Need advice on what you should be eating?

Are you eating a well-balanced diet?

What foods to avoid?

►►► Post your question now on our Facebook Q&A Event Wall.

We’re holding a live Facebook friends Q&A Session with our Senior Dietitian and Author Ms. Fahma Sunarja. She is one of the authors for recipe book ‘Awakening the Appetite’ published by Parkway Cancer Centre. Fahma has also co-written a book of sport nutrition recipes, titled “Asian Flavour of Fitness – Recipes for the sporting individual” and published by Singapore Sports Council.

One of Fahma Sunarja’s greatest joys is seeing patients enjoy their food even though they are recovering from a surgery or treatment. Many patients tend to restrict their diets after treatment, but she knows that different people can benefit from diets that are tailored to their needs.

“Upon diagnosis, patients tend to follow certain diet restrictions,” she notes. “It may be something that they read on the Internet or in books, or on advice by well-meaning relatives and friends.”

This is where Fahma comes in. As Parkway Cancer Centre’s (PCC) first-ever dietitian, her mission is to help patients create individualised, suitable diets that can help them cope with their treatments for cancer.

Perhaps you’re looking for tips about food, diet and healthy eating. Or perhaps you would like to know what foods we eat can affect our risk of developing certain types of cancer.

Date: 27 December 2012, Thursday

Time: 11:00am – 11:30am

►►► Join our live Q&A event on Facebook and you may start leaving your questions on our Facebook event wall now.

If you would like the opportunity to ask questions about all things on diet, nutrition, health and more then DON’T MISS this LIVE Q&A event on 27 December.

We look forward to answering your questions!

About Fahma Sunarja:


Recap for Live Facebook Q&A Session (27 Dec 2012) with Senior Dietitian Ms.Fahma Sunarja

Q1. How should the diet of a colon patient after the chemo treatment?

It depends on which part of colon that is affected and also the symptoms experienced after chemotherapy treatment.

If experiencing diarrhea or constipation, symptoms can be relieved by:  


Foods to avoid:

  •     Hot, spicy foods
  •     High fibre foods
  •     Fatty, greasy or fried foods
  •     Rich desserts
  •     Nuts, seeds, or dried fruit

Beverages to avoid:

  •     Drinks that are very hot or cold
  •     Drinks containing caffeine (coffee, tea, cola, and chocolate)
  •     Drinks containing dairy products

Diet tips to try:

  •     Eat broth, soups, electrolytes drinks, bananas and canned fruits to help replace salt and potassium lost by diarrhea
  •     Avoid cruciferous vegetables such as broccoli, cauliflower and cabbage
  •     Drink plenty of fluids through the day, room temperature fluid may be better tolerated
  •     Limit dairy products until the problem is solved
  •     Limit sugar-free candies made with sorbitol
  •     Drink 1 cup of fluid after each loose bowel movement



Constipation is defined as fewer than 3 bowel movements per week. It is very common problem for cancer patients and may result from lack of water or fibre in the diet; lack of physical activity; anticancer therapies such as chemotherapy; and medications.

Diet tips to try:

  •     Increase the amount of fibre e.g. fruits, vegetables, and whole grains)
  •     Drink plenty of fluids at least 8 – 10 glasses
  •     In some cases a low fibre diet may be appropriate with increase clear fluids
  •     Introduce some physical activity if allowed
  •     Include over the counter constipation treatments


Q2. Can the patient go to TCM to strengthen his body?

Yes they can, but it is best to inform their Oncologists if they wish to consult TCM so that the Oncologist and the TCM specialist can co-managed patient.


Q3. If the patient does not like plain water. Drinking wolberries with chrysanthemum everyday, is it ok?

It is ok, but could also introduce other fluid/drinks like barley water, green bean soup, coconut water, water with sliced lemon, honey water, etc


Q4. How should the diet to the stomach cancer after surgery and ready for the first chemotherapy?

Depending on the type of surgery, e.g. removal of stomach or part of stomach, the diet may differ.

Post gastrectomy (removal of stomach) diet guidelines are as follows:

* eat 6 to 8 small meals and snacks each day
* eat foods with protein at every meal
* choose grains low in fibre
* keep meals dry
* choose soft and well cooked foods
* avoid very hot or very cold foods
* avoid sugars and sweets


Q5. Our son was diagnosed with Hodgkins Lymphoma last May 2011 & he underwent 6 cycles of chemotherapy. The last PET Scan we did in Feb 2012 was all clear. We like to know what kind of food he should take to keep healthy & to boost his immunity. We are very thankful to you for giving us this advice.

Generally diet should be:

* regular and balanced meal
* include good portion of carbohydrate, protein, fruit and vegetables
* include high quality of protein such as lean meat, poultry, fish, shellfish, eggs, dairy products etc to help boost immune system
* reduce intake of lower quality of protein foods such as fishball, chicken nuggets, meat patties etc
* include whole grain variety as much as possible
* avoid processed foods, preserved foods such as sausages, salami, salted fish, salted vegetables, smoked foods etc.


Q6. I was diagnosed with leiyomyosarcoma Stage IV last November 2010, and has undergone radiotherapy in Phils. and six cycles of chemotherapy in Singapore under Dr. Ang Peng Tiam. My question is what particular nutrition program do I need? What type of food is best for my health ? What food should I avoid? What physical exercises should I need? Nowadays, I have taken more vegetables than meat. I also drink vegetable juices daily. Thank you for giving us this opportunity. Your answers will greatly be appreciated and help us in our journey.

Answer same as Q5, Physical activity depends on your usual exercise program.


Q7. How safe is it to eat supplements on a regular basis? Will our bodies get used to the supplements and in the long term lose their effects? Worse, in view of the nature of supplements, being mainly extracts and then artifically produced or enhanced, will prolonged consumption cause undesirable effects? Such as cancer etc?

It depends on what type of supplement you are referring to. If it is water soluble, like vitamin B and C, it is generally safe as our kidney will excrete it out any excess. If it is fat soluble vitamins, any excess will be stored in our liver. Prolonged consumption of any supplements especially in mega-doses may lead to toxicity.


Q8. How can vegans(vegetarian) obtain vitamin b12 in Singapore other than supplements?

Another alternative to getting vit B12 for vegan would be vitamin B12 injection given every 6 month.


Q9. Is it OK to take supplements alongside with medication? Supplements are said to help boast immune system while getting cancer treatment, but will it affect the effectiveness of prescribed medications?

It is best to check with your oncologist on all supplementation you are taking. During chemotherapy and radiation therapy, it is best to avoid all antioxidants supplementation as they may affect the effectiveness of the cancer treatment.


Q10. Will the recommended interval of taking medication/supplements impact its effectiveness? Say patient is asked to take medication 1 hour before meal, what will happen if it is taken only 10 minutes before meal? With so many supplements and medications to take, sometimes it is not possible to follow the recommended guidelines to take the dosage required.

In general  timing of intake of medication has been prescribed with a purpose, for example, gastric medication to be taken an hour before meal, to help reduce stomach acid production. Hence, if it is taken 10 minutes before meal, it may not give optimum result.

Some medication may be time sensitive, i.e. need to be taken 12 hours apart, or need to be taken at night.


Q11. Nausea, no appetite are some known side effects to chemotherapy. What type of diet is recommended to increase appetite & increase nutrients intake during treatment?

Tips for managing symptoms to achieve a good diet after chemotherapy:

Loss of appetite for food (Anorexia)

Diet tips to try:

  •     Eat 6 small and regular meals throughout the day
  •     Plan ahead – plan daily menu in advance
  •     Have help with preparing meals
  •     Make every bite count – choose high protein high energy foods
  •     Eat breakfasts that contain at least 1/3 of your calorie needs
  •     Pack snacks to keep on hands at all times
  •     Eat foods with odors that are appealing
  •     Cooking odors can be minimized by:




    •         Cooking outdoor on the grill
    •         Using kitchen fan when cooking
    •         Serving cold or room temperature food instead of hot
    •         Ordering take-away, meal delivery
  •     Try new foods as food likes and dislikes may change from day to day.

Taste Changes

Patients undergoing chemotherapy often complain of changes in their sense of taste, in particular a bitter taste sensation. A sudden dislike for certain foods may occur.

Diet tips to try:

  •     Rinse mouth with water before eating
  •     Try citrus fruits such as oranges, tangerines, lemons, grapefruit, unless mouth sores are present
  •     Eat small meals and healthy snacks several times a day
  •     Eat meals when hungry rather than at set mealtimes
  •     Use plastic utensils if foods taste metallic
  •     Meat often tastes bitter, substitute with chicken, fish, eggs and cheese
  •     Try vegetarian sources of protein such as gluten, tofu, beans, etc
  •     Eat meat with something sweet,  such as cranberry sauce, jelly or applesauce