Written by Jackie Novak, MS, RD, LDN

What Caregivers Need to Know

A cancer diagnosis is devastating, not only for the person receiving the diagnosis, but also for the family members and friends who often step into the role of caregiver. Overnight, life can become filled with appointments, treatments, side effects, and uncertainty about what comes next.

For many caregivers, the desire to help is overwhelming. We want to fix the situation and do whatever we can to support them. But the reality is that much of cancer care can feel out of our hands. Chemotherapy, radiation, surgeries, scans, bloodwork… all things we cannot control.

Because of this, nutrition becomes an area where patients and caregivers feel they can take meaningful action. Food is something we can focus on when so much else feels uncertain. It is something we can prepare, offer, and adjust based on changing needs and preferences. While nutrition is an important part of cancer care, it can also become a source of stress and confusion. Between advice from friends and family, information found online, and suggestions from social media, it can be difficult to know what truly supports health during treatment.

Understanding the role of nutrition—and focusing on what matters most—can help caregivers provide meaningful support without adding unnecessary pressure during an incredibly challenging time.

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Loss of Appetite

One of the most common side effects of cancer treatment is loss of appetite. This is not a failure of caregiving. Watching someone you care about eat less than usual and start losing weight can be frustrating, worrying, and emotionally exhausting. Many factors can affect appetite during treatment, including changes in taste, sensitivity to smells and temperatures, mouth sores, nausea, constipation, fatigue, and many other treatment-related side effects. Rather than pressuring your loved one to eat, focus first on patience and understanding.

Some practical strategies to try include:

• Offer small, frequent meals. Instead of focusing on three large meals, aim for 5-7 smaller meals or snacks. Smaller portions are typically less overwhelming and may be better tolerated.
• Prioritize high-protein, high-calorie foods. When appetite is low, every bite matters. Choose foods that provide protein, calories, and nutrients in a smaller volume. For example, if your loved one enjoys smoothies, consider adding peanut butter (protein + calories), Greek yogurt (protein), avocado (healthy fat + calories), or a tablespoon or two of olive oil (healthy fats + calories) to increase calories and nutrients without increasing portion size.
• Use protein shakes when needed. Protein shakes such as Ensure Plus, Boost, Fairlife, Quest, and similar products available at most grocery stores can be helpful tools during treatment. Especially when eating solid foods feels difficult. Most provide 20+ grams of protein and are available in a variety of flavors, which is beneficial when taste preferences change on a day-to-day basis. While these are not intended to replace all meals, they can help support overall intake when appetite is limited.

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Problems with Taste

Taste changes are a common side effect of cancer treatment, particularly chemotherapy. Foods that were once favorites may suddenly taste bland, bitter, metallic, or simply “off”. While this can be frustrating for both patients and caregivers, there are several strategies that may help.

• Try tart or sour foods. Foods such as lemon, lime, orange, grapefruit, and pineapple may help “wake up” taste buds and improve flavor. **If mouth sores are present or your loved one struggles with acid reflux (GERD), use caution, as acidic foods may worsen symptoms.
• Avoid dry foods. Dry foods may be difficult to tolerate, so providing sauces, gravies, dressings, and dips can improve both flavor and texture.
• Experiment with new food. Get creative! Sometimes foods that were previously enjoyed become unpalatable (ex., coffee with cream), and foods that were once disliked are now tolerable (ex., peppermint tea). Be open to trying different flavors, seasonings, and meal options.
• Switch utensils. If foods have a metallic or copper-like taste, using plastic, bamboo, or reusable non-metal utensils may help.
• Limit exposure to strong smells and cooking odors. Treatment may increase sensitivity to smell, making certain foods hard to tolerate. When possible, use kitchen ventilation, serve food at room temperature, or choose cold foods (which tend to have less odor).
• Rinse the mouth regularly. Keeping the mouth clean and moist can help improve taste and overall comfort.

Most importantly, stay creative and try not to let yourself or your loved one become discouraged. Taste changes are often temporary. What doesn’t taste good today may be delicious next week. Stay flexible, remain patient, and keep trying different foods and flavors—you may be surprised by what works.

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Changes in Bowel Movements

Constipation is another common side effect of cancer treatment. Chemotherapy, anti-nausea medications, pain medications (especially opioids), reduced food intake, and decreased physical activity can make it difficult for your loved one to have regular bowel movements. Signs of constipation include bowel movements that are hard or dry, difficult or painful to pass, or occurring fewer than three times per week.

As a caregiver, it can be helpful to check in regularly with your loved one about their bowel habits, even if the conversation feels a little uncomfortable. Many people feel embarrassed discussing constipation, or may not realize it is important to mention. Reassure your loved one that constipation is a very common side effect of treatment and that there is no reason to feel embarrassed. Addressing the issue early can help them feel more comfortable and prevent symptoms from becoming more severe. If constipation becomes a concern, make sure to first discuss it with your loved one’s healthcare team. They may recommend a stool softener, laxative, or other treatment ot manage symptoms. In addition, the following nutrition and lifestyle strategies may help:

• Stay hydrated. Try to encourage your loved one to consume 8-10 cups of fluid per day, unless otherwise directed by their healthcare provider. Adequate hydration helps keep stools softer and easier to pass.
• Increase fiber gradually. Fiber can help promote regular bowel movements, but adding too much too quickly may worsen bloating, gas, or discomfort. Be mindful of this, especially if your loved one has had a poor appetite. Slowly incorporate fiber-rich foods such as quinoa, popcorn, barley, kiwi, berries, pears, dried fruit, broccoli, cabbage, squash, carrots, beans, peas, and lentils.
• Encourage movement when possible. Even light physical activity, such as a short walk, can help stimulate digestion and support regular bowel movements.

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Read Medication Instructions

During cancer treatment, it is common for patients to start several new medications. Taking a few minutes to review the instructions can help prevent unnecessary side effects.

Things to pay attention to:

• Should medication be taken with food or on an empty stomach?
• Should medication be taken at the same time every day?
• What foods and beverages should be avoided (i.e., grapefruit, grapefruit juice, alcohol, dairy products)?

While these details seem minor, they can have a significant impact on how medication is absorbed and tolerated. Using labels, setting reminders, or creating a medication schedule may be helpful to keep track of important instructions and potential food-drug interactions.

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A Final Note to Caregivers

Caring for someone with cancer is one of the most challenging roles a person can take on. While you cannot control every aspect of the journey, your support, patience, and presence can make a meaningful difference. Remember, nutrition does not have to be perfect to be helpful. Focus on meeting your loved one where they are, celebrating small victories, and giving yourself grace along the way.

If you have questions about nutrition during cancer treatment—or would like personalized guidance for yourself or a loved one—don’t hesitate to reach out. Our dietitians are here to help you navigate the challenges of cancer care.