Transcription:
Nutrition's Role in Cancer Care

Scott Intro: Welcome to Conversations on Cancer, brought to you by the Riverside Cancer Institute. Providing answers, debunking myths, and sharing patient stories.

Gabby Cinnamon (Host): Welcome back to Conversations on Cancer, brought to you by the Riverside Cancer Institute. I'm your host, Gabby Cinnamon. And today, Katie Swafford, a registered dietician at the cancer institute is joining us to talk about the role nutrition plays in cancer care.

Thank you so much for coming on the podcast today, Katie. Before we get into the episode, can you tell us a little about yourself, because I think this is your first podcast with us and kind of your role as a dietician at the cancer institute?

Katie Swafford: Oh, yes. Thanks for having me, Gabby. My name is Katie and I've been at Riverside for 17 years and I've been out at the cancer treatment center for the past seven years. So as a dietician, I provide medical nutrition therapy, I aid in symptom management, I optimize patient's nutritional status during and after treatment. Ultimately, I'm a resource to our patients here at Riverside. I help patients with meal and snack ideas. I discuss ways to increase calories and protein in their diets. I provide tube feeding recommendations when needed. I discuss different types of nutritional supplements. I can also provide diet education and general nutritional counseling.

Gabby Cinnamon (Host): So kind of when I was researching for this episode, I realized just how important nutrition is for cancer patients during their cancer journey. Can you tell us why nutrition is so important in cancer care?

Katie Swafford: Absolutely. Many patients do not realize the impact that a healthy diet can have on the side effects from treatment. Nutrition helps our patients maintain a healthy body weight, maintain strength, maintain nutrition stores. It helps to repair tissues and cells, decrease side effects during treatment, fight off infection. It can help heal and recover and just ultimately help us feel better.

Gabby Cinnamon (Host): Can you kind of talk about some of the nutrition concerns associated with a cancer diagnosis or some concerns that patients might face in their cancer journey?

Katie Swafford: Yes. Nutrition concerns are usually related to treatment side effects, such as nausea, vomiting, diarrhea, constipation, dysphagia, decrease in appetite, lack of desire for food. Changes in taste and smell. And all of these ultimately can lead to malnutrition due to decreased oral intake.

Malnutrition can be identified through unintentional weight loss, as well as noting loss of muscle mass, noting a decrease in oral intake. When nutrition stores are depleted, you can have decreased mobility. You don't tolerate treatment as well. It's harder for your body to fight off infection. Treatment could be placed on hold and recovery is just more cumbersome in the end.

Gabby Cinnamon (Host): So what should a patient or a caregiver do if the patient is starting to become malnourished or maybe the treatment has gotten to a point where it is causing the lack of appetite or other side effects like that?

Katie Swafford: First, the patient and families, they really need to express that to the doctors, a PA, the NP, the nursing staff and of course, if a dietician is on staff, they need to express that to them. The priority first is finding out the cause of being malnourished. Sometimes meds can be adjusted or they can be added to aid in symptom burden. Sometimes it's a matter of interviewing the patient about typical eating and hydration patterns. How often other eating and drinking? When are they eating and drinking? What are they actually consuming? Who prepares the food? Are there financial concerns for the patient to obtain the food or the supplements? Am I able to suggest ways to increase calories in the food they're already eating or suggest nutritionally dense foods, or even add a nutritional supplement?

Gabby Cinnamon (Host): So what happens if malnourishment, malnutrition isn't addressed right away?

Katie Swafford: So treatment might not be tolerated as well. There's difficulty in healing and repairing. Treatment could be put on hold, difficulty fighting off infections. Patients could have weakness, they can have falls, which ultimately lead to hospitalizations and, unfortunately, even death as 20% of cancer deaths are related to malnutrition.

Gabby Cinnamon (Host): So it sounds like getting the nutrition a patient needs is very important. And kind of switching gears a little bit, you know, having an overall healthy diet through a cancer diagnosis, let's say a patient maybe didn't have the healthiest diet before they were diagnosed with cancer, what nutrition tips do you have for patients to kind of get a healthy diet and get the nutrition they need, if maybe even before the diagnosis, they weren't leading a healthy lifestyle?

Katie Swafford: So in a perfect world, I'd want them following the recommendations from the American Cancer Society, which is to eat a plant-based diet, variety of foods, eating colorful fruits and vegetables, low-fat dairy products, lean proteins, beans, legumes, whole grains. But right now, when patients are coming to me, they're scared, they're nervous, sometimes defensive about their eating habits. So I try to meet my patient where they are and try to build that rapport first. Sometimes it takes a couple of visits to gain a patient's trust. So over time, I can start discussing the benefits of that healthy diet to hopefully win them over of the importance of that nutrition.

Gabby Cinnamon (Host): Yeah. In general, diet and food is a very personal thing and, definitely, I'm sure it can be a touchy subject telling people what they should and shouldn't be eating. Some people might take it better than others. Are there any foods that you tell patients, "Hey, like don't eat this or really try to avoid this food group or type of food?"

Katie Swafford: So I really try to avoid listing foods in that bad or good category, but there are recommendations for healthier lifestyle. So limiting red meat and avoid processed meats, such as bacon and sausage, sugary beverages, highly processed foods and alcohol. All of those things should be avoided to help reduce that cancer risk.

Gabby Cinnamon (Host): So you touched on healthy foods and we kind of hear about superfoods and there are some super foods associated with fighting cancer. Are there any types of foods that you just really recommend patients should be eating or food groups?

Katie Swafford: Sure. Oftentimes, we get so wrapped up in foods we should avoid, we forget about the foods that provide us with all those good nutrients, those vitamins, the minerals, the antioxidants, the phytochemicals, choosing plenty of fruits and vegetables with a variety of colors. Think of it as eating from the rainbow. You always want to pluck each of those fruits and vegetables from each of those colors. And then don't forget about the legumes, the beans, plenty of whole grains, such as quinoa. Think in terms of whole foods. When planning meals, we want them to be balanced, something from each food group, fruit, veg, grain, protein, dairy.

MyPlate.gov is a great tool and it explains this concept in significant detail and there's great visuals on there.

Gabby Cinnamon (Host): So, once someone has been diagnosed with cancer, I'm sure it can be overwhelming. You know, a lot of new things are happening, treatment. They might have a caregiver helping them. How can that caregiver help them ensure that they're getting the nutrition they need and kind of what tips do you give caregivers to help them help the patient that they're caring for?

Katie Swafford: Offering a variety of foods, a food item from each food group to make the meals nice and balanced, but also be willing to make adjustments in your usual cooking. Maybe our patient needs less flavor, maybe they need more flavor. And don't be afraid to try new recipes during this time as well. As difficult as it can be, offering patients and compassion for your loved one and for yourself as well. C for Cancer Facility has a dietician on staff that can help and give you individualized recommendations. And the American Cancer Society is really a fantastic website and a great place to start, and that website's www.cancer.org.

Gabby Cinnamon (Host): Yeah. Nutrition, it seems like it's a group effort. Everyone kind of working together, especially if the patient does have a caregiver helping them. It sounds like that's really important. Do you have any other nutrition tips for cancer patients or anything else that you'd like to add?

Katie Swafford: I mean, really just remember everyone's journey is different from their diagnosis, their treatment, the response to treatment, side effects. And try not to compare yourself to other. You know, have compassion for yourself in this journey and it's okay to feel your feelings, whatever they are. Don't be afraid to ask for help. It might be difficult times, but try to maintain that positive attitude and absolutely find support from family, friends, support groups, whether they're online or in person, or from the staff at the clinic that you are at.

Gabby Cinnamon (Host): I think that's a great place to end off on. Thank you so much for all this information and coming on the podcast today, Katie. We really appreciate it.

Katie Swafford: Thank you so much, Gabby.

Gabby Cinnamon (Host): And thank you, listeners, for tuning into another episode of Conversations on Cancer. For more information about cancer care at Riverside, visit riversidehealthcare.org.