Holistic cancer care is enjoying growing popularity as the body of evidence on the benefits of treating the whole patient – the physical, emotional, and socioeconomic aspects – increases. Yet nutritional support is often overlooked in otherwise comprehensive treatment plans. It’s an oversight that can exacerbate side effects, prolong or delay treatment, and complicate short- and long-term recovery.
That is why American Oncology Network (AON) has assembled a team of highly qualified and credentialed oncology dietitians to work with its community practices on ways to integrate personalized nutrition counseling into care plans. While the program is still in its infancy, early response has been positive as patients and clinicians alike see first-hand how proper nutrition and in particular prevention of malnutrition is creating a solid foundation for successful treatment.
Why Nutrition Matters
Proper nutrition plays a vital role in how well a cancer patient responds to treatment. Not only does nutrition impact energy and stamina levels, but it can help boost the body’s response to treatment and therefore the efficacy of prescribed therapies.
An important goal of oncology nutrition is preventing a patient from becoming malnourished – which is much easier than treating malnutrition. When a patient maintains a healthy nutritional status, they are typically able to handle treatment much better. They don’t need to pause treatment or change treatment plans due to weight loss or the body’s inability to tolerate the full course. Thus, the ability to maintain a base level of nutrition from the outset of treatment sets the patient up for success and helps drive better outcomes.
Maintaining healthy eating habits can also give patients an emotional boost, especially when side effects from treatment sap their appetite or make eating a struggle, for example due to appetite changes, nausea, fatigue, or changes in how things taste or smell. By reframing how they view food into something with purpose, for example as fuel to power the body through treatment rather than simply an act to be performed, can help patients overcome some of the mental challenges which can be particularly helpful when eating is the last thing someone wants to do.
Nutrition – and nutrition counseling – can also help prevent patients from developing an unhealthy relationship with food. A handful of studies have found a relationship between a cancer diagnosis and development of an eating disorder like orthorexia, which is an obsession or fixation with “proper” eating to the point it becomes unhealthy. One theory is that patients fixate on food and nutrition to regain some of the control that cancer has taken away. Others suggest that controlling food intake becomes a way of subconsciously punishing their bodies for getting sick in the first place.
Working with oncology dietitians can help maintain a healthy nutritional status by identifying the right foods to fuel patients’ bodies. It also helps them maintain a healthy relationship with food, nutrition, and their bodies as they battle cancer.
Food for Wellness
When it comes to healthy choices from both a prevention and treatment standpoint, variety is the key, as is understanding how nutritional needs evolve over time for many patients. In general, the ideal diet for optimal nutrition consists of a wide variety of nutrient dense foods. These are typically plant-based – foods that are grown and eaten in their natural state such as vegetables, whole grains, beans, nuts, and seeds. However, during treatment or recovery, food priorities may shift to focus on adequate calorie or protein intake to promote maintenance of lean body mass and/or weight.
Along with variety and flexibility, another good rule of thumb is to eat the rainbow. Consuming foods that encompass a wide range of bright colors is an easy way to ensure the body is getting a variety of antioxidants and phytochemicals. These components also work together synergistically to help support overall health and wellness.
Adding protein to the mix supports lean body mass and muscle stores and adds calories – all of which are particularly important for patients who are undergoing treatment. Nutritional needs should be assessed periodically to ensure they are being met, and adjustments made as patients transition through treatment and into recovery.
An Important Focus
AON understands the importance of proper nutrition for cancer patients. That is why every member of its nutrition team is a Board Certified Specialist in Oncology Nutrition (CSO), a credential that was developed by the Oncology Nutrition Dietetic Practice Group together with the Commission on Dietetic Registration. A recommended minimum of two years of clinical practice with documentation of 2,000 hours of practice experience in the oncology care setting is required to sit for the certification exam – which must be retaken every five years to remain certified.
CSOs and oncology nutrition are important additions to the holistic care model used by AON’s community-based practices. A cancer diagnosis is traumatic, and treatment can be grueling. But a whole-person care plan that includes nutrition counseling can put the patient on the path to the most successful outcome possible.