Adequate nutrition plays a critical role in supporting mesothelioma treatment. Research shows that patients who maintain nutritional status during treatment experience fewer complications, tolerate therapy better, and may achieve improved outcomes. Cancer cachexia (wasting syndrome) affects 50-80% of cancer patients and is associated with reduced survival.
The American Cancer Society and National Comprehensive Cancer Network recommend nutritional assessment and intervention as part of comprehensive cancer care. For mesothelioma patients facing aggressive treatments, proper nutrition becomes especially important.
Nutritional counseling starting at diagnosis improves outcomes compared to waiting until problems develop. Ask for a registered dietitian referral early in your treatment.
Nutritional Challenges in Mesothelioma
Mesothelioma and its treatments create unique nutritional challenges:
Disease-related effects:
- Pleural effusions can cause early satiety and shortness of breath during eating
- Tumor metabolic activity increases caloric needs by 10-30%
- Cancer-related inflammation alters metabolism and reduces appetite
- Peritoneal mesothelioma may directly impair digestive function
Treatment-related effects:
- Chemotherapy causes nausea, taste changes, and mouth sores
- Immunotherapy can cause digestive side effects including colitis
- Surgery requires increased protein for wound healing
- Radiation to the chest or abdomen affects nearby digestive organs
Studies of cancer patients undergoing treatment have found malnutrition rates of 40-80%, depending on cancer type and treatment intensity. Early nutritional intervention can help prevent or address these problems.
Caloric and Protein Requirements
Cancer treatment increases caloric and protein needs:
Caloric needs during treatment:
- Maintenance: 25-30 calories per kilogram body weight daily
- During active treatment or recovery: 30-35 calories per kilogram daily
- For a 150-pound (68 kg) patient: approximately 2,000-2,400 calories daily
Protein requirements:
- During treatment: 1.2-1.5 grams protein per kilogram body weight daily
- After surgery: 1.5-2.0 grams per kilogram for wound healing
- For a 150-pound patient: approximately 80-100 grams protein daily
Meeting these requirements can be challenging when appetite is reduced or treatment side effects interfere with eating.
Evidence-Based Dietary Recommendations
Research supports several general dietary principles during cancer treatment:
Adequate protein intake:
- Protein supports immune function and tissue repair
- Include protein at every meal and snack
- Sources: lean meats, fish, eggs, dairy, beans, nuts, protein supplements
- Studies show protein supplementation during chemotherapy reduces treatment delays
Anti-inflammatory foods:
- The Mediterranean diet pattern has been associated with reduced cancer-related inflammation
- Emphasis on fruits, vegetables, whole grains, fish, olive oil
- A 2022 meta-analysis found Mediterranean diet adherence associated with improved quality of life in cancer patients
Omega-3 fatty acids:
- Found in fatty fish, walnuts, flaxseed
- May help maintain muscle mass during treatment
- Some studies show benefit for cancer cachexia when combined with adequate protein
Adequate hydration:
- Fluid needs increase during treatment, especially with nausea/vomiting
- Aim for 8-10 cups of fluid daily
- Chemotherapy requires additional hydration to protect kidneys
Managing Treatment Side Effects
Nausea and Vomiting
Chemotherapy-induced nausea affects the majority of patients:
Dietary strategies:
- Eat small, frequent meals (5-6 per day)
- Avoid strong odors and greasy/fried foods
- Try bland, room-temperature or cold foods
- Ginger (ginger ale, ginger tea, ginger candy) may help
- Eat dry crackers or toast before getting up
Medical support:
- Anti-nausea medications (ondansetron, granisetron, prochlorperazine) are very effective
- Request prescription anti-nausea medication proactively
Taste Changes
Chemotherapy commonly alters taste perception:
Strategies:
- Use plastic utensils if foods taste metallic
- Try marinades, seasonings, and citrus to enhance flavor
- Cold foods often taste better than hot
- Experiment with new foods while taste is altered
- Protein may taste bitter; try cold chicken, cheese, or eggs instead
Mouth Sores (Mucositis)
Chemotherapy and some targeted therapies can cause mouth sores:
Strategies:
- Avoid acidic, spicy, and rough-textured foods
- Choose soft, moist foods
- Use straws for liquids
- Rinse mouth frequently with salt water or baking soda solution
- Avoid alcohol and tobacco
Diarrhea
Chemotherapy and immunotherapy can cause diarrhea:
Strategies:
- Avoid high-fiber, greasy, and spicy foods during episodes
- Try the BRAT diet (bananas, rice, applesauce, toast) temporarily
- Stay well-hydrated with electrolyte-containing fluids
- Report severe or prolonged diarrhea to your medical team
Loss of Appetite
Cancer and treatment commonly reduce appetite:
Strategies:
- Eat by the clock rather than waiting for hunger
- Make the most of good appetite days
- Use high-calorie supplements when needed (Ensure, Boost, etc.)
- Add healthy fats (olive oil, nut butters) to foods for extra calories
- Consider a registered dietitian consultation
Nutritional Supplements
When Supplements May Help
Oral nutrition supplements:
- Appropriate when food intake alone cannot meet needs
- Studies show improved outcomes when supplements prevent weight loss
- Products like Ensure Plus, Boost Plus, or Benecalorie can add significant calories
Fish oil/omega-3 supplements:
- Some evidence for preserving muscle mass during chemotherapy
- Typical dosage in studies: 2-3 grams EPA+DHA daily
- May interact with blood thinners; discuss with your oncologist
Vitamin D:
- Deficiency is common in cancer patients
- May support immune function
- Blood levels should be tested; supplementation based on results
Supplements to Approach Cautiously
High-dose antioxidants during treatment:
- Theoretical concern that antioxidants could protect cancer cells from treatment
- Studies have not consistently shown harm, but evidence is unclear
- Discuss with your oncologist before taking high-dose vitamins C, E, or beta-carotene
Herbal supplements:
- Many interact with chemotherapy and other medications
- St. John’s wort, for example, can reduce chemotherapy effectiveness
- Always disclose all supplements to your medical team
Peritoneal Mesothelioma Considerations
Patients with peritoneal mesothelioma face additional nutritional challenges:
Digestive involvement:
- Tumor spread on abdominal organs can impair digestion and absorption
- Ascites (fluid accumulation) reduces stomach capacity
- Surgery involving the intestines may temporarily or permanently alter digestion
Post-HIPEC nutrition:
- After cytoreductive surgery with HIPEC, patients typically cannot eat for several days
- Gradual return to oral intake is supervised by the medical team
- Long-term dietary adjustments may be needed based on extent of surgery
Monitoring needs:
- More frequent nutritional assessment may be needed
- Vitamin and mineral deficiencies are more common
- Registered dietitian involvement is particularly important
Working with Your Healthcare Team
Nutritional care should be integrated into cancer treatment:
Registered dietitians:
- Specialized oncology dietitians can provide personalized guidance
- Request a referral through your cancer center
- Many centers include nutrition services in comprehensive care
Regular assessment:
- Weight should be monitored at each appointment
- Report changes in appetite, eating, or weight promptly
- Early intervention is more effective than treating advanced malnutrition
Communication:
- Tell your team about eating difficulties
- Ask about anti-nausea medications, appetite stimulants, or other support
- Request help with specific concerns (taste changes, swallowing difficulty, etc.)
Practical Tips
Meal preparation:
- Cook when you feel well and freeze portions for difficult days
- Accept help from family and friends with food preparation
- Keep easy, nutritious snacks readily available
High-calorie, high-protein foods:
- Greek yogurt, cheese, nuts, nut butters
- Avocado, eggs, whole milk
- Smoothies with added protein powder
- Fortified cereals and oatmeal
When eating is difficult:
- Liquid nutrition may be easier than solid food
- Smoothies can pack significant calories and protein
- Small, frequent intake often works better than large meals
- Focus on favorite foods when appetite is present
What the Research Shows
Studies on nutrition in cancer patients support several conclusions:
Weight maintenance matters:
- Patients who maintain weight during chemotherapy have fewer treatment delays and fewer dose reductions
- Weight loss greater than 5% during treatment is associated with worse outcomes
Protein is protective:
- Adequate protein intake helps maintain muscle mass
- Loss of muscle mass (sarcopenia) is independently associated with reduced survival
Early intervention works:
- Nutritional counseling starting at diagnosis improves outcomes compared to waiting until problems develop
Exercise complements nutrition:
- Physical activity combined with adequate nutrition best preserves function and quality of life during treatment
Related Articles
- Mesothelioma Treatment Options
- Mesothelioma Caregiver Guide
- Palliative Care for Mesothelioma
- Managing Treatment Side Effects
How many calories do I need during mesothelioma treatment?▼
Most patients need 30-35 calories per kilogram of body weight daily during active treatment. For a 150-pound (68 kg) patient, that’s approximately 2,000-2,400 calories daily.
What's the most important nutrient during treatment?▼
Protein is critical—aim for 1.2-1.5 grams per kilogram of body weight daily (80-100g for a 150-pound person). Protein supports immune function, tissue repair, and helps maintain muscle mass.
Should I take supplements during chemotherapy?▼
Discuss all supplements with your oncologist before taking them. Some supplements (like high-dose antioxidants) may interfere with treatment. Fish oil, vitamin D (if deficient), and oral nutrition supplements may be beneficial.
What if I can't eat enough?▼
Try small, frequent meals; liquid nutrition like smoothies or supplements; and high-calorie additions like olive oil and nut butters. If weight loss continues despite efforts, talk to your medical team about additional interventions.