Preparing for chemotherapy or radiotherapy

This information leaflet has been written for people who will be having radiotherapy or chemo-radiotherapy to the head and neck region.

It means preparing for treatment by improving your:

• Nutrition.
• Physical fitness.
• Psychological wellbeing.

It can help you to:

• Improve your resilience to the side-effects of treatment.
• Enhance your recovery.
• Feel more in control.

• Read through this booklet.
• Take advantage of the information and support that is being offered.
• Use the next few weeks to get ready for your treatment.

Nutrition

Radiotherapy or chemo-radiotherapy to the head and neck region is likely to affect how well you are able to eat. It is important that you prepare for treatment by using the next few weeks to make sure your body is as well-nourished as it can be.

By keeping well-nourished you will be able to:

• Reduce the risk of infections.
• Heal more quickly.
• Maintain your strength and energy levels.
• Maintain your quality of life.
• Cope better with your treatment.
• Prevent your treatment being delayed or re-planned because your mask doesn’t fit properly.

There are no special foods that you should eat and no foods that you need to avoid. Have a good, balanced diet based on foods you enjoy and try to follow the guidelines below:

• Eat a diet that is high in energy (calories), aim to maintain your weight, or put on a few pounds if you have lost weight recently. Even if you are overweight at the moment, your body needs to be sustained with nutrition before and during treatment and you should aim to maintain your weight until you are fully recovered.
• Eat a diet that is high in protein. Aim to include good sources of protein with every meal. High protein foods include:
• Meat and poultry.
• Fish and seafood.
• Cheese and milk.
• Eggs.
• Pulses (eg lentils, beans, chickpeas).
• Quorn, tofu and other soya protein foods and soya drink.
• Nuts and seeds.
• Aim for five portions of vegetables and fruit each day. A portion is 80g,  that is about 3 tablespoons of veg (eg peas, carrots, greens), one medium fruit (eg apple, banana), two small fruits (eg easy peelers) or a handful of grapes. A small glass of fruit juice (150ml) can count as one of your five a day.
• Include potatoes, rice, pasta, bread, cereals or other starchy foods with your meals to provide energy. Where possible choose wholegrain versions and leave the skins on, for extra fibre.
• Have desserts and extra snacks between meals if you need them to keep your weight up.
• Aim to drink 1.5-2.5 Litres of non-alcoholic fluids a day. This can include water, tea and coffee, herbal teas, squash, milky drinks. Don’t drink more than 14 units of alcohol a week.

If you are finding it difficult to maintain your weight, if you have a reduced appetite, if you have any problems with swallowing or you have special dietary issues, please contact your dietitian on the number at the end of this leaflet for more individual advice.

It is useful to prepare for treatment by stocking your freezer and store cupboard with easy to eat and ready prepared meals and snacks. For instance you could freeze portions of softer, easier to chew foods like shepherd’s pie, casseroles and stews; ice cream is useful to have in the freezer as it can be soothing if your mouth becomes sore. Make sure you have a good supply of easy to eat tinned/ premade foods in your store cupboard, e.g. custard and rice pudding, soups (choose ‘cream of’ soups and lentil or meat based soups if possible), ready brek or Weetabix which can be soaked in warm milk to soften, evaporated and condensed milk, tinned meats and tuna fish etc.

If you have Type 1 or Type 2 diabetes the side effects of chemotherapy and radiotherapy can disrupt your blood glucose levels. You may need to monitor your blood glucose more often and you may need adjustments to any diabetes medication you take. To prepare for treatment, please contact your diabetes nurse or GP to discuss the best way to manage your diabetes during treatment.