Living Well with Stomach Cancer

Stomach Cancer and Nutrition

As with many cancers, dietary choices remain a key component in the prevention, treatment, and survivorship of stomach cancer. As stomach cancer is a complicated disease, linked to many contributing risk factors—some unknown—proper dietary choices can only reduce your risk. Nonetheless, healthy lifestyle and dietary choices serve not only serve as a preventative measure against stomach cancer, but other conditions as well, such as heart disease.

Lower your Cancer Risk

According to the American Cancer Society, the rapid decline in the rates of stomach cancer over the past several decades is largely thought to be a result of the population reducing many of the known dietary risk factors; for instance, the more widespread use of refrigeration for food storage as opposed to preserving foods by salting, pickling, and smoking [1]. Here are a dietary few tips from the American Cancer Society, on the prevention of stomach cancer [2]:

  • Avoid a diet high in smoked or pickled foods and salted meats and fish
  • A diet high in fresh fruits and vegetables; citrus fruits may be especially helpful
    • Grapefruit and grapefruit juice can change the blood levels of certain drugs you take so consult a healthcare professional before adding it to your diet
  • A plant-based diet is also recommended, incorporating at least 2 ½ cups of veggies and fruits every day. Whole grains and leaner meats, fish or beans may also help reduce your risk
  • Dietary supplements as a means to lower risk have had mixed results so far; combinations of antioxidant supplements (vitamins A, C, E and the mineral selenium) might reduce the risk in individuals with poor nutrition but, otherwise, show no benefit to people with good nutrition
  • Some small studies have shown that drinking tea, in particular, green tea may help reduce risk
  • Being overweight or obese may add to the risk of stomach cancer, whereas being physically active may help lower our risk

Avoiding tobacco use

Tobacco use can increase the risk of cancers of the proximal stomach (the portion of the stomach closest to the esophagus). Furthermore, tobacco use increases the risk for many other types of cancer and is the leading cause of preventable illness, disability and death in Canada (via Alberta Health Services).

Aspirin use

Aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen seem to aid in reducing the risk of stomach cancer, in addition to other diseases such as colon cancer. Yet they can cause serious potential health risks like internal bleeding in some individuals.

Doctors consider any reduced cancer risk a bonus for patients taking NSAIDs to treat other medical conditions, but they do not yet recommend it solely for stomach cancer prevention. Further studies need to be done to determine whether the benefit of a lower cancer outweighs the risk of bleeding complications [4].

Nutrition During treatment

Diet becomes even more important if a person is diagnosed with cancer, the right amount of calories, protein, vitamins, and mineral will help you to maintain your strength and fight the cancer. All the same, stomach cancer and its treatment makes it challenging to eat; fatigue, discomfort or little desire to eat leave patients in predicament. You also may have nausea, vomiting, constipation or diarrhea from cancer treatment or pain medicine [5].

Changes in diet, food selection, and preparation techniques can help patients manage their symptoms. A registered dietitian who specializes in oncology nutrition (CSO) can recommend dietary choices that will provide adequate nutrients and calories for the specific needs of the patient to help in managing their food-related symptoms and side effects [6].

Here are a few tips to start off with [7]:

  • Eat frequent but small meals and snacks
  • Seek counseling from a registered dietitian who is a certified specialist in oncology nutrition
  • Rely on information from sources which are sound and scientific
  • Avoid ‘miracle cures’ and unknown dietary supplements, most of which do not have evidence to support their use or benefit

Here are resources for managing nutrition-specific symptoms of stomach cancer:

Debbie’s dream – Managing specific nutrition-related symptoms
Nutrition therapy – Nutrition therapy for stomach cancer

After surgery

It can be challenging to follow the correct diet after surgery when living with a partial or full gastrectomy. After surgery, it is important not to irritate the post-operative area that may be inflamed or healing. As you begin to heal, there are certain foods that are important to avoid as they may be harder to digest or contribute to uncomfortable digestive symptoms.

Here are some helpful tips to help guide you on how to plan your meals after surgery:

  • Consume small, frequent meals – Try to consume a small portion every 1-3 hours as you are able. Your body is learning how to digest food again and similar to a newborn, it is helpful to eat more frequently and in smaller quantities to allow your body to more easily adapt to digesting after surgery
  • Separate eating and drinking – It is suggested to wait 30-60 minutes after eating solid foods to have a beverage to avoid irritating the post-operative area and prevent nausea
  • Limit foods high in sugar/sugar alcohols and avoid added sugars like sugar, honey, syrup, sorbitol, xylitol – These can affect the movement of food through your digestive system and may cause discomfort.
  • Avoid high-fiber foods (>2 grams of dietary fiber per serving) such as whole grain or whole wheat breads, rice, cereals, and pastas – It is also important to avoid raw fruits and vegetables and any fruits and vegetables that are not cooked well. For example, even a stir fry with broccoli can be difficult to digest because often the broccoli and vegetables are still firm and crunchy. Certain foods are tough to digest whether cooked or not and should be avoided – including foods like corn, nuts and seeds.
  • Consume low fiber foods (<2 grams of dietary fiber per serving) such as white breads, rice, pastas, cereals – Consume only well-cooked vegetables that are tender enough to cut with a fork and canned fruits canned in their own juices (not in syrup).
  • Avoid gas-producing foods such as artichokes, asparagus, broccoli, cabbage, cauliflower, Brussels sprouts, green pepper, peas, lentils, beans, onions, apple, apricot, banana, melon, and prunes. – Sugar substitutes can also contribute to gas. If you are sensitive to lactose, choose lactose-free dairy products. Also avoid drinking through a straw, chewing gum, and drinking carbonated beverages as these can also contribute to gas.
  • Avoid meals that are too heavy such as those with dense gravies and sauces, large amounts of cheese, oils and grease – Full fat dairy products, poultry skin, and red meats are also more significant sources of fat.
  • Be sure to eat slowly – Eating to quickly you can contribute easily to digestive discomfort. Small frequent meals are important to promote better digestion and allow your body to handle small amounts of food at a time
  • Keeping a food diary – Keeping a food diary is very helpful for those who have undergone stomach surgery. It is important to slowly introduce one new food at a time. A food diary may help you to assess your tolerance of a new food or meal and identify those that may be triggering pain, discomfort, or indigestion. Even though the food suggestions above are a guideline, everyone’s body may have different sensitivities to various foods, and meals cooked with different oils, spices, etc. Be sure to communicate with your healthcare team if you experience anything unusual. It is also very important to seek the advice of a registered dietitian during this time to ensure that you are able to meet your nutritional requirements for healing.

Some easy food suggestions:

  • Sandwiches with a soft, tender lean meat or fish
  • Blended soups with well-cooked vegetables
  • Well-cooked pasta and rice dishes with lean meat or fish and without heavy sauce or gravy
  • Egg dishes and breakfast cereals

Information taken from Debbie’s Dream Foundation

Managing side effects of gastrectomy

The partial or total loss of the stomach means significant lifestyle changes for the patient. A patient will only be able to small, frequent meals for a while after surgery. Many people find certain foods may upset their digestion, while those foods vary from person to person. Patients will in all likelihood be in close consultation with a dietician before, during and after surgery.

Other common side effects after gastrectomy include [26]:

  • A feeling of fullness
  • Dumping syndrome
  • Diarrhea
  • Morning vomiting
  • Indigestion and colic

Stomach Cancer’s Dietary Affects and Changes

No stomach for cancer – Life without a stomach – Further resources for those who have had a gastrectomy procedure including nutritional information, symptoms and more.

No stomach for cancer – Basic principles of nutrition after gastrectomy – Nutrition tips to prevent sudden weight loss and maintain and gain more weight for stomach cancer patients.

Mayo clinic – Dumping syndrome – Dumping syndrome is a common, frequent symptom for patients after having a gastrectomy.

Cancer wellness centres often offer complementary and alternative medicines, such as yoga, and other healthful practices to help patients and their caregivers. Researching the programs and services available at a local cancer wellness centre may give an idea of the alternative treatments one is looking for.

Complementary and alternative medicines

Complementary and alternative medicines (CAM) are alternate medical products and practices that do not make up a part of conventional medical practice; CAM therapies can include acupuncture, chiropractic, and herbal therapies [29]. They can be used in conjunction with conventional medical practice or on their own; sometimes to ease the side effects of cancer treatment, both physical and psychological or treat the cancer itself. There is no certain guarantee these treatments will work, but they may provide relief and comfort for some patients.

Canadian Cancer Society – Complementary and alternative therapies (CAM) – Useful definitions pertaining to CAM that will help patients determine whether it would be beneficial to them

Inspire health – Integrative cancer care – Inspire Health, based in British Columbia, offers health care for cancer patients which incorporate both conventional and complementary therapies surrounding cancer care; they also offer an online program.

Wellspring cancer support network – Programs – Wellspring offers free programs for patients and caregivers such as Tai Chi and other meditative practices to help them during the cancer journey; most of their centres are located in Ontario.

More Resources

Cancer research UK – Diet after stomach surgery – Information on how stomach cancer can affect your diet and how to manage new dietary patterns.

No stomach for cancer – Life without a stomach – Further resources for those who have had a gastrectomy procedure including nutritional information, symptoms and more.

No stomach for cancer – Basic principles of nutrition after gastrectomy – Nutrition tips to prevent sudden weight loss and maintain and gain more weight for stomach cancer patients.

Mayo clinic – Dumping syndrome – Dumping syndrome is a common, frequent symptom for patients after having a gastrectomy.

Exercise for Patients and Survivors

Exercise research has shown that exercise at any point of the cancer journey including pre-diagnosis and prevention, pre-treatment, during treatment and post-treatment, is very beneficial to your recovery, day-to-day healthy life and also provides cancer patients with a higher functional capacity (via Physical activity can improve your physical and emotional health, and improve your quality of life after your cancer journey.

Exercise can:

  • Make you feel happier
  • Help you feel better about yourself
  • Reduce fatigue and can help you have more energy
  • Help you maintain and healthy lifestyle

Many cancer treatments have problematic side effects. Cancer and associated treatments can cause:

  • Weight gain
  • Bone loss
  • Muscle loss
  • Appetite loss
  • Depression
  • Anxiety
  • Poor sleep
  • Pain
  • Stiffness
  • Confusion
  • Reduced quality of life

Many of the listed treatment side effects above can be improved or eliminated with proper exercise. Please refer to the exercise guidelines, recommendations and resources below.

Exercising Safety Precautions

Check with your doctor before starting any exercise program, even if you exercised regularly prior to treatment. Your health care team will help you develop a safe and effective exercise program (via Canadian Cancer Society).

Some general safety precautions for people with cancer include (via Canadian Cancer Society):

  • Don’t exercise if you have anemia or if mineral levels in your blood, such as sodium or potassium, are not normal.
  • Avoid public places, such as gyms, if you have low white blood cell counts or a weakened immune system.
  • Avoid uneven surfaces or any weight-bearing exercises that could cause falls or injury.
  • If you have osteoporosis, arthritis, nerve damage or cancer that has spread to the bone, do not use heavy weights or exercise that puts too much stress on the bones.
  • Avoid swimming pools if you are receiving radiation therapy as chlorine can irritate skin in the treatment area.

Tips for Cancer Patients and Survivors when Beginning an Exercise Program (via Canadian Cancer Society)

  • Start slow. Start with something simple like walking and slowly increase how often and how long you walk.
  • Try exercising when you have the most energy or feel the best.
  • Try to exercise a little or do some type of activity each day, even if you are feeling unwell. Sometimes just a few minutes of gentle stretching can make you feel better.
  • If you don’t have the energy to exercise for a long period of time, break it up into a few shorter sessions throughout the day.
  • Try to include physical activity that uses large muscle groups such as your thighs, abdomen, chest and back.
  • Vary activities to include strength, flexibility and aerobic activities.
  • Try something new like yoga, tai chi or dancing.
  • Make exercise enjoyable by exercising with a friend or listening to music.
  • Try to remain active within your daily routine.
  • If you’re able, do housework such as vacuuming, washing floors and dusting. This is exercise, too. Try doing a little every day instead of all at once.
  • Mow the grass, wash the car or weed the garden.
  • Walk instead of drive or park your car in a parking space a distance from a building and walk to it.
  • Use the stairs instead of the elevator.
  • Get some fresh air or try meditation exercises to help reduce fatigue and motivate you.
  • Drink plenty of fluids before, during and after exercise. Stop and rest when you’re tired.

Pre-Treatment Exercise Benefits

  • Tolerate your treatment better
  • Proceed with difficult treatments
  • Reduce treatment complications
  • Reduce hospitalization duration
  • Maintain minimum levels of strength, even after long periods of bed rest
  • Keep you calm
  • Recover more quickly

Benefits of Exercise during Treatment

  • Improves fatigue
  • Improves physical function
  • Decreases weight and body fat
  • Improves immune system function
  • Improves cardio?pulmonary function
  • Improves upper extremity lymphedema
  • Improves quality of life
  • Reduces depression & anxiety
  • Regulates bowel movements
  • Improves appetite
  • Improves sleep
  • Preserves bone health
  • Reduces hospitalization duration

Benefits of Exercise for Cancer Survivors

  • Cardiovascular & musculoskeletal fitness
  • Vigor
  • Mental Clarity
  • Lymphedema
  • Physical functioning
  • Fatigue
  • Bone mineral density
  • Body composition
  • Joint mobility
  • Immune factors
  • Quality of Life
  • Reduced Risk of comorbidities
  • Reduced chronic treatment? related side?effects
  • Improved body image and self?esteem

Information taken from

For exercises specifically designed for stomach cancer patients and survivors, please visit a health care professional for recommendations and referrals.

[1] “Can Stomach Cancer Be Prevented?” Stomach Cancer. American Cancer Society, 20 May 2014. Web. 19 Nov. 2014.
[2] ibid.
[3] ibid.
[4] ibid.
[5] National Cancer Institute. What You Need To Know About Stomach Cancer. National Cancer Institute, What You Need To Know About Stomach Cancer. U.S. Department of Health and Human Services, July 2009. Web. 19 Nov. 2014.
[6]”Nutrition During Stomach Cancer Treatment.” Debbie’s Dream Foundation: Curing Stomach Cancer. Debbie’s Dream Foundation, 2014. Web. 19 Nov. 2014.
[7] ibid.