How to eat well with lymphoma - Lymphoma Association

Freephone helpline 0808 808 5555 

information@lymphomas.org.uk 

www.lymphomas.org.uk 

How to eat well with lymphoma 

Eating a well-balanced diet is essential for everybody to maintain good health and 

fitness, but it is all the more important when you have lymphoma. If you are already 

eating healthily, you might not need to make many changes to your diet and you 

should continue to eat as normal. 

However, having lymphoma might change how you feel about food or your ability to 

eat normally. There may be times when side effects of treatment or the lymphoma 

itself make eating and drinking more difficult. It is always a good idea to discuss your 

nutritional needs with your healthcare team. 

In this article we aim to answer the following questions: 

• What does a healthy diet look like (see below) 

• Why is nutrition important during treatment for my lymphoma (page 2) 

• How will my treatment affect my eating and drinking (page 3) 

• What can I do to eat well and eat the right amount for me (page 5) 

• What can I do to make it easier for myself (page 5) 

• Will nutritional supplements help me (page 6) 

• What happens if I am unable to maintain my weight through eating and drinking 

alone (page 7) 

• How can I ensure the food I eat is safe (page 7) 

What does a healthy diet look like 

Eating a healthy, balanced diet will provide you with all the nutrients you need, as well 

as help you maintain a healthy weight. A healthy diet includes eating foods from a 

number of different food groups, including: 

• fruit and vegetables 

• bread, pasta, rice, potatoes and other starches 

• meat, fish, eggs, beans and other non-dairy proteins 

• milk and dairy foods 

• fatty and sugary foods. 

A balanced diet contains carbohydrates, protein, vitamins and minerals, fat and fibre. 

Carbohydrates provide us with energy. Protein is essential for growth and repair of the 

body. Vitamins and minerals play a major part in the healthy functioning of our bodies. 

Fat provides us with energy and also helps us to absorb certain vitamins, but it is 

important not to have too much of the wrong sort of fat. Fibre helps with bowel health 


LYM0070/EatWell/2013v2 

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(especially important for those who have slower bowel movements as a result of not 

being able to exercise or taking certain medications). 

The eatwell plate shows you the different types of foods you need to eat and in what 

sizes of portions. 

The eatwell plate 

Department of Health in association with the Welsh Government, the Scottish Government and the Food Standards Agency in Northern Ireland 

© Crown copyright 2011 

Why is nutrition important during treatment for my 

lymphoma 

Treatments for lymphoma, particularly chemotherapy, can be easier to cope with if 

you are well nourished and continue to eat and drink well. You are likely to be able to 

tolerate higher doses of chemotherapy with fewer delays and fewer infections if your 

dietary intake remains adequate. Becoming malnourished – not following a nutritious 

diet – can lead you to feel down, both emotionally and physically. 

Healthy eating is always important and never more so than during treatment for 

lymphoma. If you are able to continue eating a normal diet – and your appetite remains 

good – you should aim to maintain your weight throughout treatment, no matter what 

your starting weight is. If you start to struggle with eating and drinking at any time of 

your treatment, it is important to let your healthcare team know – they can quickly start 

to help and support you in finding ways to prevent further weight loss. 

During the times when your lymphoma affects how you feel about food, you may be 

encouraged to make changes to your normal diet. If you think though that you could 

make some changes to improve what you eat anyway, it would be a good idea to make 

plans for how to achieve this. 



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It is important to remember that there is no specific diet for lymphoma and so the 

information in this article is suitable for the whole family as long as they are fit and well. 

Energy (calories) 

It is important to eat just the right amount each day. If your energy intake becomes 

too low you will start to lose weight, which can lead to increased tiredness and slower 

recovery of blood counts. 

You may find that you need more energy than usual, particularly if your lymphoma 

is associated with night sweats and fever. At other times, your energy needs will be 

increased if you have an infection or a raised temperature and during chemotherapy. 

If you feel that you are eating normally but continue to lose weight, discuss this with 

your medical team or dietitian. It may be that you need to consider some strategies 

for increasing the amount of energy in your everyday diet. 

If your appetite is very good and you are eating large portion sizes, aim to fill up 

on foods that are lower in calories, such as fruit and vegetables or starchy foods. 

However, if your appetite is poor and you are only managing small portions, increase 

the energy density of your meals with foods such as butter, cream or cheese, which 

are much higher in energy. This way you can regulate your energy intake depending on 

your appetite at different times. 

Protein 

During treatment you may need more protein, particularly if your body needs 

additional healing following treatment. Many people worry about their protein intake 

during chemotherapy as some protein-rich foods, such as red meat, can become 

difficult to eat. There are several other good sources of protein, such as fish, milk, 

cheese, eggs, nuts, seeds, beans and pulses. If you are not eating your usual sources 

of protein, try to supplement with another source from the list in Table 2 (see page 6). 

Vitamins and minerals 

Our daily requirements for vitamins and minerals are relatively small so, generally, 

there is no need to supplement the diet if you are not restricting any particular food 

group or type. Occasionally, if your eating and drinking have decreased or if you are 

unwell, it may become more difficult to meet your daily vitamin and mineral needs. 

If you are concerned about whether you are getting enough, you should discuss this 

with your healthcare team or dietitian as some supplements can react with other 

medication and should be avoided. High doses of some vitamins and minerals can be 

dangerous - only take supplements if recommended to do so by your doctor. 

How will my treatment affect my eating and drinking 

How you might be affected is very individual and will depend on the type of lymphoma 

you have and your particular treatment plan. Even if people are on the same treatment, 

everyone will have different side effects to different degrees. Table 1 (see page 4) 

highlights some of the more common side effects of lymphoma treatments. It has 

some simple ideas to help if you are experiencing these side effects. 



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Table 1: Problems that may affect food intake and some helpful suggestions 

Problem Likely cause Possible solution 

Poor appetite Chemotherapy 

Radiotherapy 

Other 

medication 

Eat little and often 

Have nutritious drinks 

Have an aperitif (an aperitif before dinner might 

improve your appetite but check with your doctor first 

whether an alcoholic drink is permitted) 

Ask your doctor about appetite stimulant tablets 

Nausea and 

vomiting 

Feeling full 

quickly 

Sore mouth/ 

sore throat 

Taste 

changes 

Diarrhoea 

Constipation 

Chemotherapy 

Radiotherapy 

Other 

medication 

Chemotherapy 

Lymphoma in 

the gut 

Radiotherapy to 

the gut 

Chemotherapy 


the mouth and 

throat area 

Chemotherapy 

Other 

medication 

Chemotherapy 


the gut 

Painkillers 

Chemotherapy 

Anti-sickness 

medication 

Take regular anti-sickness medication 

Eat dry plain foods 

Have nutritious drinks 

Ginger drinks, ginger biscuits and fizzy drinks 

might help 

Eat little and often 

Separate drinks from food (ie have drinks 30 minutes 

before or an hour after food) 

Avoid filling up on bulky, low-energy foods such as 

beans and salads 

Have a soft/liquid diet 

Take nutritious drinks 

Avoid spicy and rough foods 

Ask for medication for mouth care and painkillers 

from your doctor 

Brush your teeth regularly and use prescribed 

mouthwashes 

Concentrate on foods that taste good 

Use strong flavours such as citrus and strongflavoured 

sauces and chutneys 

Ask your doctor for anti-diarrhoea medication 

Drink plenty of fluids to avoid dehydration 

If medication is not controlling your diarrhoea, speak 

to your doctor or dietitian for further advice 

Ask your doctor for laxatives 

Make sure you are drinking plenty of fluids 

Keep as active as possible 

Try a high-fibre diet 

If you have diabetes, talk to your doctor or dietitian about any impact treatment could 

have on that condition. 



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What can I do to eat well and eat the right amount for me 

While it is very normal for the side effects from lymphoma or the treatment to affect 

your desire to eat and drink, it is possible that you will continue to have a good appetite 

throughout treatment and there will be no need to make any changes. However, if you 

feel that the amount you eat has decreased, it is time to start making some simple 

changes to increase your daily intake: 

• Eat little and often, aiming to include small snacks between your meals. 

• Be positive about what you do eat and remember that every mouthful counts. 

• Do not use diet, light, low-fat or reduced-sugar products as these are lower in 

energy. 

• Try adding extra butter, cream, cheese, honey or sugar to foods to increase the 

energy in everything you eat. 

• Add high-fat dressings and sauces to meals wherever possible. Examples include 

French dressing to salads, mayonnaise and butter to jacket potatoes, cheese sauce 

to vegetables or ice cream and custard to desserts. 

• If you are feeling too tired to prepare meals, then ready-made and convenience 

foods can be a useful standby. Alternatively, when you prepare meals yourself, cook 

more than you need and freeze a portion for another day. 

• Eat more of the foods you do enjoy, whatever time it is. For example, you may find 

the idea of having a bowl of porridge or cereal easier to face in the evening than a 

cooked meal. 

• Make the most of your best times. You may find early mornings easier, so make sure 

you have a good breakfast or consider having a cooked breakfast in the morning. 

• You may find it easier to have your main meal in the middle of the day, rather than in 

the evening when you may be feeling more tired. 

What can I do to make it easier for myself 

Depending on where you are with your treatment – and how it might be affecting you – 

some of the following tips might be very useful: 

• Serving smaller portions of food can be more appetising, perhaps using a smaller 

plate so that your meal does not look overwhelming. If your portion sizes are smaller 

than usual, eat six small meals or nourishing snacks spaced out throughout the day. 

• Sometimes the smell of food being cooked can be off-putting. If other people are 

able to cook for you this might be helpful. Keep the kitchen door closed and maybe 

get some fresh air while the meal is being prepared. 

• Food served cool or cold has less aroma and is just as nourishing. 

• Try not to fill up on salads and vegetables which add bulk to your meal but provide 

few calories. 



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• Make sure you have food in your fridge or cupboard that is quick and easy to 

prepare, such as pasta with a sauce or ready-made puddings. 

• Vary the consistency and flavour of food from meal to meal by simply adding a 

sauce. This can also add valuable calories too. 

• Accept offers from friends and family to help with cooking and shopping if you are 

feeling too tired to prepare meals yourself. Many supermarkets offer home delivery 

services if you don't feel up to a trip to the shops. 

• Consider using a meals on wheels or a meal delivery service for times when 

preparing food is particularly difficult. 

Will nutritional supplements help me 

Sometimes you might be advised to take some nutritional supplements to help keep 

your weight up. These come in a range of forms. A registered dietitian will be able to 

help you decide which are best for you and how to take them. 

Some supplements are available to buy in the supermarket without a prescription and 

are designed as a meal replacement, while others are suitable as a drink in addition to 

your usual meals. 

Other supplements are available on prescription from your doctor. Some are designed 

to fortify your regular food and drink, and to increase the energy or protein content, 

while others are taken as a supplementary drink. There is also a range of supplements 

that are nutritionally complete, meaning that they can provide all the nutrients you 

need each day, if taken in sufficient quantity. 

Table 2 (see below) shows some of the more common supplements that you may 

be advised to try. This list is not exhaustive and you should always discuss the most 

appropriate choices for you with your doctor or dietitian. 

Table 2: Nutritional supplements 

Type of supplement 

Milky flavoured drink (without fibre) 

Milky flavoured drink (with fibre) 

Juice/squash flavoured drinks 

Yoghurt flavoured drinks 

Examples of supplements available 

Ensure Plus, Fresubin Energy, Fortisip Bottle, 

Fortisip Compact, Complan Shake, Calshake, 

Scandishake, Enshake 

Ensure Plus with Fibre, Fortisip Multi Fibre, 

Fresubin energy fibre, Buildup 

Ensure Plus Ju-ce Style, Provide Xtra, 

Fortijuice, Complan Smoothie 

Fortisip yoghurt style, Ensure Plus yoghurt 

style 



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What happens if I am unable to maintain my weight 

through eating and drinking alone 

Sometimes the side effects of treatment or the lymphoma itself might mean you 

develop difficulties swallowing or are unable to eat or drink in sufficient quantities. If 

this happens, you may need to consider an alternative method of nutrition support. 

There are several options available, and your medical team and your dietitian will talk 

you through the details and advise you of the most appropriate options for you, should 

the need arise. 

Generally, nutrition support can be considered in two categories and will largely 

depend on whether your digestive system is functioning normally. 

1. Tube feeding (enteral nutrition) involves the insertion of a soft, narrow tube 

directly into your stomach or intestine. It will not stop you from eating and 

drinking, and is usually only a temporary measure to ensure you get sufficient 

nutrients. 

2. Intravenous nutrition (parenteral nutrition) involves providing a carefully 

balanced formula of nutrients directly into your bloodstream via a central venous 

catheter. It is usually only given in a hospital setting when your digestive system 

is not functioning properly or if it is impossible or unsafe to access your digestive 

system. 

Speak to your dietitian if you are having problems or want to find out more details 

about your options. 

How can I ensure the food I eat is safe 

Food safety is always important – no one, however healthy, wants to get food 

poisoning. High-dose chemotherapy or a stem cell transplant mean you may be 

particularly vulnerable to infection from food-borne bacteria. This is for two reasons: 

• The white blood cells, that usually fight bacteria, are at a low level. This is called 

neutropenia or immunosuppression. 

• The gut lining acts as a barrier between bacteria and the bloodstream. Chemotherapy 

and radiotherapy damage the gut lining, making it easier for any bacteria to cross 

this barrier. During this time you may be advised to follow a ‘clean’ or ‘neutropenic' 

diet. You should contact your treatment centre for further details on specific foods 

to avoid at this time. 

The information in Table 3 (see page 8) is a general guide for all people whose immune 

system is compromised in this way. If you become severely neutropenic it is likely 

that you will be given additional restrictions to follow. 



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Table 3: Food safety guidelines 

Shopping 

Avoid buying food with damaged packaging 

Avoid fridges and freezers that are overloaded 

Buy chilled and frozen food last and take it home as soon as 

possible 

Only buy fresh products where raw and cooked foods are 

displayed separately 

Storage Fridges should be kept between ‐0°C and 5°C 

Freezers should be kept below ‐18°C 

Store cooked food at the top of the fridge and raw food at the 

bottom 

Never refreeze thawed food 

Defrost food in the bottom of the fridge 

Always consume food according to manufacturers’ guidelines 

and before their best-before date 

Preparation 

Cooking 

Wash your hands with warm soapy water before preparing food 

and again after touching any uncooked food, rubbish, pets, dirty 

washing or after sneezing or using the toilet 

Do not dry your hands on the kitchen tea towel but use a separate 

towel for hands 

Cover any cuts or grazes 

Ensure any cloths and towels are regularly bleached, disinfected or 

changed 

Disinfect worktops regularly 

Avoid cross-contamination by using different coloured chopping 

boards for raw and cooked foods, and wash utensils between uses 

Cook all food thoroughly and ensure it is piping hot all the way 

through 

Cook meat until the juices run clear 

Pre-heat the oven to ensure food is cooked at the desired 

temperature 

Always follow manufacturers’ guidelines 

Never reheat cooked food 

Do not put hot food in the fridge as this raises the temperature of 

all the food in the fridge – leave to cool first 

Only use a microwave for defrosting or heating prepared foods 

according to the pack instructions 

Following any type of chemotherapy, care should be taken with the preparation and 

handling of any food or drink. In addition to the preparation guidelines in Table 3 (above), 

certain foods should also be avoided if you are at risk of neutropenia (see Table 4). 



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Table 4: High-risk foods to be avoided by all immunocompromised people 

All unpasteurised dairy products such as farm-fresh milk, parmesan 

Soft mould-ripened cheese, such as Brie, Camembert, goat’s cheese 

Raw or under-cooked eggs such as homemade mayonnaise, mousse, egg nog, 

meringue or hollandaise sauce 

Raw or undercooked shellfish 

Raw or undercooked meat, poultry or fish, such as rare meat, sushi, smoked meats/ 

fish (eg Parma ham, salmon paté and fish paste) 

Probiotics or bio products, such as probiotic-containing supplements or drinks 

The information in this article is designed as a guide only. If you have any specific 

questions about your diet and diagnosis, you should contact your medical team or 

dietitian who will be able to provide you with individual advice. 

As a general rule, there is no special diet that you need to follow. Whenever possible, 

try to enjoy a wide variety of different foods and drinks. Aim to make mealtimes 

relaxed, making the most of the times you feel at your best. If you’re not able to 

manage a full meal, try changing your meal pattern so you graze throughout the day, 

with small but regular snacks. Remember too that regular, gentle exercise can help 

you maintain a healthy weight. 

Now you have a better understanding of how to eat well with lymphoma, you should 

be able to find solutions which suit you. You might also feel better prepared for times 

when you might need to make some adjustments. 

If you would like further information about any aspect of lymphoma and its treatment 

or information about neutropenic diets please ring the helpline (0808 808 5555) or 

email information@lymphomas.org.uk. Please also visit our website 

(www.lymphomas.org.uk). 

Acknowledgement 

We are grateful to the Committee of the Haematology Sub Group of the Oncology 

Group of the British Dietetic Association for its assistance in the reviewing of this 

information. 

Further information 

Healthy eating and cancer and Eating problems and cancer 

Both booklets are published by Macmillan and are available free of charge from 

their website: www.macmillan.org.uk/HowWeCanHelp/Publications/Macmillan_ 

Publications.aspx http://be.macmillan.org.uk 



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Eating well when you have cancer 

Available from the Rehabilitation Secretary, the Royal Marsden NHS Trust, Fulham 

Road, London SW3 6JJ. 

020 7808 2811 or through their website 

www.royalmarsden.nhs.uk/cancer-information/patient-information/pages/booklets.aspx 

After treatment: a guide for cancer patients 

Available from the Rehabilitation Secretary, the Royal Marsden 

NHS Trust, Fulham Road, London SW3 6JJ. 

020 7808 2811 or through their website 

www.royalmarsden.nhs.uk/cancer-information/patient-information/pages/booklets.aspx 

Dietary advice for patients with neutropenia 

Published by Leukaemia & Lymphoma Research 

020 7504 2200 

www.leukaemialymphomaresearch.org.uk 

Penny Brohn Cancer Care 

www.pennybrohncancercare.org/eating-well 

Recipe ideas from Macmillan 

www.macmillan.org.uk/Cancerinformation/Livingwithandaftercancer/Eatingwell/ 

Recipes/Recipes.aspx 

Meals on Wheels 

www.gov.uk/meals-home 

Selected references 

The full list of references is available on request. Please contact us via email 

(publications@lymphomas.org.uk) or telephone 01296 619 409 if you would like a copy. 

Wilson R. Optimising nutrition for patients with cancer. Clinical Journal of Oncology 

Nursing, 2000. 4: 23–28. 

National Cancer Institute: http://www.cancer.gov/cancertopics/pdq/supportivecare/ 

nutrition/HealthProfessional/Page4#Section_117 

NHS Choices:http://www.nhs.uk/Livewell/Goodfood/Pages/Healthyeating.aspx 

World Cancer Research Fund / American Institute for Cancer Research. Food, 

Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. 

Washington DC: AICR, 2007 (http://eprints.ucl.ac.uk/4841/1/4841.pdf) 

Macmillan. The importance of physical activity for people living with and beyond 

cancer: a concise evidence review, 2012 (http://www.macmillan.org.uk/Documents/ 

AboutUs/Commissioners/Physicalactivityevidencereview.pdf) 



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How we can help you 

We provide: 

● a freephone helpline providing information and emotional support 0808 808 5555 

(9am–6pm Mondays–Thursdays; 9am–5pm Fridays) or information@lymphomas.org.uk 

● information sheets and booklets about lymphoma (free of charge) 

● a website with forums – www.lymphomas.org.uk 

● the opportunity to be put in touch with others affected by lymphoma through our 

buddy scheme 

● a nationwide network of lymphoma support groups. 

How you can help us 

We continually strive to improve our information resources for people affected by lymphoma 

and we would be interested in any feedback you might have on this article. Please visit 

www.lymphomas.org.uk/feedback or email publications@lymphomas.org.uk if you have 

any comments. Alternatively please phone our helpline on 0808 808 5555. 

We make every effort to ensure that the information we provide is accurate but it 

should not be relied upon to reflect the current state of medical research, which is 

constantly changing. If you are concerned about your health, you should consult 

your doctor. 

The Lymphoma Association cannot accept liability for any loss or damage resulting 

from any inaccuracy in this information or third party information such as 

information on websites which we link to. Please see 

our website (www.lymphomas.org.uk) for more 

information about how we produce our information. 

© Lymphoma Association 

PO Box 386, Aylesbury, Bucks, HP20 2GA 

Registered charity no. 1068395 

Updated: August 2013 

Next planned review: 2015 



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How to eat well with lymphoma - Lymphoma Association

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