Maintaining proper nutrition is a supportive measure for individuals managing liver cancer. The goal of nutritional intervention is to help maintain strength, support the body through treatment, and enhance overall quality of life. Liver cancer and its therapies can significantly impact the body’s ability to process and absorb nutrients, making careful dietary planning an important part of the overall care strategy. This information provides general guidance and should always be discussed with a medical oncologist and a registered dietitian specializing in oncology to create a personalized nutritional plan.
Foundational Dietary Goals: Supporting Strength and Weight
The primary nutritional challenge in liver cancer is combating cancer-related cachexia, a wasting syndrome characterized by substantial loss of weight and muscle mass. To counteract this, the diet must be rich in calories and essential nutrients to support energy needs and prevent muscle breakdown. Adequate intake of high-quality protein is necessary for maintaining muscle tissue and aiding in the repair of body cells damaged by disease or treatment. Guidelines recommend a protein intake ranging from 1.0 to 1.5 grams per kilogram of body weight per day to preserve lean mass.
Lean sources of protein, such as poultry, fish, eggs, and low-fat dairy products, should be prioritized. Complex carbohydrates, including whole grains, oats, and brown rice, provide steady energy and prevent the body from breaking down protein for fuel. Consistent carbohydrate intake helps stabilize blood sugar levels, as the liver plays a primary role in glucose regulation.
Healthy fats, such as those found in avocados, nuts, seeds, and olive oil, are calorie-dense and aid in nutrient absorption, helping patients maintain or gain weight. Omega-3 fatty acids, found in fatty fish like salmon, are beneficial due to their anti-inflammatory properties. A diet rich in colorful fruits and vegetables provides antioxidants, vitamins, and minerals that support overall health and help the body manage oxidative stress.
Nutritional Strategies for Managing Liver Impairment
When liver function is compromised, dietary adjustments are necessary to manage specific physiological complications.
Managing Ascites (Fluid Retention)
Ascites, the accumulation of fluid in the abdomen, requires strict control over sodium intake. The damaged liver struggles to regulate water and salt, causing the body to retain excess sodium and exacerbating fluid buildup. Guidelines recommend restricting sodium intake to 2,000 milligrams per day or less, which means avoiding highly processed foods, canned soups, cured meats, and fast food. Using herbs, spices, lemon juice, or vinegar to flavor foods instead of salt is a practical substitution. Fluid restriction may also be imposed in severe cases, requiring careful monitoring of all liquid intake.
Managing Hepatic Encephalopathy
Hepatic encephalopathy causes cognitive changes due to the buildup of toxins like ammonia. While protein was historically restricted, current evidence suggests that restriction is detrimental and can worsen malnutrition. Patients should aim for the recommended protein intake of 1.0 to 1.5 g/kg/day. If encephalopathy symptoms are present, a temporary adjustment or a switch to plant-based proteins, such as soy and vegetable sources, may be recommended. The liver’s impaired ability to regulate blood glucose also necessitates eating smaller, consistent portions of carbohydrates throughout the day to prevent wide fluctuations in blood sugar.
Practical Eating Tips During Treatment
Treatment side effects, such as nausea, appetite loss, and fatigue, can interfere with eating. Eating five to six small, frequent meals throughout the day, often called “grazing,” helps maintain energy levels and prevents the overwhelming fullness that accompanies large meals. Setting scheduled meal and snack times, rather than waiting for hunger, ensures consistent nutrient intake when appetite is low.
To manage nausea, choose bland, low-fat, and easy-to-digest foods like toast, crackers, bananas, or rice. Avoiding fried, greasy, spicy, or strong-smelling foods reduces the likelihood of triggering nausea. Since hot foods release more odor, consuming foods that are cold or at room temperature, such as yogurt, cold sandwiches, or chilled fruits, may be more tolerable.
Maintaining hydration is a priority, especially when dealing with vomiting or diarrhea. Sipping fluids throughout the day is advised, rather than drinking large amounts with meals, which can cause early fullness. Water, clear broths, and electrolyte-rich drinks are good choices. When solid food is difficult to tolerate, liquid nutritional supplements, protein shakes, or homemade smoothies can provide concentrated calories and protein.
Foods and Substances to Limit or Avoid
Strict avoidance of alcohol is necessary for individuals with liver cancer, as it places a toxic burden on the damaged organ and can interfere with treatment effectiveness. Certain dietary fats and sugars should also be limited, including those high in saturated or trans fats, such as fried foods, excessive red meat, and commercially baked goods. Reducing the intake of simple sugars and sweetened beverages is advisable, as the liver can convert excess sugar into fat, potentially worsening underlying liver disease.
Because cancer treatments can weaken the immune system, strict food safety practices are necessary to minimize the risk of foodborne infection. This includes avoiding:
- Raw or undercooked meats and fish (like sushi).
- Raw eggs and unpasteurized dairy products.
- Foods from communal buffets.
Meat should be cooked to a safe internal temperature, and all fruits and vegetables must be thoroughly washed before consumption. Caution must also be exercised regarding dietary supplements, including high-dose vitamins and herbal remedies. Many of these substances are metabolized by the liver and can interact negatively with cancer treatments. Any supplement must be reviewed and approved by the healthcare team before being introduced into the diet.