Living Well


Like many other cancers, undergoing treatments like chemotherapy and radiation can have a significant impact on a lung cancer patient’s dietary needs. A loss of appetite, nausea, pain, tenderness in the throat, and difficulty swallowing are all symptoms in lung cancer patients have to cope with. This can make the prospect of eating incredibly unappealing [1]. Fortunately, there are food selection and preparation strategies that can ease the burden on the patient and help them meet their nutritional needs.

The process of finding a diet plan that suits your needs during lung cancer treatment can involve a lot of trial-and-error. Some foods affect your lung cancer symptoms, improving or worsening them. You may want to ask to see a registered dietitian nutritionist and work with them to come up with solutions that work best for you [2]. Here are a few general nutritional goals to keep in mind [3]:

  • Maintain a healthy weight. For some people this may mean eating enough calories to avoid weight loss and for others it may mean safely losing weight. Your doctor can help you determine your healthy weight.
  • Get essential nutrients the body needs. These are protein, carbohydrates, vitamins, minerals and water.
  • Avoid foods that make your lung cancer treatment side effects worse. Certain foods worsen diarrhea, constipation and mouth sores.

Food nutrition and preparation tips

Safely getting the nutrients you need is possible even if you are undergoing lung cancer treatment. For the most part, this will mean adjustments in diet and food preparation. A bland diet, for example, can ease the strain on your digestive system and avoid nausea by introducing soft, non-spicy, low-fibre foods into your diet, such as cooked, canned or frozen fruit or veggies, oatmeal or cream of wheat, breads made with refined flour or poultry, lean fish and shellfish that is steamed, baked or grilled with no added fat [4].

Avoiding foods that are very tart, acidic or spicy, such as citrus fruits or tomato-based foods can help the throat from being aggravated. This also includes foods that have rough textures or sharp edges, including raw fruits and vegetables, crackers, or pretzels. Thickening liquids, such as smoothies or soups, with added vegetables, protein or carbohydrates can help make your meals more calorically dense without straining your throat [5]

Food preparation

When you are receiving lung cancer treatment, the immune system is often compromised. This puts you at greater risk of infection, which means you should take extra care when preparing food. Below are some general guidelines to follow [6]:

  • Wash hands thoroughly before eating
  • Wash fruits and vegetables thoroughly
  • Use special care in handling raw meats, fish, poultry and eggs
  • Clean anything that has touched raw meat
  • Cook food to proper temperatures and drink pasteurized beverages
  • Store foods promptly at low temperatures to minimize bacterial growth (below 40ºF)
  • Avoid foods that may have potential bacterial contamination such as salad bars, sushi or undercooked meat
  • Contact your local health department if you are worried about water purity

Patient coping methods

Liz Williams, of Levittown, NY, describes loading up on food and calories—such as salads, steaks, baked potatoes—before the chemo medications took effect because she knew she wouldn’t be able eat much then. On those occasions, she found could sometimes manage watered-down Sprite or a bowl of chicken noodle soup [7]. ‘It’s very important to drink fluids to flush the chemicals,’ she says, and to eat whenever you have an appetite to get through lung cancer treatment [8].


Cooking tips for the lung cancer patient – Everyday health
Nutrition for lung cancer – American lung association

Physical activity

According to Lee Jones, PhD, scientific director of the Duke Center for Cancer Survivorship at Duke University School of Medicine, fitness levels in lung cancer patients are 30 to 40 percent below average healthy adults, in many cases related to long-term effects of smoking [9]. ‘Fitness, believe it or not,’ he says, ‘is among one of the strongest predictors of how long you will live [10].’

Cardiorespiratory fitness is the capacity of the heart, lungs and circulatory system to transport oxygen to the working skeletal muscles. This capacity depends on the age, gender and amount of exercise a person gets. Physical activity not only improves cardiorespiratory fitness in lung cancer patients, but patients report mprovements in fatigue, depression, sleep, quality of life and breathlessness. Jones says that these benefits may extend across the board, regardless of disease stage, treatment or surgical intervention [11].

But many health care professionals tend to not use exercise as therapy for lung cancer patients due in part to the lack of evidence-based consensus as how and when to implement increasing physical activity [12].

Studies have examined the impact of physical activity on reducing the risk of lung cancer. According to the National Cancer Institute, twenty-one studies looking at this relationship suggest that the most physically active individuals experience about a 20 per cent reduction in lung cancer risk [13]. For those diagnosed, multiple trials have also shown that increased physical activity reduces the lung cancer symptoms and exercise interventions may have beneficial effects on the quality of life of patients [14]. A 2015 review of lung cancer studies from the Medical University of South Carolina concluded that [15]:

‘[…] clinicians should (at minimum) consider physical activity early, counsel against inactivity, and encourage physical activity in all stages of lung cancer patients and survivors. This review shows uniform recognition that exercise and physical activity are safe for those with lung cancer, patients are requesting increased activity counseling, and multiple studies and reviews show potential clinical benefit in quality of life, exercise tolerance, and post-operative complications. Further, we know that inactivity in cancer patients is associated with worse outcomes.’

Exercise and lung cancer at different stages

Perioperative exercise (continual exercise before and after surgery) in lung cancer patients appears to be safe with improvement in operability, operative risk, post-operative complications, as well as increased exercise capacity—however, preoperative exercise interventions appear to be more beneficial than post [16]. Non-surgical advanced-stage lung cancer patients may also benefit from increased physical activity by relieving symptoms, but exercise recommendations for this patient subgroup are less clear [17].

Chronically-ill cancer patients have more exercise limitations than other lung cancer patients: comorbid conditions and increased symptom burdens adds another dimension to finding a physical activity regimen that helps not harms metastatic lung cancer patients. Low-intensity programs such as daily walking or step-counting may provide a safe way to increase physical activity while identifying an individual patient’s activity limits [18].

The increased activity that also appears to benefit lung cancer patients seems to have the same effects for lung cancer survivors as well, especially in terms of improved symptoms and quality of life [19].

Exercising with lung cancer

The Dana Farber Cancer Institute reported that most lung cancer patients, regardless of their disease stage, wanted exercise advice directly from a physician at a cancer centre before cancer treatment. Furthermore, guidance from a clinician may help patients stick with an exercise program [20]. Consulting with your care team will help you develop a program tailored to your personal needs. If you were not active prior to diagnosis, you can start slowly with light walking or stretching, or if you were active previously, you can do a modified versions of the activities you engaged in before diagnosis [21].

Aerobic training is a good way to improve your cardiorespiratory fitness. Aerobic or endurance training improves your heart’s ability to pump blood around the body but also your oxygen carrying capacity. Aerobic training includes activities like walking, swimming, or any activity that requires the heart and lungs to work harder than at rest [22].

A key to building a manageable physical activity routine is to finding out what you’re able to do and then building on that. For a person who can’t walk 50 feet before getting short of breath, try walking 25 feet, taking a short rest, walking another 25 feet, and then resting again. A pedometer can be particularly useful in keeping track of steps. It can be empowering to take small, manageable steps towards your goals [23].

Walking with a pedometer and counting steps can be particularly motivating for lung cancer survivors because as you continue to walk you’ll find that you’re able to walk longer distances for longer periods of time [24].


Physical activity and lung cancer – American lung association
Exercising with lung cancer – Dana-Farber cancer institute
Lung cancer and exercise – Cure today

Mental health

Lung cancer has an intense effect on not only your body but your mind and spirit. Diagnosis, treatment, surgeries and survivorship all can acutely impact your mental health. Symptoms from treatment or the lung cancer can affect your self-esteem, mood and how you relate to those around you [25]. Being sick changes how we behave and the onset of lung cancer brings uncertainty and worry. Emotions like shock and denial, fear, anger, anxiety and frustration are reasonable to expect [26].

Going through lung cancer is not an experience that everyone around you will understand. A former smoker might be angry they stopped smoking but still got lung cancer. It can be very helpful to reach out to others who can relate to and share your feelings [27]. This can help you work through and process your emotions.


Conversely, guilt and shame around a lung cancer diagnosis are common feelings to experience as well. A 2008 study showed that current and former smokers with lung cancer are more likely to feel guilt and shame about their cancer than patients breast or prostate cancer [28]. This can become internalised from the strong negative association between smoking and lung cancer. Implying that lung cancer patients are to blame for their cancer is irresponsible [29]. Smoking is one of the most difficult addictions to overcome and when support pillars like social support or financial resources are absent it can be very challenging [30].

Stigma from lung cancer can result in patients experiencing [31]:

  • Complex self-blame and intensified guilt and shame
  • Fear of disclosing one’s diagnosis of lung cancer
  • Avoidance of social situations, leading to increased feelings of isolation
  • Increased stress and difficulty coping
  • Threats to economic opportunities and financial problems

This can affect the quality of life of lung cancer patients and may in fact raise the possibility of morbidity. A study looking at stigma and lung cancer showed that stigma had serious consequences: avoidance of social situation was found to be a common behaviour amongst lung cancer patients in order to prevent being asked about smoking or being blamed, be it real or implied [32].

Despite lung cancer being one of the major cancers in Canada, it rarely gets the attention from the press it needs. It is only reported when a prolific figure has passed away and their history of smoking is often tied up in the story. Stories of survivorship and/or overcoming a smoking addiction are very rarely told [33]. Compassion from a lung cancer patients’ support network and, furthermore, changing social attitudes towards smoking and lung cancer are paramount to the present and future well-being of many lung cancer patients. While this will take time and effort, Lung Cancer Canada says support groups can help lung cancer patients by assisting members to resist stigmatization and victim blaming [34].



Coping with lung cancer – Cancer research UK
Emotional effects of lung cancer – Livestrong dot com
Stigma – Lung cancer Canada


[1] “Cooking Tips for the Lung Cancer Patient.” Everyday Health. Everyday Health, 29 Sept. 2010. Web. 19 Apr. 2016.
[2] “Nutrition.” American Lung Association. American Lung Association, 2016. Web. 19 Apr. 2016.
[3] ibid.
[4] ibid.
[5] “Cooking Tips for the Lung Cancer Patient.” Everyday Health. Everyday Health, 29 Sept. 2010. Web. 19 Apr. 2016
[6] “Nutrition.” American Lung Association. American Lung Association, 2016. Web. 21 Apr. 2016.
[7] “Cooking Tips for the Lung Cancer Patient.” Everyday Health. Everyday Health, 29 Sept. 2010. Web. 19 Apr. 2016.
[8] ibid.
[9] Meyer, Lacey. “Lung Cancer and Exercise?” Cure Today. Cure Today, 4 Mar. 2010. Web. 22 Apr. 2016.
[10] ibid.
[11] ibid.
[12] Wynes, Murry W. “Physical Activity Benefits Lung Cancer Patients, Survivors.” International Association for the Study of Lung Cancer (2015): Science Daily. International Association for the Study of Lung Cancer, 2 Apr. 2015. Web. 22 Apr. 2016.
[13] “Physical Activity and Cancer.” National Cancer Institute. National Cancer Institute, 22 July 2009. Web. 22 Apr. 2016.
[14] Wynes, Murry W. “Physical Activity Benefits Lung Cancer Patients, Survivors.” International Association for the Study of Lung Cancer (2015): Science Daily. International Association for the Study of Lung Cancer, 2 Apr. 2015. Web. 22 Apr. 2016.
[15] ibid.
[16] ibid.
[17] ibid.
[18] ibid.
[19] ibid.
[20] “Exercising with Lung Cancer.” Dana Farber Cancer Institute. Dana Farber Cancer Institute, 2016. Web. 22 Apr. 2016.
[21] ibid.
[22] Meyer, Lacey. “Lung Cancer and Exercise?” Cure Today. Cure Today, 4 Mar. 2010. Web. 22 Apr. 2016.
[23] ibid.
[24] ibid.
[25] “Coping with Lung Cancer.” Cancer Research UK. Cancer Research UK, 31 Mar. 2014. Web. 27 Apr. 2016.
[26]”Emotional Effects of Lung Cancer.”, 27 Jan. 2015. Web. 27 Apr. 2016.
[27] ibid.
[28] ibid.
[29] “Stigma.” Lung Cancer Canada. Lung Cancer Canada, 2016. Web. 27 Apr. 2016.
[30] ibid.
[31] ibid.
[32] ibid.
[33] ibid.
[34] ibid.