Eating well after cancer treatment: what to eat now

Most people can go back to a healthy, balanced diet once treatment ends and eating has settled, unless their team has advised otherwise [15]. The American Cancer Society's guideline for survivors recommends "a healthy eating pattern that meets nutrient needs and is consistent with recommendations to prevent chronic disease" [3]. World Cancer Research Fund (WCRF), a UK charity, says its general advice "should be safe to follow for most adults who have cancer", and that where it differs from your doctor's or dietitian's advice "you should always follow their advice as it will be specific to your needs" [15].

Macmillan's healthy eating advice for people during and after cancer treatment includes "lots of fruit and vegetables – at least 5 portions a day" and "some protein-rich foods, such as lean meat, poultry, fish, nuts, eggs and pulses (beans and lentils)" [1]. Macmillan also suggests eating less processed and red meat, limiting red meat to "1 or 2 portions per week", and cutting down on foods high in fat, sugar and salt [1].

Macmillan also suggests "plenty of starchy foods (carbohydrates) – choose wholegrain types such as wholemeal bread" and "some milk and dairy foods, such as cheese and yoghurt, or dairy alternatives" [1]. The American Cancer Society's 2022 guideline for survivors describes the same plant-rich pattern, with little or no red and processed meat, sugary drinks and highly processed foods [3].

Taste after chemotherapy often improves over 1 to 2 years, with most recovery in the first year, but the timing varies with the type, length and dose of treatment [4]. WCRF says "How long it takes for your taste to return to normal depends on many things" [4]. WCRF adds that "Taste often improves for 1–2 years after chemotherapy" [4].

Cancer Research UK's practical tips for taste changes and a small appetite [5]:

• Strong flavours. Choose foods with strong flavours if everything tastes the same; tart foods have a strong taste.
• Marinades. Marinate food for a few hours or overnight; "even 10 minutes will make a difference".
• Metallic taste. Use plastic cutlery and avoid food and drinks from cans.
• Mouth care. Keep your mouth clean and brush your teeth well.
• Small amounts, often. Eat small amounts of high-protein, high-calorie foods every 2 or 3 hours instead of 3 large meals.

If you are still losing weight, see our guide to nutrition during cancer treatment and ask for a dietitian.

Protein helps the body repair itself and keep muscles healthy after treatment, especially alongside strength exercise [6]. The American Cancer Society advises survivors to "maintain or increase muscle mass through diet and physical activity" [3].

WCRF explains that proteins "are needed for the body to grow and repair itself and help to keep our muscles and bones healthy", that "Getting enough protein in your diet is key to maintaining muscle mass", and that "Living with a disease increases your protein needs" [6]. Plant proteins are found in foods such as pulses, like beans, peas and lentils [6].

Protein works best alongside exercise. European nutrition guidelines (ESPEN, 2017) say cancer survivors "should engage in regular physical activity and adopt a prudent diet" [7]. Our guide to exercise after cancer treatment covers how to build up safely. If tiredness is getting in the way of both eating and moving, read our guide to cancer-related fatigue.

Lose weight slowly, if you need to, and talk to your GP, cancer doctor or nurse before you start [2]. Macmillan suggests aiming to lose "about 0.5 to 1kg (1 to 2 pounds) a week" [2].

Macmillan says some cancer treatments can cause weight gain, for example by increasing your appetite, and that it is important to keep taking your medication [2]. Our guide to weight gain after cancer treatment explains the causes and how to lose weight safely.

Keeping to a healthy weight and being physically active "helps you feel stronger" and "gives you more energy", according to Macmillan, and your GP or a dietitian "can help you set a target weight that is healthier for you" [2]. A body mass index (BMI) result "cannot tell if someone is carrying too much fat or a lot of muscle" [1], so rebuilding muscle matters as much as the scales.

If you lost weight during treatment, ask your team about gaining weight safely instead. Macmillan says "If you gain or lose a lot of weight during or after cancer treatment, you may need to be referred to a dietitian" [1].

For cancer prevention, WCRF says it is best not to drink alcohol at all, and the NHS advises not regularly drinking more than 14 units a week [9][10]. Ask your team whether alcohol is a concern with your own cancer and medicines.

WCRF says "Drinking any type of alcohol increases your risk of 7 different types of cancer", including breast, bowel and liver cancer, and "Drinking less alcohol can reduce your risk of cancer" [10]. Macmillan adds that alcohol "is high in calories and can cause weight gain" [1].

If you drink, NHS guidance is to keep to 14 units a week or fewer, spread over 3 or more days, with several drink-free days each week [9]. A small 125ml glass of 12% wine is 1.5 units [1].

The evidence on alcohol and outcomes after cancer is mixed. The American Cancer Society found "insufficient evidence" across all cancer types for a separate alcohol rule for survivors, although a link has been seen for some cancers, and avoiding alcohol is still relevant "to reduce risk for a new cancer" [3].

It is not yet clear whether any diet can lower the chance of cancer coming back. Laboratory and observational studies suggest weight, activity, diet and alcohol "may affect risk for recurrence", but this evidence is "more limited than that for the development of cancer" [3].

Bowel Cancer UK states plainly: "We don't yet know how to stop bowel cancer coming back after treatment" [11]. WCRF says "There's no scientific evidence that changes to your diet or lifestyle can cure cancer" [15]. Macmillan says "Reducing your weight may also help reduce the risk of some cancers coming back" [1]; note the word "may".

The American Cancer Society's 2022 guideline adds that the evidence is "much more limited for cancers that are less common and/or have lower survival rates" [3]. Observational studies show links, not proof that a food changes the outcome.

On sugar, WCRF says "There isn't any evidence that eating a diet low in sugar affects cancer in a good or bad way" [8]. For supplements and "anti-cancer" diets, see our guide to nutrition during cancer treatment.

Ask for a dietitian if your weight has changed a lot, if you are struggling to eat, or before you make big changes to your diet. Macmillan says "If you gain or lose a lot of weight during or after cancer treatment, you may need to be referred to a dietitian" [1].

Some cancers and treatments leave lasting changes to how you eat. After bowel cancer treatment, for example, Cancer Research UK says "your digestion takes time to settle down", and high-fibre foods may cause loose poo and wind [12]. Bowel Cancer UK suggests increasing fibre gradually and advises: "Always speak to your healthcare team or a dietitian before making any big changes to your diet" [11]. If you have problems, you can ask to see a dietitian at the hospital [12].

Your cancer team, specialist nurse or GP can refer you; The Health Nav does not match people with dietitians.

Eating well and staying active work best together: food provides the energy and protein, and exercise rebuilds strength and fitness. Macmillan says keeping to a healthy weight and being physically active "may also reduce your risk of developing some cancers, or the risk of some cancers coming back" [2].

Clinical exercise physiologists (CEPs) are "university qualified health professionals who specialise in the prescription and delivery of evidence-based exercise interventions" for acute, chronic and complex conditions [16]. A CEP can test your strength and fitness and build a programme around your energy levels and your eating plan, working alongside your dietitian and cancer team.

For NHS and private support, see cancer rehabilitation in the UK or cancer rehabilitation in London.

Request a match with a verified clinical exercise physiologist through The Health Nav.