A guide to eating socially

Tips for socialising with friends and family for people living with head and neck cancer and their caregivers

Socialising with family and friends often revolves around eating and drinking. This can be challenging for people living with head and neck cancer and their caregivers. You may be experiencing changes in appetite, taste and smell or have difficulty swallowing as a result of your treatment. Knowing what food to prepare that can be enjoyed by everyone can have caregivers in the kitchen scratching their heads.

While we know it’s important to maintain good nutrition during treatment and recovery, quality time such as social interactions with loved ones is one of the simple joys over the holidays. We asked Merran Findlay, Advanced Accredited Practising Dietitian, for some tips on finding ways to enjoy food with family and friends.

Swallowing Difficulties
Swallowing difficulties are common for people with head and neck cancer. If this is the case for you, choose foods that are easier to swallow such as soft, minced or puréed foods. If your Doctor or Speech Pathologist has provided you with information about the most suitable meal textures for you, it’s important to follow their advice.

Here are some menu ideas to try:

• Soups made from your favourite vegetables with added chicken, meat or fish. Try blending these if you find a smoother consistency easier to swallow.
• You may be able to manage very soft, tender pieces of meat such as turkey or pulled pork with mashed potato and gravy or apple sauce.
• Egg-based meals including omelette, frittata or crust-less quiche can be nourishing and soft to swallow.
• Other vegetarian options might include dishes made from tofu, chickpeas, lentils or other legumes which can offer a high protein alternative. Foods like hummus, baked beans and bean dips with soft wraps may also be good option.
• Dessert options that may be easier to swallow include trifle, mousse, crème caramel and stewed fruit or jelly with ice-cream, yoghurt or custard. Good old-fashioned steamed pudding with custard may be something you can enjoy along with everyone else.
• If you require thickened fluids, take your thickening powder with you to social events. Individual serve sachets are available from some companies which are perfect for meals away from home.

Reduced Appetite
If your appetite is poor, it’s important to ensure you are getting enough nutrition by choosing foods high in protein and energy (calories) to avoid unplanned weight loss.

• If you don’t feel like eating, opt for small but frequent meals or snacks a few hours apart.
• Try a nourishing drink like a milkshake, smoothie or thick shake. Coffee made on full cream milk or even an iced coffee with added ice-cream and whipped cream might be appealing in warmer weather.
• Adding cream, sour cream, oil or extra margarine or butter to foods is an easy way to add extra energy when your appetite is small.

Dry or Sore Mouth
Radiotherapy and chemotherapy can often leave you with a dry, sensitive or sore mouth and can change the way food tastes. Here are some tips to help:

• Speak to your care team about saliva replacement sprays and gels and ensure you take pain relief medication as prescribed, particularly around meal times so that eating is comfortable.
• Add moisture to meals with extra sauce or gravy to make it easier to chew and swallow. Casseroles and stews or soft fish with white sauce can be good options to try.
• You may wish to limit alcohol and caffeine which can be dehydrating and make a dry mouth feel worse. • Carry a water bottle with you znd take frequent sips throughout the day.
• Ice chips or frozen treats such as icy-poles might help sooth a sore or dry mouth.

Taste Changes
Another approach Merran suggests is to experiment with food and drink. Trying a few different options will help increase the variety in foods you find more enjoyable, for example:

• If you are finding that food tastes bland, experiment with seasoning and condiments to bring out flavour like herbs, garlic, ginger or pickles.
• Try a flavour-filled marinade or include food with lots of flavour like bacon or cheese.
• If your mouth is sensitive, some items such as citrus and spices may irritate so be guided by what you find most comfortable.

Nausea and Vomiting
Nausea and vomiting is a very common side effect of chemotherapy and smell can play a large part. Here are some ideas that might help:

• Try and stay away from the kitchen while meals are cooking. Cold foods can also be nourishing but give off less food aromas. Sandwiches or cold puddings can be good options to try.
• Some people find dry food like crackers or toast works for them.
 If you are unable to keep food down, try to at least stay hydrated by sipping fluids frequently and speak to your doctor or nurse about how best to manage your nausea and vomiting.

Food Safety and Hygiene
Food safety and good food hygiene practices are important for everyone but especially so for people who have a reduced immune system, for example, those having chemotherapy. The Cancer Council NSW provides helpful advice on food safety and avoiding high risk foods. 

Advice for Caregivers
Food is one of the most fundamental ways we have to nurture our loved ones yet those experiencing problems with eating can feel isolated from family occasions, leaving caregivers unsure how to help. A tip to get the most out of socialising with family and friends is to plan ahead. If you are visiting others in their home, speak to the host in advance about what options might be available for your loved one and any modifications that can be made to meals being served. Offer to bring along something to share so that everyone feels included.

Remember to also focus on other important aspects socialising, play music that brings a smile and enjoy spending time together. Apart from memorable meals, it’s often the little things that can bring the greatest joys.

You may also like to listen to Beyond Five's Ambassador, Julie McCrossin, interview Merran on the NSW Cancer Council The Thing About Cancer Appetite Loss and Nausea podcast episode.