For almost 20 years, my goal has always been to provide generalized science-based information about nutrition for cancer patients on my website, CancerRD.com, in order to counter all the misinformation that exists on the Internet. A recent article published in the Journal Nutrition and Cancer (“Dietary Recommendations During and After Treatment: Consistently Inconsistent”) [i] and subsequently commented on by Dr. Sanjay Gupta [ii], reported that there exists a lack of consistent dietary guidelines among the many websites providing nutritional recommendations to cancer patients. In fact, there are over 170 million different websites when typing “cancer nutrition” into an internet browser such as Google [iii] and these websites do vary widely on their purpose (sales of a product versus education) and diet recommendations as well as the scientific basis behind these recommendations.
Dr. Gupta’s recommendation was that we need more research to combat this issue. While not disputing that more research would certainly be helpful, including research designed to evaluate both medical and quality of life outcomes as a result of specific interventions from Registered Dietitians (RDs), my view is that first, more than anything, we need more Registered Dietitians in cancer centers to help patients sort through and prioritize the nutritional information that is both available and appropriate to their current needs.
Why Oncology Dietitians are Important
Knowing how many questions I had after my two breast cancer diagnoses, knowing how difficult it was (even as a highly-trained RD) to sort through and evaluate the accuracy and appropriateness of the overwhelming amount of nutrition information available to cancer patients, plus knowing that the purpose of both my website and book has only been to provide generalized information, I have been advocating for almost two decades that cancer centers provide proactive and individualized nutritional information by an RD as a component of true comprehensive cancer care, first upon diagnosis (i.e., during treatment) and when a patient enters the survivorship phase (i.e., when treatment has ended or continues into the new phase of the diagnosis being considered a chronic disease). Thanks to the Oncology Nutrition Dietetic Practice Group of the Academy of Nutrition and Dietetics, cancer centers and thus patients now have access to oncology-credentialed RDs, Certified Specialists in Oncology Nutrition (CSOs).
There will be greater than 1.6 million people in 2016 hearing the chilling words “You have cancer” in the US alone. Cancer only rarely happens in a vacuum, and the fact is that the majority of these patients also have (or are now at increased risk of developing) many diet-related chronic diseases such as diabetes, cardio-vascular disease, osteoporosis, etc. Which of those 1.6 million patients does not need help sorting through and prioritizing nutritional actions to both improve their odds for long-term survival and/or quality of life? Which would not benefit from (or deserve) care from an RD as a professional involved in optimizing their comprehensive cancer care and life after cancer?
More research studying the specific recommendations for specific cancers will always be important and of value. In fact, proceeds from the sale of my book, A Dietitian’s Cancer Story, have been donated to the Diana Dyer Endowment at The American Institute for Cancer Research (AICR) since 1999, helping to fund annual research projects focused on defining nutritional strategies to optimize the odds for long-term cancer survivorship plus enhanced quality of life after cancer.
Dietitian Counseling – A Complementary Therapy to Cancer Treatment
Research is painstakingly slow, too slow for the 1.6 million people who will be newly diagnosed with cancer this year, those diagnosed last year, and those who will be diagnosed next year. The bottom line is that cancer centers (large and small) need to be hiring more dietitians now to provide nutritional care to these patients that will improve their overall oncology care and life after cancer treatments. Information on the internet, reputable website or not, consistent information or not, pamphlets, DVDs, books, well-intentioned advice (and likely inconsistent also) from other oncology staff members, etc., are only a first step and can never replace the benefits of comprehensive, proactive, individualized nutrition counseling (Medical Nutrition Therapy) from a Registered Dietitian. This is where we need to start.
My words to cancer centers, please start identifying the barriers (real or perceived) to hiring RDs.
To those cancer centers that already have hired an RD (thank you!) but your cancer center serves 5,000-10,000 unique patients annually, please increase the RD staffing.
My words to patients, ask, ask, and ask again for a referral to an RD, and don’t take ‘no’ for an answer. I have seen more than one cancer center hire their first RD because of ‘grass roots efforts’ from patients just like you. Go big, don’t fly low, set the bar high.
The goal of all health care professionals is creating healthy communities and that can only be done by including, indeed embracing, healthy food and nutrition into the care plan!
[i] Champ, C; Mishra, M; etal. Dietary recommendations during and after cancer treatment: consistently inconsistent? 2013. Nutrition and Cancer. V65(3)
[ii] Laino, C. Cancer patients poorly served by online nutrition info. Medpage Today. Accessed at: http://www.medpagetoday.com/Columns/TheGuptaGuide/38124
[iii] Google.com, search cancer nutrition (without quotation marks) on 4.19.2013
[iv] Cancer facts and statistics. American Cancer Society. Accessed at: http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-036845.pdf