Eating Well During Cancer Treatment: A Guide for Sri Lankan Patients

One of the most common questions I receive from patients and their families is: "Doctor, what should we eat?" It is the right question to ask. Nutrition during cancer treatment is not about miracle foods or extreme diets — it is about eating enough of the right things to keep your body strong enough to tolerate treatment and heal.

Let me give you practical guidance rooted in the foods Sri Lankan households actually use.

Why Nutrition Matters During Treatment

Cancer and its treatments — surgery, chemotherapy, radiotherapy — place enormous demands on the body. They can:

• Increase the body's caloric and protein needs
• Cause nausea, mouth sores, or taste changes that reduce appetite
• Affect the gut's ability to absorb nutrients
• Lead to muscle wasting if protein intake is insufficient

Malnutrition during cancer treatment is associated with poorer treatment tolerance, longer hospital stays, and worse outcomes. Eating well is not optional — it is part of your treatment.

Protein: Your Most Important Priority

Protein is what your body uses to repair tissue, maintain immunity, and preserve muscle. During cancer treatment, you need more than usual. Good Sri Lankan protein sources include:

• Fish — tuna (fresh or canned), seer fish, sprats. Sprats are particularly affordable and rich in protein and calcium.
• Eggs — one of the most complete protein sources available. Boiled, scrambled, or in a milk toffee — eggs are excellent.
• Dhal (red lentils) — a staple protein for many Sri Lankan households; easy to digest and gentle on the stomach.
• Chicken — grilled or boiled is easier to digest than fried. Avoid deep-frying during treatment.
• Tempe and soya — good plant-based options if you prefer.

Try to include a protein source at every meal.

Calories: Do Not Restrict

Many patients, particularly women, arrive with the belief that they should eat less to "starve" the cancer, or to lose weight. This is a dangerous misconception. During active treatment, you need adequate calories. If your appetite is poor, focus on energy-dense foods:

• Full-fat coconut milk in curries and kiribath
• Peanuts and pol sambol
• Avocado (readily available in Sri Lanka's hill country)
• Coconut oil used in small amounts in cooking

What to Do When You Have No Appetite

Nausea and taste changes are common during chemotherapy. These strategies help:

• Eat small portions frequently — six small meals rather than three large ones
• Cold or room-temperature foods often smell less and are better tolerated than hot meals
• Plain rice with dhal is gentle and easily digested on difficult days
• Coconut water is excellent for hydration if plain water tastes metallic (a common chemotherapy side effect)
• Ginger tea (without milk) can reduce mild nausea — but tell your oncologist before using any herbal remedy regularly
• Suck on small pieces of ice if mouth sores make eating painful

Foods to Be Careful With

When your immune system is suppressed by chemotherapy, food safety becomes especially important:

• Avoid raw or undercooked meat and fish — eat only fully cooked protein
• Avoid unpasteurised dairy — stick to commercially pasteurised milk
• Wash all vegetables and fruit thoroughly, or peel them
• Avoid stale or reheated street food during neutropenic periods (when your white cells are at their lowest)

This does not mean you must stop eating Sri Lankan food — it means being careful about preparation and freshness.

A Note on Supplements

Vitamin and mineral supplements are widely available and aggressively marketed. My advice: do not take any supplement — including high-dose vitamin C, turmeric capsules, or "immune boosters" — without telling your oncologist. Some supplements interfere with chemotherapy. A balanced diet provides what most patients need. If there is a specific deficiency (confirmed by blood test), we will recommend the appropriate supplement.

Ask for a Dietitian Referral

Apeksha Hospital has dietitians on staff who can provide personalised nutrition plans. If you are losing significant weight or struggling to eat, ask your oncologist to refer you. This is part of your treatment, not an optional extra.