Some side effects of cancer treatment—such as taste changes and appetite loss—can prevent a person receiving cancer treatment from eating and drinking enough. In this podcast, oncology dietitians Maureen Gardner and Annette Goldberg will discuss how they work with people with cancer and their families to address these and other common nutrition concerns.
ASCO: You're listening to a podcast from Cancer.Net. This cancer information website is produced by the American Society of Clinical Oncology, known as ASCO, the world's leading professional organization for doctors that care for people with cancer. Some side effects of cancer treatment, such as taste changes and appetite loss, can prevent a person receiving cancer treatment from eating and drinking enough. In this podcast, oncology dietitians, Maureen Gardner and Annette Goldberg, will discuss how they work with people with cancer, and their families, to address these and other common nutrition concerns. Maureen Gardner is a clinical dietitian at the Moffitt Cancer Center and an executive committee member of the Oncology Nutrition Dietetic Practice Group. Annette Goldberg is an outpatient dietitian at the Boston Medical Center Cancer Care Center. ASCO would like to thank Ms. Gardner and Ms. Goldberg for discussing this topic.
Annette Goldberg: Hi. My name is Annette Goldberg. I'm a registered dietitian working at Boston Medical Center's Cancer Care Center. Boston Medical Center is about a 500-bed medical center, located in Boston's south end, and it's the largest safety net hospital in the area. Therefore, the patient population I deal with is quite diverse. Please let me introduce my colleague, Maureen Gardner.
Maureen Gardner: Hello. My name's Maureen Gardner. I am also a registered dietitian. I work at Moffitt Cancer Center, which is a cancer center in Tampa, Florida. And we're the only NCI that's made a comprehensive cancer center, based in the State of Florida. We also have many outpatients, a bone marrow treatment center, and an inpatient center of 203 beds.
Annette Goldberg: Maureen, can you briefly explain the role of a dietitian in the care of a person with cancer? When should someone with cancer consider working with a dietitian?
Maureen Gardner: Annette, yes, I will. I work with the medical team, and we try to identify patients who might need a dietitian - maybe they've lost a lot of weight, they have trouble swallowing, or they have difficulty consuming enough fluids. Mostly, when we meet with the dietitian we try to optimize their intake - whether it's by mouth, or sometimes they'll have feeding tubes - in order to get them the best nutritional status, so they get through treatment. Because, as you know, if your nutritional status is good and your side effects are lessened, and you might get through your treatment better, without an admission for dehydration or malnutrition.
Annette Goldberg: Yes, definitely.
Maureen Gardner: Annette, I wanted to ask you, when you go through your patients and see your clients, what's the common nutritional challenges that your patients face? And how are you able to manage them?
Annette Goldberg: Sure. Maureen, I'm sure you see some of the same things, but some of the common nutritional challenges are the result of the side effects from the different treatments the patients are required to go through. And many of these side effects results in weight loss. You had talked about this in your responses to the first question. You know, we want to make sure that our patients are not malnourished. It's very common for patients to struggle with nausea, gastrointestinal distress - such as constipation and diarrhea. They have taste changes, and they have a loss of appetite. And, to help the patients with their side effects, we provide handouts that are available, providing tips and tricks to manage their symptoms. But it's also important to remember that every patient is different. The dietitian tries to understand their taste preferences, their cultural background, their support systems. And then we work to develop an individualized plan and recommendation to help them. Maureen, what do you think a person with cancer expects when they're working with a dietitian? Is there anything they can do to prepare for their first visit?
Maureen Gardner: That's a great question. So often I'll have patients that they don't really know what I do for the team, and what I can help them with. So I think if they have a list of questions prepared, that's really helpful. Because then they won't forget anything, and they'll be ready for any possible thing that might pop up. Also, super helpful is if they can bring a copy of their usual diet, or food diary, or any specific foods that they have a question about. They might bring a copy of the food label, or even the package, or something. And, I guess, a lot of times people want to take nutritional drinks, or vitamin, mineral, herbal supplements. So if they could bring the bottle of that supplement, or at least a picture of it, or a screenshot, that's super helpful, because then we can help them make a decision - with the physician, and any other members of the team - to make sure there's no interactions with their treatment. Annette, do you ever have anything that you think patients should bring with them, or think ahead on their first visit?
Annette Goldberg: I think that you mentioned it, in that coming with a list of questions prepared, because I think sometimes the visits can become overwhelming, and so to think about what you would like to ask, and have it written down - sometimes even to bring somebody with you - I think that's very, very helpful. Because your visits can be very overwhelming.
Maureen Gardner: Oh, that's so true. I agree. But what do you think-- if you were to say what's the most important thing, Annette, for the person who has cancer, what should they keep in mind about nutrition? The most important thing. What do you think?
Annette Goldberg: Oh, that's a tough question. But, I would say, the most important thing for patients to remember is that it's important to consider nutrition another medication for your body. As you're going through this treatment, and your body is trying to fight and repair, your nutrition becomes very important. You're no longer just simply eating for enjoyment, like we feel like we do every day. As you mentioned earlier, Maureen, a food diary really helps, because this allows your dietitian to review the nutritional intake, and ensure that the proper type of nutrients are available to fuel your recovery. Would you agree with that Maureen, or do you have anything to add to that?
Maureen Gardner: Definitely.
Annette Goldberg: What do you think is an important thing to remember?
Maureen Gardner: I always used that analogy when I talk to patients, and I'd say, "This is your fuel." I tell them, "You're in a marathon, you're like the person going to the Olympics, you're just getting that calories and protein in and fluids. And the better you get your nutrition into your body, the better you're going to be going through this marathon," which sometimes is only chemo, sometimes it's only radiation, or both, but it's truly a marathon. And the better your nutrition is, it is truly like a medication for your body, and it's a huge part of your treatment.
Annette Goldberg: I agree. I agree. Well, Maureen, it was a pleasure speaking with you.
Maureen Gardner: It was nice to talk to you, Annette. I hope we can maybe help our patients, and other patients who might hear this, by asking for a registered dietitian and help them with their nutrition during treatment.
Annette Goldberg: I agree. Every patient, at the beginning of their treatment, should feel very comfortable asking their medical team if they have a dietitian - either on staff or available - to help them as they're working through their treatments. Definitely helpful, and a requirement, I think, for a successful result.
Maureen Gardner: I agree.
ASCO: Thank you, Ms. Gardner and Ms. Goldberg. Maureen Gardner and Annette Goldberg talk more about the role of dietitians and cancer care on the Cancer.Net Blog. Visit www.cancer.net/blog to learn more.
Cancer.Net is supported by the Conquer Cancer Foundation, which is working to create a world free from the fear of cancer by funding breakthrough research, sharing knowledge with physicians and patients worldwide, and supporting initiatives to ensure that all people have access to high-quality cancer care. Thank you for listening to this Cancer.Net podcast.