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Oncology Nutrition: Expert Insights on Diet and Cancer · Talking FACS

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  Welcome to Talking FACS, and thank you for tuning in to Cancer Conversations
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  on Talking FACS, a podcast collaboration between the University of Kentucky
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  Markey Cancer Center and the UK Martin-Gatton College of Agriculture,
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  Food, and Environments Cooperative Extension Service.
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  We will share with you the latest developments in cancer prevention,
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  diagnosis, treatment, and research from the experts at Markey Cancer Center,
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  Kentucky's only National Cancer Institute-designated Comprehensive Cancer Center.
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  Talking FaCS is hosted by the UK Family and Consumer Sciences Extension Program.
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  Our educators share research knowledge with individuals, families,
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  and communities to improve quality of life.
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  Hello and welcome to Cancer Conversations on Talking FACS. This is your host, Dr.
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  Jennifer Hunter, Assistant Extension Director for Family and Consumer Sciences.
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  Today, I'm pleased to be joined by Rachel Miller, an oncology dietitian in the
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  University of Kentucky Markey Cancer Center. Welcome, Rachel.
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  Hi, thanks for having me. So, Rachel, today we're going to talk about diet and
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  diet in terms of cancer prevention.
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  But first, I wanted to ask you, so your long title is a certified specialist in oncology nutrition.
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  And I wanted to kick off by just asking if you could explain to us the role
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  of a certified specialist in terms of oncology nutrition?
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  Of course. I've held that title for about eight years now. It is a national certification.
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  You have to have so much experience as an oncology dietician to be qualified
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  to take this examination.
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  I actually participate on the subject matter expert review committee and have
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  contributed to writing questions for that test.
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  I've been at Markey for 12 years, so oncology is my niche.
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  One of the things that I've really enjoyed about doing this podcast is I've
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  learned about so many of what I guess I would call wraparound services that Marquee provides.
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  If you think about an individual or a family that is working through a cancer
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  diagnosis, I've been very impressed with all of the services that Marquee provides.
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  An oncology dietitian is kind of what I would think of in terms of one of those
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  services. Can you explain the role or your day-to-day in terms of an oncology dietician?
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  Yes. I am outpatient alongside my other co-worker and oncology dietician,
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  and we see patients when they're here for doctor's appointments, for example,
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  with their medical oncologist or if they're here for radiation therapy or chemotherapy
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  or any other appointments that they have.
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  We try to see folks when they're here in person so that we don't have to make
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  a separate appointment for those who have a long way to travel.
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  We may see patients that our doctors and staff identify as someone who is at
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  risk of malnutrition during their therapy,
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  someone who presents with a weight loss or any barrier to having a good nutrition
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  status during and after their cancer treatment.
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  So we do a lot of education. We work with folks that need feeding tubes and
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  we answer a lot of questions.
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  One of my favorite parts of the job is being able to spend time with people
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  and give them a peace of mind about what they're eating and that piece of it
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  as they go through their journey.
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  And that leads us to today that we're going to talk really and truly about two
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  primary questions in terms of diet and cancer prevention, as well as managing
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  your diet during a cancer diagnosis.
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  But let's start first with diet in terms of cancer prevention.
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  And I think just if you listen to the popular press and the news that you can
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  hear so much about eat this food, don't eat that food, and what's the impact
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  of this food, etc., in terms, you know, potential cancer risks.
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  So today we're going to talk about some of that. And so let's start just with
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  a general question about diet and cancer prevention. That's a great question.
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  There can be so much information out there. So part of what I do is help patients
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  sift through that because everybody has needs that are specific to them as an
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  individual based on diagnosis or based on their physical condition or how they present.
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  And so part of what I also do is help dispel some of the myths that are out
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  there, some of the misinformation or the recommendations by people all over
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  the internet that tell you not to eat something.
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  I try to stay away from that anything is quote unquote bad.
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  We encourage for cancer prevention, a general healthful diet leaning more toward
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  what you've probably heard is called a plant-based diet.
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  But what that means is that we're looking at a mostly plant-based diet that
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  does not have to exclude animal proteins.
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  It is, per the American Institute of Cancer Research, a diet that's kind of
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  putting plant foods first, so to speak, and looking at all those nutrients that
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  those plant-based foods can offer.
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  You've probably heard the term phytochemicals and antioxidants,
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  and those are naturally occurring compounds in those foods that work together
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  to keep our cells healthy and prevent them from damage.
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  Also, more of a plant-based approach to a diet can help with achieving a healthier
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  body weight, which can also decrease cancer risk.
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  It is very high in fiber, which has numerous health benefits and can keep us
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  healthy in the long term.
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  So a plant-based diet can be.
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  Per a patient's preference. Also, including some of those lean protein foods,
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  fish, chicken, turkey, lower fat dairy, eggs.
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  It can be flexible, but with an emphasis on a lot of the plant foods being first in focus.
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  I love that you say that, that it can be flexible, but it's being mindful of
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  what you're eating, what you put first.
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  In our unit, we have several nutrition faculty members, several dieticians,
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  I always tell them, well, I'm a finance expert, that that's my subject matter
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  training, you know, but sometimes in apologizing for what I might be eating for lunch,
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  etc., they're always very quick to say, it's in moderation, be mindful of what
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  you're eating, make good choices.
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  So I like reinforcing that point.
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  How does or does diet recommendations change from going for cancer prevention
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  to an individual that may be in cancer treatment?
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  That's a very good question. And that's something that I work with patients
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  on a regular basis because cancer treatment, depending on which modality they
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  are facing, can cause a wide variety of side effects.
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  And with those side effects, barriers or challenges to getting enough nutrition.
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  So we may have to modify what they're eating based on how they're feeling,
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  what they're able to tolerate.
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  Are they having nausea, vomiting, or diarrhea? Or do they have Do they have
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  weight loss or is their appetite changed or are they having a change in taste?
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  So where foods may taste off or bland or a bad taste or metallic to them.
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  Nobody does it perfect every time. There's no certain algorithm that is 100%.
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  This is what you should do.
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  We have to take it case by case. And sometimes we have to take it a week at a time.
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  I kind of try to talk to people about taking the pressure off themselves.
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  What is our priority here?
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  Getting enough nutrition. So it may not be the typical diet that they're used
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  to or a quote-unquote healthy everything.
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  Sometimes we just have to focus on calories and protein. So we're not restricting
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  in certain ways and ending up with weight loss and inability to complete treatments
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  and other hiccups, so to speak, during therapy.
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  So like I that it changes throughout the whole course of treatment.
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  And sometimes you have to change what you're doing and that's okay.
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  So again, when I talked earlier about the services that are available through
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  Marquee, is it standard because our listeners are all across the state and outside
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  of the state of Kentucky,
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  is having a position such as yours in terms of an oncology dietician,
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  is that standard in other cancer care centers in terms of patient care? I know that.
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  Currently, there has been more of a push for dietitian availability in cancer centers.
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  Some places have, depending on their volume, have more dietitians than others.
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  And some cancer centers may not have as much access to a dietitian.
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  So that is something that we continue to advocate because some of the statistics
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  are that 40% to 80% of cancer patients experience malnutrition at some point
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  of their cancer journey.
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  And with a malnutrition diagnosis, we have incomplete therapy.
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  We have breaks in treatment because of hospitalization, because we're not able
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  to keep the patient healthy enough to keep from therapy toxicities, for example.
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  So it is a vital role and one that we continue to advocate for.
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  For our listeners that may be interested in exploring more about eating for
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  cancer prevention or eating for just general longevity and healthy lifestyles,
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  are there resources that you recommend?
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  Yes, I really like the American Institute of Cancer Research.
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  Their website is AICR.org. They have lots of good evidence-based information,
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  recommendations on cancer prevention during cancer treatment into survivorship
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  and health and longevity going forward.
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  They have lots of healthy recipes. They have frequently asked questions.
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  They have several articles that are even just on specific topics.
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  So if you're curious about one nutrient or another, you can search for that there.
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  They have a lot of good information. We actually use their resources and written
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  materials for patients quite often.
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  Also, the National Cancer Institute is cancer.gov,
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  and that is another wonderful resource for written materials,
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  research, if you're interested in reading about that, but also just evidence-based
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  recommendations and information.
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  And you can feel comfortable that you're in the right place and reading things
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  that are applicable to the field.
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  Thank you. For our listeners, just a reminder that we will have both websites
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  linked in our show notes in addition
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  to information for the University of Kentucky Markey Cancer Center.
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  Rachel, thank you so much for joining us today and sharing with our listeners
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  and providing information in terms of diet for cancer prevention as well as cancer care.
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  You're so very welcome. Enjoy your fruits and veggies. Wonderful.
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  Thank you for listening to Cancer Conversations on Talking FACS.
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  Our goal is to connect you with the latest advances in cancer research in the Commonwealth.
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  If you enjoyed today's podcast and have a suggestion for a future show topic,
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  please message us on the UK Markey Cancer Center Facebook page at facebook.com
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  forward slash UK Markey or visit our website at markey.uky.edu for more information.
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  You can find University of Kentucky Family and Consumer Sciences Extension programs
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  at your local extension office or online at fcs.uky.edu.
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  Building strong families, building Kentucky.
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  Music.