Recipes
Head and neck cancer group
Recipes and tips for eating well
In the six years that the Calvary Mater Newcastle Head and Neck Cancer Support Group has been running, one of the most commonly discussed topics is dealing with changes in eating habits during and after treatment. While every person is different, most people face some challenges with eating which can either be temporary or permanent, and may change throughout the phases of recovery and survivorship.
This section of the website aims to share tips and recipes to help overcome these challenges. You will find recipes suitable for dry mouth, puree options, and a selection of recipes which are higher in protein and energy for people with higher requirements or trying to regain lost weight.
In the words of one cancer survivor, “Keep trying. Don’t give up. What may not work today, may work tomorrow. So, never stop trying”. Determination requires patience and perseverance. Keep in mind that what may work for one person might not be suitable for the next, so experimentation will often be the way to find what works best for you.
People with head and neck cancer may need to modify the texture of their diet due to side effects of treatment and/or the location of the cancer. Dry mouth (xerostomia), mouth ulcers (mucositis), taste changes (dysgeusia) and chewing or swallowing difficulties can all affect a person’s ability to stay well nourished.
Foods can be chopped, minced or even pureed to minimise the need for chewing and make swallowing easier.
A speech pathologist can advise on any texture modifications needed, while a dietitian can assist to ensure a person is meeting their nutrition requirements.
Soft texture: Food that is easy to chew and swallow. The food may be cut into small pieces or it may be soft enough to eat as it is. The food should be moist, otherwise sauces or gravies may be added to increase moisture.
Minced moist texture: Food that is cut or mashed into small pieces no larger than 0.5cm (1/4 inch), requiring minimal chewing. Food lumps should be rounded, without any sharp or hard pieces.
Puree texture: Food that is blended until smooth, but not runny. It could have a grainy quality, however has no lumps and does not require chewing.
Some people may find it difficult to maintain their weight during and/or following treatment due to chewing or swallowing difficulties or increased energy and protein requirements.
A high energy high protein diet may be recommended by a Dietitian to ensure a person’s nutrition requirements are met. This diet may also be recommended if someone is underweight; losing weight without trying; experiencing poor appetite due to treatment side effects such as nausea/vomiting; and higher energy and protein needs associated with treatment.
If you require more protein and energy (kJ) in your diet, some of the recipes below will be suitable.
- Make sure foods are moist. Use soft or minced foods.
- Moisten foods with gravy, sauces, stock, custard or cream.
- Try soups and casseroles and add extra fluids if needed.
- Pour sauces and gravies over meats, fish, chicken, bread or vegetables.
- Take smaller mouthfuls.
- Sip plenty of fluids with meals. You may need to have a sip of fluid between each mouthful of food.
- Make gravy a staple in your household. It goes with almost everything savoury and is easy to make.
- Try warm water to help with chewing and swallowing at meals (if you are struggling to maintain your weight, your Dietitian may recommend sipping on nourishing fluids such as milk instead).
- Make soups/casseroles/stews in bulk and freeze. This means you will have a variety of options on hand.
- People have found sausage mince easier to manage than standard beef mince if your mouth is very dry, which can be used to make rissoles/meat loaf – provided plenty of gravy is added.
- Invest in a slow cooker. They are affordable and cook meat until it is so tender it falls apart.
- Stick blenders are great for pureeing meals, soups and smoothies. Look for a stick blender with a stainless steel end so it won’t melt when blending hot soups! The stick blender is a quick option compared with a standard blender. If using a standard blender, you should let the soup cool down before blending – otherwise you risk the lid exploding due to a build-up of hot steam. If you are pureeing warm soup in a blender, never fill it to the top and place a tea towel over the lid. Remember to always keep your hand firmly on the lid when blending, and never leave unattended!
- Add a little boiling hot water to breakfast cereals to help soften before adding milk. This is particularly useful for Weet-Bix and Vita Brits. If you are a slow eater add more milk as you are eating to stop the cereal from drying out and becoming claggy.
- Keep well hydrated (usually drink up to 1.5 litres of water per day or as recommended by your dietitian/doctor) and have a drink of water during or after having dairy products including milk, chocolate, cheese, yoghurt, caffeine.
- Regular mouth care is essential i.e. salt mouthwash (1/2 tsp of salt to 200ml water) or sodium bicarbonate (baking soda) mouthwash (1 tsp to 200ml water) following meals and before bed. Non-alcoholic mouthwashes are also suitable. Listerine Zero comes recommended by a number of patients.
- Soda water is great for thinning out thick salivary secretions.
- You could take Papaya Enzyme Tablets 2-3 times per day. Suck as required or place under your tongue (whole or cut up) and allow to dissolve slowly.
- Drink dark grape juice or pineapple juice (provided you have no mouth ulcers).
- Steaming: place boiled water in bowl/saucepan and put a towel over head/bowl. Deep inhalations of steam as tolerated.
Recipes
A special thank you to the Head and Neck Cancer Support Group members who contributed to the recipes supplied.
We would also like to acknowledge the Queensland Government Nutrition Education Materials Online (NEMO) website where you will find some great high energy high protein recipe and drink ideas (see links below):
We would like to acknowledge Griffith University staff and students who have produced some excellent recipes for patients with head and neck cancer and swallowing difficulties.
Savoury options
Texture: Soft
Serves: 4
Equipment
You will need an oven, hot plate/stove top, non-stick frying pan and a saucepan for this recipe.
Ingredients
- 2 teaspoons olive oil
- 1 onion, finely chopped
- 1 large carrot, grated
- 2 sticks celery, finely chopped
- 2 garlic cloves, crushed
- 500g lean beef mince
- 1 tablespoon tomato paste
- 300ml salt reduced beef stock
- 2 tablespoons Worcestershire sauce
- 60g All-Bran
- 700g sweet potato, diced
- 2 tablespoons chives, finely chopped
- 1 cup cheese, grated
Method
- Preheat oven to 200 degrees Celsius or 180 degrees Celsius fan forced
- Heat the oil in a large non-stick pan over a medium heat
- Add the onion, carrot and celery, cook stirring occasionally for 5-6 minutes or until soft
- Add the garlic, cook for a minute more
- Add the beef mince, cook breaking the mince up with a wooden spoon for 5 minutes or until the mince is browned
- Add the tomato paste, stirring for a minute
- Add the stock and the Worcestershire sauce. Bring to the boil, reduce heat to low and simmer for 5 minutes
- Add the All-Bran, simmer for 5 minutes more or until thickened
- Meanwhile, place the potatoes in a saucepan, mash until smooth, stir through the chives
- Spoon the mince mixture into 4 individual (1 cup) ramekins. Top each with a quarter of the sweet potato mash. Finish each ramekin with a quarter of the grated cheese
- Place in a preheated oven and bake for 10-15 minutes or until golden and bubbling
Nutrition information per serve: 2550kJ, 55g protein, 39g carbohydrates, 19g sugar, 23g total fat, 11g saturated fat, 760mg sodium, 13g
Texture: Soft
Serves: 4
Equipment
You will need a hot plate/stove top and a frypan for this recipe.
Ingredients
- 1 tablespoon butter
- 2 teaspoons curry powder
- 1 large onion, diced
- 2 sticks celery, sliced
- 1 tablespoon brown sugar
- 1 tin tomato soup
- 1 tin drained pineapple pieces
- 1 capsicum, diced
- 1 BBQ chicken, shredded
Method
- Saute butter, curry powder, onion, celery in a pan for 2-3 minutes
- Add brown sugar, tomato soup, pineapple, capsicum, chicken
- Heat for 6 minutes or until hot
Nutrition information per serve: 4500kJ, 67g protein, 22g carbohydrates, 20g sugar, 70g total fat, 20g saturated fat, 590mg sodium, 4g dietary fibre.
Texture: minced, moist
Serves: 1
Ingredients
- 1/3 cup pasta
- ½ cup water
- ¼ cup full cream milk
- ½ cup shredded cheddar cheese
Method
- Combine the pasta and water in a large mug
- Place the mug in a bowl to catch the water which will overflow when cooking, or cook in a bowl, whichever you prefer
- Microwave on high for two minutes and stir
- Repeat this for at least two to four more minutes, stirring at each one-minute interval. The water should absorb completely and the pasta will be cooked through
- If the pasta needs another minute, you can add another teaspoon of water and microwave
- Remove from the microwave and stir in the milk and cheese
- Microwave for another minute
- Stir thoroughly and serve
- Tip: add 2 tsp butter at the end and stir through for extra taste and kilojoules
Nutrition information per serve: 1700kJ, 22g protein, 30g carbohydrates, 4g sugar, 21g total fat, 14g saturated fat, 435mg sodium, 1g dietary fibre.
With added butter per serve: 2000kJ, 22g protein, 30g carbohydrates, 4g sugar, 29g total fat, 19g saturated fat, 435mg sodium, 1g dietary fibre.
Texture: puree
Serves: 4
Equipment
You will need a hot plate/stove top and saucepan for this recipe.
Ingredients
- 1 tablespoon olive oil
- 1 small brown onion, diced
- 1 kg orange sweet potato, peeled, roughly chopped
- 2 medium carrots, peeled, roughly chopped
- 2 cans lentils
- 5 cups vegetable stock
- 1 cup fresh basil (optional)
- Cream for serving
Method
- Heat oil in a saucepan over medium-high heat
- Cook onion, stirring for 2-3 minutes until soft
- Add sweet potato, carrot and stock. Add pepper to taste
- Bring saucepan to the boil, then reduce to low-medium
- Simmer for 20-25 minutes or until carrot is soft. Stir in lentils until hot
- Remove from heat and sit for 5 minutes
- Blend in batches (or use stick blender in saucepan)
- Return to saucepan over low heat.
- If soup is too thick, add water (or full cream milk for additional energy/protein) and keep stirring until soup is hot
- To increase energy value, add cream on top
Nutrition information per serve (with cream): 3000kJ, 26g protein, 85g carbohydrates, 25g sugar, 24g total fat, 13g saturated fat, 1400mg sodium, 22g dietary fibre.
Sweet options
Texture: minced moist
Serves: 1
Equipment
You will need a microwave oven safe breakfast bowl for this recipe.
Ingredients
- 2 dessertspoons rolled oats
- 2 dessertspoons All Bran
- ½ crushed Weetbix
- 2 or 3 teaspoons honey
- Full cream milk
- 1 scoop vanilla Sustagen (you can use neutral or chocolate flavour if you prefer)
Method
- Combine rolled oats, All Bran and Weetbix in a breakfast bowl (safe for microwave oven use)
- Pour in enough full cream milk to cover ingredients
- Microwave for approximately 2 minutes (stop cooking when ingredients start to rise)
- Remove from microwave. Stir in Sustagen and add honey to taste. If necessary, add more milk
Nutrition information per serve: 1315kJ, 12g protein, 52g carbohydrates, 34g sugar, 6g total fat, 3g saturated fat, 155mg sodium, 4g dietary fibre.
Texture: minced moist
Serves: 6
Equipment
You will need a large serving bowl and electric mixer for this recipe.
Ingredients
- 2 x 85g packet jelly crystals – port red wine flavour works well
- 1 swiss jam roll
- 1 300g tinned apricots in syrup (you can use peaches or any tinned fruit you prefer)
- 3 cups (750ml) double thick custard
- 1 cup (250ml) cream (to be whipped)
- 1 425g tinned berries in syrup (optional)
Method
- Make jelly to instructions and set aside to cool.
- Drain tinned fruit and layer in serving bowl.
- Pour over jelly mixture and refrigerate until set.
- Remove jelly mixture from fridge. Slice and layer jam roll over mixture.
- Pour over double thick custard.
- In a separate bowl, whip cream using an electric mixer.
- Top trifle with whipped cream and (optional) tinned berries.
Nutrition information per serve: 2170kJ, 9.7g protein, 68g carbohydrates, 53g sugar, 21.3g total fat, 14.3g saturated fat, 260mg sodium, 1.5g dietary fibre.
Texture: Puree
Serves: 1
Equipment
You will need a blender/NutriBullet (or similar) for this recipe.
Ingredients
- 4 tablespoons ice cream
- ½ cup full cream milk
- ½ banana
- 2 or 3 scoops vanilla Sustagen (you can use neutral or chocolate flavor if preferred)
Method
- Into blender, add milk, then honey followed by chopped banana and Sustagen
- Blend until smooth and serve
Nutrition information per serve: 1800kJ, 21g protein, 66g carbohydrates, 45g sugar, 10g total fat, 6g saturated fat, 240mg sodium, 1g dietary fibre.
Texture: Puree
Serves: 2-3
Equipment
You will need a blender/NutriBullet (or similar) for this recipe.
Ingredients
- 1 cup full cream milk
- 1 cup vanilla ice cream
- 1 cup canned peaches in syrup
- 2 drops vanilla essence
Method
- Combine all ingredients in a blender and process until smooth
Nutrition information per serve: 2200kJ, 15g protein, 70g carbohydrates, 65g sugar, 21g total fat, 14g saturated fat, 160mg sodium, 4.5g dietary fibre.
Texture: Puree
Serves: 4
Equipment
You will need boiling water, a bowl, whisk and a 500ml container for the jelly mixture to set.
Ingredients
- 1 x 85g packet jelly crystals (any flavour)
- 125ml boiling hot water
- 500ml pouring cream
Method
- In a bowl, add 125ml boiling hot water to jelly crystals. Allow to cool.
- Whisk in 500ml cream to jelly mixture. Pour into jelly mould or container.
- Refrigerate until set.
Tip: You can use a combination of cream and custard when making the mixture. For an ice cream alternative, whisk mixture well and place in the freezer until partly frozen. Remove mixture from freezer, whisk again and freeze overnight. Allow to stand for a few minutes before serving.
Nutrition information per serve: 1262kJ, 2.5g protein, 5.9g carbohydrates, 5.8g sugar, 30.5g total fat, 19.7g saturated fat, 40.2mg sodium, 0g dietary fibre.