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Nutritional Counseling During Cancer Treatment

We know that nutritional coaching helps people live a healthier life. People turn to dietitians every day to lose weight, manage their diabetes, and keep conditions like Crohn’s under control. What about cancer?

When people think of cancer, they think of the nausea, vomiting, and taste changes of chemo. While we all know cancer patients are plagued by problems eating, very few patients ever see a dietitian. Those who do often wait until it’s too late.

It has been shown that cancer patients feel better emotionally and physically, perceive control of their condition, and notice improved health indicators after nutritional counseling [i].  It goes beyond just feeling better about treatment: extreme malnutrition is common among cancer patients. And it can be fatal.


Nutritional Requirements During Cancer Treatment

Nutritional needs change during the different phases of cancer treatment and nutritional counseling can help patients make well-informed lifestyle choices to address specific nutritional issues during treatment and as patients begin to improve and recover.

Physical changes like unintentional loss of body weight, loss of muscle mass, unintentional weight gain, and eating and digestive difficulties are reasons for adjustment in dietary habits and targeted nutritional counseling and intervention. An oncology dietitian can address specific nutritional issues commonly confronted by cancer patients, like treatment side effects.


What is an Oncology Dietitian?

Registered dietitians who specialize in oncology nutrition (RD, CSO) counsel patients during treatment to ensure that they are able to get the nutrition they need to maintain their strength and keep symptoms under control. They learn about a patient’s condition and tailor recommendations to their specific needs.

Two of the most important nutritional goals for the cancer patient are maintaining energy balance and preventing weight loss [ii]. Nutritional intervention can increase the patient’s total energy and protein intake, resulting in increased body weight, which is important for patients at risk of weight loss.

Keeping your energy up while undergoing cancer treatment is about more than numbers. It’s the difference between being able to stay at work, having the energy to play with your kids, being able to take a shower – or not.

Nutrient adequacy is also a major issue among cancer patients. Fat, protein, and carbohydrates are macronutrients that not only contribute calories, but also guarantee nutrient adequacy. Each has its own effect on a patient’s health in both the short and long term and, thus, it is important that an experienced dietitian works with the patient to ensure that the proper amount and balance are maintained.

Protein allows the body to heal faster. Therefore, adequate protein intake is essential during all stages of cancer treatment. Low saturated fat meats, poultry, and fish are great sources of protein; however, if consuming protein in that form is too difficult, protein can be found in eggs, dairy products, beans, soy, and nuts [iii]. Dietitians counsel patients on protein sources and how to use them effectively.


Examples of nutritional counseling for the cancer patient include the following:

  • A patient undergoing radiation to the oral cavity for head and neck cancer is advised to eat nutrient-dense soft foods, shakes, and supplements that would be appropriate to meet his or her calorie and protein needs.  The RD will suggest ways to add extra calories to those soft foods by adding things like butter, olive oil, gravies and dressings.
  • For a chemotherapy patient undergoing treatment for colon cancer, an RD, CSO would recommend that he or she consume small, frequent meals to help manage digestive side effects such as nausea and diarrhea.  The patient would also be advised to avoid higher fat meals and limit raw fruits and vegetables, which may worsen the symptoms of nausea and diarrhea.


It’s important to use all the tools you have in the battle against cancer. Don’t overlook the power of the tools you have in front of you – what you eat. Schedule an appointment with an oncology dietitian today.


[i] Schiller, M.  Journal of the American Dietetic Association 98.9 (1998): 977-82.

[ii] Isenring, et al Journal of the American Dietetic Association 107.3 (2007): 404-12.

[iii] R. Morgan Griffin, WebMD. WebMD. WebMD. Web. 22 May 2012. <http://www.webmd.com/diet/guide/nutrition-and-healthy-foods-during-cancer-treatment>
Jessica Iannotta, MS, RD, CSO, CDN

Jessica is a registered dietitian and certified specialist in oncology nutrition (CSO). She studied nutrition at Cornell University and completed her dietetic internship at New York Presbyterian Weill Cornell Medical Center. She obtained her Master's degree through the University of Medicine and Dentistry of New Jersey. Jessica has worked in inpatient and outpatient oncology settings since 2001 in the North Shore-LIJ Health System. Jessica is in charge of all operations including clinical and culinary operations ranging from menu development to evidence-based website content, relationships with registered dietitians and social workers and developing processes and protocols for intake, management and outcomes analysis of patients.

  1. Food can become so overwhelming during treatment: what to make, when to eat, how to cook. If a patient can find some support and guidance from nutritional counselling, then that’s a very good thing.

    If they can find people to cook for them, that’s even better!

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