or obstructions in your stomach, both chemotherapy and unrelated gastrointestinal issues can make it hard to stay nourished.

If you’re living with advanced gastric cancer, you may experience:

• Difficulty swallowing (dysphagia)
• Nausea and vomiting
• Loss of appetite

These complications can make it hard to get the nutrients your body needs and can often lead to unintentional weight loss.

How to adjust your eating plan when you have gastric cancer

In order to maintain your weight and give your body the energy it needs to heal, you need to be taking in at least as much food as you normally would, if not more.

“Your body is over-utilizing resources in order to heal and fight the cancer” Dr. Lo Menzo explains. He outlines the dietary changes that can help you sustain those efforts throughout your cancer journey.

Eat mostly soft foods and liquids

If you have a tumor that’s partially blocking the openings in your stomach, you need to focus on eating nutrient-rich foods that can slip by them. That means avoiding anything that takes a lot of effort to chew into a paste or yogurt-like consistency.

“That’s the reason most people will go on a liquid or mostly liquid diet,” Dr. Lo Menzo says. He also notes that poorly chewed pieces of food could get stuck, causing serious problems. Red meat and tougher white meats are among the most difficult foods to process when you have stomach cancer.

Eat small meals throughout the day

A healthy stomach can stretch out to accommodate more food. But according to Dr. Lo Menzo, it loses some of that elasticity when dealing with cancer.

“You’re not able to consume large amounts of food at a time, which naturally reduces the amount of nutrients you get from a meal,” he explains. “In order to meet your nutrition goals, you have to increase the number of meals you eat during the day.”

Dr. Lo Menzo recommends eating five to six small meals throughout the day. If you’re eating solid or soft foods, avoid drinking liquid during your meals. Only drinking in between meals will keep you from filling up too fast.

Get lots of protein, calories and vitamins

Your meals may look very different while undergoing treatment for stomach cancer. But they still need to contain the nutrients your body needs to fuel your recovery. A few examples of foods that can help you get there include:

• Protein or nutrition supplement milkshakes like Ensure™, Boost™ or Orgain™
• Condiments like hummus, gravy or cottage cheese
• Proteins like tofu, seafood or pork
• Healthy fats like avocado and olive oil
• Sides like mashed potatoes, creamed spinach or soup
• Breakfast foods like eggs, yogurt or cereal dissolved in milk

Avoid food that irritates or takes up lots of space in your stomach

Being gentle with your stomach during cancer treatment means avoiding foods that are easy to digest. You also need to avoid foods that are likely to fill your stomach up with gas.

So, it’s best to steer clear of:

• Foods that are high in fiber, like raw vegetables, lentils and whole grains
• Foods that cause acid reflux, like spicy foods, alcohol, chocolate, tomato, garlic and onion
• Foods that make you extra gassy, like beans, or cruciferous vegetables like Brussels sprouts
• Processed foods, like deli meats or chips
• Greasy, fried foods, like bacon, onion rings or doughnuts
• Sugary foods, like candy, baked goods or fruit juices
• Caffeinated beverages, like tea or coffee
• Carbonated beverages, like soda or sparkling water

You may notice some inconsistencies in what you’re reading. Cereal, for example, is both processed and high in fiber, which isn’t ideal when you have gastric cancer. But cereal also dissolves in milk, which makes it less problematic to digest. So, it might be a good way to help you maintain a varied diet.

The lesson: Don’t hesitate to speak to the different members of your care team in detail about food and nutrition. They can help you determine if you have different nutritional needs — or require different dietary restrictions — from other people with gastric cancer.

Consider taking supplements

Even if you make all the dietary adjustments we’ve mentioned, you may still need additional support. That’s why Dr. Lo Menzo encourages speaking to your doctor about supplements.

The most important supplement to ask your provider about is vitamin B12. It helps your body produce red blood cells, which are like fuel for your organs.

Keeping your B12 levels high can improve your immune response and make chemotherapy, radiation and surgery a little less taxing on your body. But we make the substance that helps us absorb B12 in our stomach. That’s why it’s so common to take B12 supplements while receiving treatment for gastric cancer.

The supplements you should take depend on many factors, but especially the type (or types) of treatment you’re receiving. Based on your specific circumstances, your provider may recommend:

• Calcium
• Iron
• Folate (vitamin B9)

Never take a supplement without talking with your care team first. Research suggests that supplements may interfere with cancer treatment or even cause additional health concerns. Not only can your provider determine what makes the most sense in your unique case, but they can also recommend brands that are safe and effective.

Dealing with appetite loss and swallowing issues

You can’t overestimate the importance of getting the nutrition you need as a person with gastric cancer. But stomach cancer can also complicate that process in ways you don’t expect. That makes keeping lines of communication open and alerting your providers to any changes in your symptoms all the more important.

If you feel like you have to force yourself to eat — or you’re unable to eat at all — tell your provider as soon as possible. There are medications they can prescribe to boost your natural hunger signals.

You should also let your provider know if you’re having trouble getting or keeping food in your stomach. Swallowing issues can be addressed in multiple ways, from physical or occupational therapy to surgery. The sooner you alert your care team, the sooner they can determine next steps.

Reach out for help

Food is an important part of our lives. And when illness changes the amount we eat, the type of food we eat or how we eat, it can have an emotional impact. It’s a legitimate thing to grieve. And you deserve to be supported in that process.

Turning to a mental health professional, a support group, or your friends and family is a great idea. But those aren’t your only options.

Don’t hesitate to reach out to the members of your care team if you notice that your thoughts and feelings about food are causing distress. Your mental health is just as important as your physical health, so treat it the same way you would treat any other symptom. Your care team can make sure you get the support you need.