Diet and exercise

If you’ve been diagnosed with liver cancer, you may need help with diet and exercise during your treatment and recovery.

Liver cancer and diet

Liver cancer and its treatment can cause a lot of physical problems that can affect your ability to eat and drink. You may have jaundice, or feel sick. An enlarged liver can make you feel full, as it takes up space in your tummy (abdomen) which can squash your stomach.

People often feel very tired when they have cancer, or during treatment. You may not feel like preparing food or eating much. If you’re a carer, try not to get upset if someone doesn’t feel like eating. Of course it’s worrying, but it can all too easily become a source of stress for you both. It’s best if everyone’s relaxed about it. Just try offering a snack again later.

Diet and jaundice

If you have jaundice, the flow of bile into your digestive system is blocked. Bile helps your body to digest fat, so it’s best not to eat too many fatty foods. You do need some fat though, as it’s a source of some essential vitamins.

Diet and treatment

Some liver cancer treatments can make you feel sick, which of course, puts you off your food. If you are recovering from surgery, you need protein to help your body repair itself. You may have lost weight so need plenty of calories.

Everyone’s needs – and tastes – are different. Do ask for advice at your treatment centre. You may be able to see a dietician, who can help to work out a diet programme that suits you. There are some tips below for how to manage various diet issues.

Diet tips

Here are some tips for managing problems with your diet. You’ll need to pick and choose for what suits you and the particular problems you’re facing.

• If you feel full or are troubled with sickness, it may help to eat several small meals a day instead of fewer larger ones. Aim to have something every couple of hours.
• Peppermint may help with feeling sick or bloated. Suck mints or try peppermint cordial.
• Some treatments cause a sore mouth or throat. Tell your doctor – they can prescribe medicines to help and may need to reduce your treatment dose.
• Some foods interfere with the way targeted therapies work. Avoid grapefruit or watercress if asked – it’s important.
• Don’t feel you have to eat a full meal – snacks are fine and may be easier to manage physically and psychologically.
• Keep a stock of foods you like, either tinned or packaged, or small portions of prepared foods in your freezer.
• Have whatever you feel like – don’t try to force yourself to eat things you don’t fancy,
• Cold foods and drinks may be more tempting if you feel sick – the smell of cooking can put you off eating.
• Try not to drink a lot during meals. You’ll fill your stomach with fluid and there’ll be less room for your food. You need fluids, but have them after or between meals.
• If you can’t manage food, sip a nourishing drink. Brands include Complan and Ensure. Or make your own milkshakes, smoothies, hot chocolate or Horlicks.
• Less fatty food choices include chicken, turkey, fish, eggs or low fat dairy. Avocado and nuts are other sources of healthier fats.
• If you can manage the fat, you can add extra calories to everyday foods by adding butter, cream or cheese.
• Fortify milk by adding 3 or 4 tablespoons of milk powder to whole milk.
• If you can manage them, wholegrain foods (porridge oats, brown bread, rice or pasta) will give you energy as well as fibre.
• Limit ‘empty calories’ from sweets, biscuits and cakes if you can. They’ll give you sugar, but little else. Healthier sweet snacks include yoghurt, bananas, wholemeal toast and jam or cereal with whole milk.
• As with any healthy diet, highly coloured fruit and veg provide lots of vitamins.

Alternative diet

People with cancer sometimes turn to alternative diets that may claim to treat, or even cure, your cancer. These claims are untrue. Most ‘alternative diets’ are faddy and don’t contain the balanced nutrition you need. Some you may hear about include Gerson therapy and the Budwig diet. The same goes for dietary ‘supplements’ such as Essiac.

Information about alternative therapies is almost always anecdotal – someone’s told someone that it worked for a relative or friend’s cancer. Unfortunately we can’t rely on this. It isn’t really evidence because we don’t know any of the medical details of these cases. So far, objective research into alternative diets hasn’t shown that any help to treat cancer.

It’s understandable that people want to believe that these approaches can help them. They may be promoted by people who genuinely believe they can help. But sometimes they are money making schemes run by unscrupulous people. It’s always best to be careful. Be wary if you’re asked for money. And talk to your own medical team before trying any alternative remedy.

Exercise

Being active is an important part of recovery from illness. There is evidence that exercise can help people who’ve had cancer by

• helping to combat anxiety and depression
• increasing energy levels, improving sleep and reducing fatigue
• improving fitness and speeding up physical recovery
• improving overall quality of life.

As with diet, everyone is different. The best exercise programme for you will depend on your age, current level of fitness and medical history. So we can’t give you a detailed exercise plan here. It’s best to check with your doctor before starting any new type of exercise, in case there are medical reasons why it isn’t suitable for you.

If you’re having surgery, your doctor may suggest you join an ‘enhanced recovery programme’. This starts even before your operation. Beforehand, it’ll include diet advice, relaxation, and exercise advice. If you stay active right up to your surgery, you are likely to recover more quickly – and may even get home sooner.

After surgery, you’ll be encouraged to become active as soon as possible. Getting up and about helps to reduce the risks of complications, such as chest infection or blood clots. The programme will advise you on how much exercise and the types of exercise that will help you. They may suggest you keep a diary of your progress.

As long as your doctor agrees, the general recommendation for people with (or who’ve had treatment for) cancer is 30 minutes of moderate intensity exercise 3 times a week. Ideally, you should also aim for 2 sessions of resistance training each week. Moderate intensity exercise includes:

• brisk walking (fast enough to be slightly breathless, but still able to talk)
• cycling
• dancing
• water aerobics
• hiking
• mowing the lawn

Resistance training means exercises that strengthen your muscles. This may mean lifting weights or doing sets of exercises like sit-ups or push-ups. But many other activities are muscle strengthening, including

• carrying heavy shopping (or children!)
• digging the garden
• pilates, yoga and tai chi

There are some face to face exercise programmes for people who’ve had cancer around the UK. Ask your doctor or specialist nurse. The Macmillan cancer helpline may also have information.

The NHS has some exercise videos online. The We are undefeatable campaign have videos and advice on exercise for people with health conditions. Do make sure they’re right for you before starting.