Medical Oncologist
Nutrition on Enzalutamide
Eating Well While on — Enzalutamide
There is no strict diet you must follow on enzalutamide, but what you eat matters for your energy, muscle strength, and bone health. Indian food can be adapted very well to support you through treatment.
Medically reviewed by Dr. C. Raghavendra Reddy, Medical Oncologist, MBBS (Gold Medal) · DNB · DM (Medical Oncology, Gold Medal) · Last reviewed August 2026
- No banned food list — Enzalutamide does not require you to cut out any major food group.
- Protein is the priority — Dal, paneer, eggs, and curd help protect muscle mass, which the drug can affect over time.
- Bone health needs attention — Calcium from milk, curd, and ragi is important throughout treatment.
- Small meals beat big ones — If appetite drops or nausea appears, frequent lighter meals work better than three heavy ones.
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Enzalutamide does not require you to avoid any specific food group. The priority is supporting energy, muscle strength, and bone health through what you eat. For most Indian men, this means more protein from dal and paneer, adequate calcium from curd and milk, and enough fluid through the day.
Why does food matter while you are on enzalutamide?
Enzalutamide works by blocking the signals testosterone uses to drive prostate cancer. Over time, this affects more than the cancer — muscles can lose bulk, bones can lose density, and appetite may fall.
Food cannot reverse these effects, but it can slow them and keep you feeling stronger for longer. Think of eating well as part of the treatment, not separate from it.
The good news is that most traditional Indian meals already contain what you need. The goal is to make sure protein, calcium, fibre, and fluid show up consistently every day.
What should you eat if your appetite has dropped or you feel nauseous?
Some men notice low appetite or mild nausea in the early weeks on enzalutamide. Smaller, more frequent meals tend to work better than waiting for hunger that does not come.
Light options that are easy to eat: khichdi with a little ghee, curd rice, soft idli with thin sambar, or daliya with vegetables. These are gentle on the stomach and still provide protein and energy.
Ginger helps settle nausea for many people. A small piece in your morning chai, or nimbu pani with a little fresh ginger, is worth trying before reaching for medicine. Tell your team if nausea continues beyond the first few weeks.
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What should you eat and drink every day on enzalutamide?
- Dal at lunch or dinnerAny dal — masoor, moong, toor, chana — provides protein and iron. Eat it most days.
- Curd or buttermilk once a dayDahi and chaas provide calcium and probiotics. Plain, unsweetened curd is best.
- A palm-sized portion of paneer, eggs, or lean meatProtein from these sources helps protect muscle. Tandoori chicken or egg curry are better choices than fried versions.
- Two or three servings of cooked sabziPalak, methi, drumstick leaves, and lauki are high in nutrients. Vary them through the week.
- A handful of nuts in the morningFour to six almonds or walnuts with breakfast add healthy fats and keep energy steadier.
- Eight to ten glasses of fluid dailyCoconut water, plain nimbu pani without extra salt, and thin chaas all count alongside water.
- Whole grains over refinedMultigrain or whole wheat roti over maida. Brown rice or daliya over polished white rice when possible.
Do you need to avoid or change any specific food or drink?
Do I need to take calcium and vitamin D as supplements?
NCCN guidelines for men on androgen-suppressing treatment recommend paying close attention to calcium and vitamin D because bone density can fall over months to years on treatment. Diet alone — milk, curd, ragi, drumstick leaves — may not always be enough, and your oncologist may recommend a supplement. Do not start one without asking first, because the right form and amount depend on your blood levels and kidney function. Ask at your next appointment whether your levels have been checked and whether a supplement is recommended for you.
Can I eat chicken, fish, or mutton?
Yes. Lean meat and fish are good sources of protein, and there is no clinical reason to avoid them on enzalutamide. Grilled, baked, or curried with minimal oil is better than deep-fried. Fish — especially fatty varieties like rohu or katla — also provides vitamin D, which matters for bone health on this treatment. If you eat meat, two to three portions a week alongside dal and curd gives you a reliable protein base without relying on any single source.
What about alcohol?
There is no direct interaction between alcohol and enzalutamide that makes it immediately dangerous, but alcohol adds to fatigue, disrupts sleep, and can worsen hot flushes — all side effects that enzalutamide itself already causes. ASCO general guidance for people on cancer treatment recommends limiting alcohol significantly. If you drink occasionally at social occasions, tell your oncologist honestly so they can factor it into your care. If you are drinking to manage anxiety or sleep problems, please say so — your team can suggest options that actually help.
Should I avoid any Indian spices or herbal remedies?
Everyday spices — turmeric, ginger, coriander, cumin, fenugreek — are fine. The caution applies to high-dose herbal supplements taken in capsule or extract form. Some herbal preparations, including St John's Wort found in certain imported products, can reduce the blood levels of enzalutamide and affect how well it works. If you or your family are giving any traditional preparation, kadha, or herbal capsule alongside treatment, name it to your oncologist. You will not be judged for it — but your team needs to know.
I am gaining weight on enzalutamide. What should I change?
Weight gain on enzalutamide is common and is partly driven by hormonal changes rather than diet alone, so food changes will not prevent it entirely. What helps is limiting fried snacks, maida-based biscuits and khari, and sweetened drinks including packaged fruit juices. Keep portions of rice steady rather than increasing them. The most effective combination is a modest dietary change alongside gentle regular movement — walking, yoga, or light stretching. Ask your oncologist what level of activity is safe for you at this stage of treatment.
Did you know?
Men on androgen-suppressing treatment for prostate cancer can lose bone density at a significantly faster rate than men of the same age who are not on treatment.
NCCN guidelines for prostate cancer specifically highlight calcium and vitamin D as something to address from the beginning of treatment — not after a fracture or scan finding has already appeared.
Source: NCCN Clinical Practice Guidelines in Oncology: Prostate Cancer
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Common questions
Frequently asked questions
Can I take enzalutamide with food or does it have to be on an empty stomach?
Enzalutamide can be taken with or without food — the prescribing information does not require an empty stomach. Many men find it easier to take with a light meal or snack, which can also reduce the chance of mild nausea. What matters more is taking it at the same time each day. If you are unsure about the instructions for your specific formulation, ask your pharmacist, who can confirm based on the exact product dispensed to you.
Is ragi a good food for bone health on this treatment?
Yes. Ragi (finger millet) is one of the richest plant-based sources of calcium in the Indian diet. Ragi mudde, ragi dosa, or ragi porridge made with milk are all practical ways to include it. It also provides iron and fibre. It will not replace a supplement if your oncologist has prescribed one, but it is a genuinely useful daily addition — particularly if you do not drink much milk.
My husband is on enzalutamide and not eating much. What can I give him?
When appetite is low, the priority is calories and protein in small volumes. Curd rice with a little pickle, soft upma with vegetables, moong dal khichdi, or warm milk with a small piece of dry fruit are all gentle and nourishing. Avoid pressing him to eat large portions — that usually makes appetite worse. If his intake drops significantly for more than two to three days, or if he is losing weight, contact his oncology team. Ask whether a dietitian referral is an option — specialist nutrition support can make a real difference.
Can I drink green tea or herbal teas while on enzalutamide?
Green tea in normal amounts — one or two cups a day — is generally not a concern. The caution applies to high-dose green tea extracts sold as supplements, which can affect liver function at high doses. More significant is St John's Wort, found in some imported herbal teas and supplements: this herb can reduce the blood levels of enzalutamide and affect how well it works. If you drink herbal preparations regularly, name them to your oncologist at your next visit.
Are whey protein or protein supplements safe to take?
Plain whey or plant-based protein powder is generally not harmful, but tell your oncologist before starting one. The concern is not the protein itself but what else the product contains — many commercial supplements include high-dose vitamins, minerals, creatine, or herbal extracts that can interact with treatment or affect something your team is monitoring. If your protein intake from food is genuinely low, a dietitian can recommend an appropriate supplement based on your specific situation.