Diet and nutrition
Whether you are living with or adapting to life after bladder cancer you might be thinking about diet and nutrition. This page explains why diet is important through the stages of treatment and beyond. It includes tips on how to eat well and maintain a healthy body weight. It aims to help you think about what changes you may want to make, and help you put them into practice.
Before making any changes to your diet, it is best to talk to your dietician, GP or clinical nurse specialist (CNS).
After researching all the options, we recommend a Mediterranean diet for people affected by bladder cancer. This diet incorporates the traditional healthy living habits of people from countries bordering the Mediterranean Sea, including Italy, France, Greece and Spain. Mediterranean cuisine varies by region and has a range of definitions, but is largely based on a healthy balance of vegetables, fruits, nuts, beans, cereal grains, olive oil and fish.
If you are a smoker, we also recommend that you think seriously about stopping smoking.
More information on food eating well with bladder cancer is available in our Diet and Nutrition booklet (see link at the bottom of this page).
The Mediterranean diet
The diet we recommend is similar to the UK government's healthy eating advice, which shows the foods needed for a balanced, healthy diet, with everything you eat during the day, including snacks.
A balanced diet contains a variety of foods. Try to eat lots of fruits and vegetables, and include plenty of starchy foods (such as cereals, bread and pasta) in your diet. Your body also needs protein, found in foods such as fish, legumes and meat.
The healthy eating plate above shows the recommended proportions of each food type. It’s a good idea to try to get this balance roughly right every day, but you don't need to do it at every meal. You might find it easier to get the balance right over a longer period, such as over the course of a week.
- Base your meals on starchy carbohydrates such as bread, pasta, rice or potatoes, choosing wholegrain varieties wherever you can; eat potatoes and other vegetables with their skins on for more fibre.
- Eat at least five portions of a variety of fruit and vegetables every day.
- Choose some lean protein, which can be meat, fish, eggs, beans or pulses, and other non-dairy sources, such as tofu.
- Include some dairy (or alternatives), such as cheese and yogurt, which are great sources of protein and calcium; non-dairy sources include almonds and seeds.
- Have only a small amount of foods high in fat and/or sugar, or eat them less often,
Food labels can guide you and help you choose healthier options, but use them wisely. The traffic light system of labelling will flag up foods that are high in salt, fat and sugar, which is a useful guide when you are out shopping. But remember that a can of diet cola will get green lights on that basis when a glass of milk will flash red — and clearly there is more goodness in the latter. One tip is that the ingredients are listed in order of how much is used in the product, so if ‘sugar’ appears first or second on the list — be warned!
Slow and steady
Making changes to eat healthier food can seem difficult, so try to improve your diet progressively. You can use the opportunity to discover and try new foods and get used to thinking about more healthy options. Take any advice and support that is offered, and aim for a gradual change in your eating habits towards a healthier balance.
Be realistic in what you can achieve and set yourself small, regular goals.
What we eat influences our health
Up to 30% of cancers may be linked to diet. Although a lot of research still needs to be done to understand which substances increase our risk of developing cancer, we know what types of food can help to keep us a bit healthier. Increasing the average intake of fruit and vegetables to 400g a day could reduce overall cancer incidence in the general population by 19% per year.
Combining a balanced diet with regular physical activity also brings many health benefits. Good habits in diet and exercise can help reduce the risk of heart disease, strokes and diabetes. They can also help us maintain a healthy weight, which can reduce the risk of developing certain types of cancer.
Can your diet influence recurrence?
People often ask if what they eat can reduce their risk of the cancer returning. This is the subject of a lot of current research. There is some early evidence from breast and bowel cancer studies that diet may make a difference to the chances of the cancer coming back. However, there still isn’t enough clear information to make precise recommendations about what someone with a particular type of cancer should eat.
For the majority of people, factors that are most likely to have the greatest impact on health include not smoking, a balanced diet, weight control and regular physical activity. The biggest difference will probably be from a combination of factors, rather than from making any one particular change.
What about alcohol?
Alcohol can increase the risk of developing certain cancers.
The current UK guidelines advise limiting alcohol intake to 14 units a week for women and men. This is equivalent to drinking no more than six pints of average -strength beer (4% ABV) or seven medium-sized glasses of wine (175ml, 12% ABV) a week.
Restoring your appetite
After treatment, many patients find that they lose their appetite and aren't interested in food, which is difficult at a time when you need to be rebuilding your strength after surgery or treatment. Some people also find that their sense of taste is affected and food tastes bland or unpleasant.
The best way to solve the problem seems to be to eat little and often, focusing on high-protein foods and presenting the dishes attractively.
For useful tips from patients, download our diet and nutrition booklet (see link at the bottom of the page).
Your GP should also be able to give you advice. Or ask your clinical team if there is nutritionist you could be referred to.
Here are a few simple tips if you are trying to lose weight:
- a balanced diet is still the best way to get all the nutrients, while also establishing good, long-term eating habits
- your diet should include plenty of fruits and vegetables
- try to limit salt, fat and sugar
- try to avoid snacking but, when you do, snack wisely — an apple rather than a biscuit, for example
- it’s not all about calories although they are important. For example, an apple contains around 100 calories, but it also has carbs, protein, fibre and vitamins, is low in fat and will help to fill you up. Compare that with four squares of milk chocolate with 134 calories, high in fat and sugar and with little nutritional value
- it’s easier to serve a smaller quantity if you use smaller plates
- try to plan your breakfast, lunch, dinner and snacks for the week, making sure you stick to your calorie allowance
- keep up your activity levels
- identify your weaknesses — if you reach for a bag of crisps when you watch TV, try a healthier snack or a drink of water
- serve your food attractively and make your meals colourful — they not only look better, but different colours of fruit and vegetables will give you a range of nutrients
- investigate the NHS website which is full of useful advice.
If you need encouragement, try a phone app in which you can log your meals and track your weight or join a local group.
As well as potentially influencing the development of some cancers, alcohol is high in calories so you should keep that in mind if you are trying to control your weight.
What foods should I avoid?
Make sure that eggs are well cooked, and use shop-bought, not homemade, mayonnaise. If your immunity is low, avoid paté, raw eggs, live bacterial yogurt and cheeses made from unpasteurised milk, such as Brie and blue-veined cheeses. These may contain bacteria that could be harmful to you.
If you're on high-dose chemotherapy, your healthcare team may suggest that you also avoid some other foods - ask them for advice.
Most patients experience some form of urinary problem as a side-effect of the cancer and its treatment, usually frequency, urgency and discomfort when weeing. Cutting out citrus, alcohol and foods and drinks containing alkaloids can help to relieve symptoms. In discussion with your clinical nurse specialist (CNS), you may want to avoid caffeine, tomatoes, white potatoes, aubergine, sweet and chilli peppers.
Should I eat red meat?
The current UK government advice says adults should eat no more than 70g (302) of red and processed meat a day. This is because there is probably a link between eating a lot of red and processed meat and bowel (colorectal) cancer.
Should I go dairy-free?
Many research studies have looked for a link between cancer (in particular breast cancer) and diets that are high in dairy but no clear link has been established, therefore, cancer experts do not recommend following a dairy-free diet to try to reduce the risk of cancer.
Dairy products are an important source of protein, calcium and some vitamins, but can be high in fat. Choose low-fat products to avoid putting on weight.
Calcium is needed for strong bones and may help reduce the risk of bowel cancer, so if you do go dairy-free, make sure you get enough calcium from other food sources, such as tinned sardines and salmon (with bones); dark green leafy vegetables, such as spinach; or fortified foods, such as some types of soya milk.
Does sugar feed cancer?
Sugar contains no useful nutrients, apart from energy, and we can get all the energy we need from healthier sources. Along with gluten and too much dairy, it can also contribute to bloating, weight gain and constipation.
Sugar in your diet doesn't directly increase the risk of cancer or encourage it to grow.
What foods should I eat?
You will soon get used to making the healthier choices in your diet if you keep these guidelines in mind:
- maintain a variety of foods with a balance of carbohydrates and protein
- eat several portions of fruit and plenty of vegetables of different colours
- keep sugar and fat to a minimum
A healthy gut
The gut naturally contains trillions of microbes, mainly bacteria, that play an essential role in your health, not only helping digestion but also benefitting your immune system, protecting against germs and influencing many other areas of health. Maintaining a healthy gut is therefore crucially important to everyone, especially cancer patients.
A diet high in processed foods and added sugar can decrease the beneficial bacteria in your gut, causing an imbalance in the good and bad bacteria that can result in further damage. A healthy balanced diet, low in processed foods and refined sugars, is the best way to keep your gut healthy, although you may like to talk to your doctor or CNS about whether a probiotic supplement would be useful.
What about superfoods?
There is no scientific evidence for any one particular food being a ‘superfood’.
The greatest benefit to your health is likely to come from eating a balanced diet that includes a wide and varied combination of foods. There are many substances in fruits and vegetables that may potentially have anti-cancer properties. However, at the moment we don't know this for certain, and we don't understand which ones are most likely to help or how they work.
So instead of looking for a ‘superfood’, it’s better to aim for a ‘superdiet’ as recommended in the healthy eating guidelines. This will help you make sure you're getting the widest possible variety of nutrients. It will also make your diet more enjoyable and interesting, and will probably be cheaper too!
Should I only eat organic food?
Many people wonder if they should follow an organic diet to maintain health and prevent their cancer from coming back. Studies that examined the nutritional benefits of organic fruit and vegetables had mixed outcomes. Some claim that organic fruit and vegetables have better flavour and stay fresh for longer. So far, no evidence has been found to show that an organic diet is more effective at stopping the occurrence or recurrence of cancer, compared to a non-organic diet.
Some people may worry that pesticides used in non-organic farming may cause cancer. In the UK, a pesticide can only be used once its safety has been tested. Laws ensure that all agricultural pesticides are used at a safe level.
Genetically modified crops have proved to be safe in the years they have been grown, but some people might feel that the long-term effects are unproven.
Buying organic or non-organic food is ultimately a personal choice. The current advice is to wash all fruit and vegetables — non-organic as well as organic — thoroughly before use.
Should I take dietary supplements?
For most people, a balanced diet provides all the nutrients they need, and taking large doses of vitamins, minerals and other dietary supplements is not recommended. However, people who find it difficult to eat a balanced diet may benefit from taking a multivitamin or mineral supplement containing up to 100% of the recommended daily allowance.
If you are currently having treatment for cancer, it's important to get advice from your cancer specialist BEFORE taking any supplements.
Supplements may be beneficial in some situations, such as for people who aren't able to absorb all the nutrients they need because of surgery for stomach cancer. People at increased risk of bone thinning (osteoporosis) may benefit from taking calcium and vitamin D supplements to help strengthen their bones and should discuss the need for supplementation with their doctor.
Several studies have looked at whether taking supplements can reduce the risk of developing certain cancers. However, the results have been disappointing. In general, the evidence is that taking supplements does not reduce the risk of cancer. There is even evidence that taking high doses of some supplements can increase the risk of cancer developing in some people. One study found that people who smoke were more likely to develop lung cancer if they took supplements of beta-carotene (a substance the body uses to make vitamin A).
It's possible that some supplements may interfere with how cancer treatments work, and make the treatments less effective.
So if you are currently having cancer treatment, talk to your cancer specialist and get their advice. They can advise you about which, if any, you should take, and which doses might be suitable for you. They can also tell you about any possible side-effects and interactions with other medication.
Do anti-cancer diets work?
There has been a lot of publicity about alternative diets for treating cancer over the past few years. Many dramatic claims for cures have been made. It’s understandable that people may be attracted to diets that seem to offer the hope of a cure. However, there is no good evidence that these diets can make a cancer shrink, increase a person's chance of survival or cure the disease.
Some people get satisfaction from following these special diets, but others find them quite boring and even unpleasant to eat as well as time-consuming to prepare. Some diets may lack important nutrients or be unbalanced in other ways, and may even be harmful.
It can be confusing to be faced with conflicting advice about what to eat, but most doctors and specialist nurses recommend a well-balanced and enjoyable diet.
Remember … Do your best to keep to a normal, well-balanced diet, keep an eye on your weight (up and down) and give up smoking!
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We’ve done everything we can to make all the information on this site as accurate as possible. Whilst we have had support from a small team of medical professionals advisors to review the general medical content of this site, please remember, that only YOUR medical team can give YOU specific advice about YOUR symptoms or illness. We encourage you to discuss any potential options with them.