Tag Archive for: cancer treatment

Expert Perspective | Managing the Emotional Aspects of a Gynecologic Cancer Diagnosis

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What emotional support and resource are available for gynecologic cancer patients? Dr. Hinchcliff discusses leveraging personal networks and highlights key resources like the Society for Gynecologic Oncology and ASCO.

Dr. Emily Hinchcliff is a Gynecologic Oncologist at Northwestern Medicine. Learn more about Dr. Hinchcliff.

See More from Evolve Endometrial Cancer
 

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Transcript:

Katherine Banwell:  

How do you counsel patients who might be having emotions around their gynecologic cancer? What advice and resources are available?  

Dr. Emily Hinchcliff:  

Yeah. So, I think that a cancer diagnosis is a life-changing experience. Even for patients who have early-stage cancers, hearing that word “cancer” on the phone, in the doctor’s office, and having to be the one to then tell family members and understand what that means for their life is truly a pivotal moment, and it does bring up all sorts of emotions and need for support. 

So, what I would say is, first and foremost, it can be really common that cancer patients sort of retreat into themselves and want to be more private. I think that I would encourage people to really use their support network that they have. Everyone’s different, and so, I definitely want them to do what feels right for them, but making sure that you leverage whatever support networks you have in your life is sort of the first foundation.  

Second, I think that there are just so many excellent resources out there for patients facing a cancer diagnosis. Certainly, in endometrial cancer, there are our big national groups of physicians. We put out a ton of information that is patient-focused, so, that is at a level that patients can understand.  

The two that I think of are the Society for Gynecologic Oncology is a big resource for patients with gynecologic cancers, and then, the overarching cancer society ASCO is another place that has a ton of cancer resources. I also think that patient support groups can be really helpful. There are many, many – so, my institution has one that is more specific to our institution as part of our institutional branch of the Woman to Woman program. 

There are also national, or city, or state cancer support groups, and I think that those can be really helpful to gain mentorship from someone who’s been through it and from someone who is a little bit further along in their journey than you might be as the patient that’s just getting a diagnosis, for example, and that can be really helpful so that you have that bird’s-eye view that sometimes, right after your own diagnosis, you just don’t have the perspective to understand. 

How Do Psychological Factors Impact Diet During Cancer Treatment?

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How can diet be impacted by psychological factors during cancer treatment? PEN Program Manager Joelys Gonzalez and Communication Manager Nicole Normandin Rueda, LMSW discuss common psychosocial factors, various impacts to diet and nutrition, and strategies to help mitigate negative impacts to patient health. 

Download Resource Guide

See More from RESTORE

Related Resources:

How Does Nutritional Screening and Assessment Impact Cancer Care?

How Does Nutritional Screening and Assessment Impact Cancer Care?

 What Supportive Care Treatments Are Available to Patients?

What Supportive Care Treatments Are Available to Patients?
What Role Does Exercise Play in Cancer Treatment?

Transcript:

Lisa Hatfield:

Have you ever wondered how psychological factors could influence your dietary intake during cancer treatment? Understanding this connection is more crucial than you might think. In this segment, we’ll dive into the complex interplay between mental health and nutrition on this Patient Empowerment Network RESTORE program. 

So, Joelys, what psychological factors most commonly affect a cancer patient’s ability to maintain proper nutrition during treatment? 

Joelys Gonzalez:

There are many psychological factors here in hand, but some most important ones will be like anxiety, depression, and stress are the most common ones in cancer patients and can significantly affect their ability to maintain the proper nutrition during and after treatment. For example, anxiety can lead to reduce their appetite or cause a patient to skip a meal altogether, because they’re super anxious about their treatment and sometimes they can actually forget to get their meal of day. Depression might also make it difficult for patients to find motivation into prepping a meal themselves, or even buying a meal.

Sometimes they could, specifically if they live alone, sometimes it’s hard to just think yourself, what can I eat? What should I eat? And that can cause stress. That’s where the stress comes, whether from the diagnosis itself, or it could be financial concern or worries about a family member. That can lead to a patient to have erratic eating patterns. And sometimes they can also, they might overeat as a coping mechanism, while there are others that might lose their appetite completely and not even recognize that they have lost their appetite or if they had a meal of the day. Additionally, this can also cause cognitive changes like chemo brain. We have all heard about chemo brain, we forget, or foggy brain.

This can also affect the meal planning or prepping. This can make it very challenging as many patients can lead to unhealthy eating habits. It’s also worth noting that taste can also change during treatment, which can also be a really huge side effect that many patients go through. As we can know, previously maybe a person, a patient enjoyed certain foods. Now they might not be able to taste that food, and they might find it unappealing. And making the patient’s ability to eat well, super complicated.

And I feel like to help address these issues, I have been working with patients closely to identify these psychological barriers and creating some coping skills or some coping strategies that can make it easier for them to eat or to make some easy to prep meals more enjoyable such as small meal prepping, like, just involving your family or friends overall to make something that you used to, that you used to like, or that you used to enjoy. That can help also a patient kind of overcome that barrier by having also the emotional support that many can gain from counseling or support groups or their family members or their neighbors. It could be anyone. Also, like for example, a puppy. You could have a puppy providing you emotional support.

I am a huge fan of puppies, and just recognizing and addressing these psychological factors is very crucial in helping a patient maintain their nutrition and overall health during and after treatment. And not just patients but also the care partners. Care partners also go through those challenges, especially wanting to make sure that the patient is eating well or that the patient is getting the correct nutrition.

Lisa Hatfield:

Okay. Thank you so much. 

Lisa Hatfield:

So for both you, Nicole and Joelys. We’ll start with Nicole. first. What strategies can be employed to help cancer patients overcome psychological barriers to healthy eating, such as anxiety, depression, or changes in taste and appetite? 

Nicole Normandin Rueda, LMSW:

So piggybacking off of what Joelys just offered, I think that really utilizing your health care team and all the resources available is going to be critical. So we want to make sure there’s nutritional counseling available.

So a lot of times, for example, a lot of times getting enough protein is difficult because, I mean, if you’re not eating a whole bunch of chicken all day, I mean, it’s hard to get enough protein in all three meals. So, things like Ensure or Boost or whatever, whatever it is that your health care team recommends, not only can they recommend it, but usually there are social workers that can help you get, either coupons or discount codes or whatever, because the cost can also add up. So that’s a huge strategy, right? Utilizing your network, your health care team, to really make sure that you’re helping alleviate any of those issues that you may be having is first and foremost.

Next, I would say, if you needed it, there are cognitive behavioral therapy techniques, as well as like behavior change techniques that you can use, and you can go through with a counselor to figure out how you can change your thought process and help set goals, monitor, food journals, all these little things that for some people super helpful, other people, maybe not so much. Other people might just be like, hey, I just need to remember to eat something today. I need to be able to keep my food down in order to take my medicine. So that’s where we’re going to prioritize our efforts, right?

And then also, as far as the taste and texture thing. There are texture things that some people either can no longer handle or have never been able to handle really. And so we want to make sure that we are encouraging or offering suggestions that are helpful. But also, there are things that happen with side effects when it comes to your mouth, your salivary glands, your taste buds, all of that, your throat.

There are side effects that so many different patients with cancer experience that are not really talked about. And so we have to make sure that we are just on top of it. So we’re making sure that if you’re not eating something, if you’re not, if you don’t go near a certain food, what’s the reason there? And then we can offer suggestions if we need to. Another thing that is difficult to do is mindful eating. And what does that mean, right? Promoting like slow eating. So there are chemicals in your brain that whenever you are eating too fast, your body doesn’t understand, like it takes a while to catch up and say, oh wait, I’m full or oh you know what, this is not what I needed right now.

So we want patients to just slow down. Make sure you are listening to your hunger, like, if you don’t really think about it, sometimes you’re like, oh my goodness, it’s gone eight hours, and I haven’t had anything but an apple. That’s not going to be helpful long term.  So we want to make sure we’re having patients understand the consumption process, what it looks like, how often should I be eating, and what are the meals, what should they look like? Are berries enough, or do we need to add like a protein, some walnuts in there to eat the berries with the walnuts?

What is it that I need to do in order to make sure that I am meeting these nutritional recommendations? 

Lisa Hatfield:

Okay, thank you, Nicole 

Lisa Hatfield:

And, Joelys, do you have anything to add to that? Different strategies that can be employed by cancer patients to help overcome those barriers to eating healthy? 

Joelys Gonzalez:

Honestly, I want to piggyback on what Nicole said. She mentioned most of the strategies that I can possibly think of at the moment, but making sure you work closely with your healthcare team. It’s very important. That could be either the dietitian or your mental health professional making sure that you are having a unique personal plan for you. That’s very important, not just for the nutritional needs of a patient but also for the psychological needs.

For example, like I mentioned before, anxiety and depression, if you’re feeling anxiety and depression, psychological support might be like counseling or therapy can be super beneficial, because they can help you manage those emotions and find motivation and for eating again. Also, for example, you mentioned the changes of taste, you can also continue to try small spices or different spices or different texture until you’re able to get to that comfortable space that you’re looking for. And not just trying to give up at the first hand, I know it can be tough.

t is tough to be focusing on whether your mental health or your nutrition, but also being able to focus on having to celebrate that little small step. It’s very important to continue motivating yourself. And also, I encourage having small meals. Don’t think about it as a full meal perspective when you’re looking at your nutrition, because starting small is better than starting big and being disappointed and having that disappointment or overwhelming feeling.

Lisa Hatfield:

You heard it here directly from our experts. Thanks for joining this RESTORE program. I’m your host, Lisa Hatfield.

What Role Does Exercise Play in Cancer Treatment?

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How can exercise benefit cancer patients? PEN Program Manager Joelys Gonzalez and Communication Manager Nicole Normandin Rueda, LMSW discuss the benefits of exercise to cancer health and recovery, recommended exercise types, and tips for patient support and maintaining some level of activity. 

Download Resource Guide

See More from RESTORE

Related Resources:

How Does Nutritional Screening and Assessment Impact Cancer Care?

How Does Nutritional Screening and Assessment Impact Cancer Care?

 What Supportive Care Treatments Are Available to Patients?

What Supportive Care Treatments Are Available to Patients?

 How Do Psychological Factors Impact Diet During Cancer Treatment?

How Do Psychological Factors Impact Diet During Cancer Treatment?

Transcript:

Lisa Hatfield:

How can staying active during cancer treatment benefit your overall health and recovery? In this Patient Empowerment Network RESTORE program, we’ll explore the vital role of exercise in cancer care and uncover how incorporating physical activity into your treatment plan may enhance your well-being and support a better outcome. 

Joelys, how can physical activity be safely incorporated into a cancer treatment plan? And what types of exercises are most beneficial for patients? 

Joelys Gonzalez:

Well, incorporating physical activity into a cancer treatment plan requires more of a personalized approach, considering the type of cancer or the treatment being received or the overall health. I often start this discussion with patients by letting them know the importance of exercising during and after treatment, explaining how it can help manage side effects such as fatigue, stress, and depression. I usually recommend starting with low impact activities such as swimming, walking, or gentle yoga, as long as, of course, the patient is able to move around, whatever you’re capable of, which can be just adjusted based on the patient’s energy levels and how they’re feeling on day by day. Of course, if they’re feeling low, they can start doing small activities, light activities, such as moving your fingers or moving your head around. 

I also stress the importance of listening to your body, making sure you know how your body works, and making sure that you’re not overstressing your body. It’s very important. Resting as much as needed. It’s very important to be able to stay active. To ensure safety, I encourage them to check in regularly with their healthcare team just to make sure that they are having a tailored, a personalized plan, a personalized exercise plan with them. That could be involving physical therapists or their dietician to make sure that they have a unique plan. And by making physical activity as flexible as possible and adaptable to their part of their daily routine, patients can enjoy its benefits without feeling overwhelmed and alone.

Lisa Hatfield:

Thank you for that. And I really appreciate your comments. And I know Nicole and I have talked before, even small movements like moving your fingers and your toes or any movement is better than no movement, because sometimes we are just flat out too exhausted or in too much pain to do much more. So I appreciate you saying that for patients that you can do any little movement and that’s beneficial. So thank you. And, Joelys, what are the potential benefits of maintaining an active lifestyle during cancer treatment, particularly regarding treatment outcomes and overall well-being? 

Joelys Gonzalez:

Maintaining an active lifestyle during cancer treatment can have some profound effects on both treatment outcomes and the patient’s overall well-being. And when I mentioned that physically, physically staying active helps fight the treatment-related side effects, such as fatigue or muscle loss or weight changes. It could also support the cardiovascular health, which is very important since most cancer treatments can affect your heart. For instance, if you do such light exercise like walking or cycling, that can help you improve your blood circulation, helping you reduce the risk of blood clots or other complications from the treatment.

And this can also help you mentally. Maintaining that regular physical activity can significantly reduce your stress and improve your mood, especially when it comes to anxiety and depression, which are the most common among patients living with cancer. I’ve seen patients who incorporate daily movements into their routine, which has made them stronger than they have been before in the sense of control over their overall health, which boosts their confidence and their resilience during their cancer treatment.

Additionally, exercise has been shown to improve sleep, which is often disturbed during their treatment. And from a social work perspective, engaging in group activities or even walking with a friend or a family member can reduce your feelings of isolation, the feelings of being alone, and it can actually help you in building that support network that you need through your cancer journey, which is very very important. I really reiterate that having someone next to you not just to talk and just to make small exercise that can help you a lot during your cancer treatment, and the overall maintaining an active lifestyle helps patients manage their treatment better and contribute to a higher quality of life during and after cancer treatment.

Lisa Hatfield:

Nicole, how can healthcare providers effectively support and motivate cancer patients to stay active despite the challenges posed by their treatment? 

Nicole Normandin Rueda, LMSW:

Great question. So healthcare providers are often the first line of defense, right? And so they have this unique opportunity to really invest in getting to know their patients, which will then in turn…it will be the strategy that they use whenever it comes to tailoring the actual like exercise plan, for each patient. What that means really is that we get to know the patient’s needs, their abilities, knowing a little bit more about their diagnosis or their treatment, the side effects, or potential barriers. The more, the better you can tailor the actual personalized plan for each patient.

That also means not just the oncology team, but all the ancillary services. So your physical therapist, your exercise specialists, there are movement specialists. I mean, there’s a whole, a plethora of resources that can be brought in to help make sure that a patient…their treatment stage, their overall health, any secondary or other diagnoses that they may be managing as well as their just physical capabilities are all things that we want to make sure are very…we’re thinking about those at all times. We want to make sure whatever it is that we’re asking them to do is safe and achievable and aligned with their needs.

The encouragement from your oncology team and hearing that you know what you’re doing great, your small steps are baby steps, but they are steps and we are proud of that. Kind of that affirmation is huge. The next thing I would say would be setting the realistic goals and being on top of the potential barriers. So we all know how great it feels to check something off a box or cross something off a list, right? So we want to give patients that sense of pride and the sense that they are able to do whatever it is that we’re asking them to do, even if it’s very small and manageable.

Our goal is to help alleviate any potential future issues or current issues, secondary to their diagnosis. So if that means it’s fatigue, if it’s pain, if it’s the circulation, all of these things that we want to alleviate or inhibit from happening or getting worse, that’s important that patients know why we’re asking them to do something and setting the goals that are small enough and achievable that they can feel that sense of accomplishment is a big deal. Again, I mean, I can’t say this enough, I want every patient to know they are not alone. There are fantastic resources online to get, even if it’s stretching exercises.

I mean, there are things that are tailored to people with cancer that are absolutely incredible and free, that patients should be able to have the support that they need. Not just emotionally, but also physically, if that’s in-person or virtual, there are resources available that can help get whatever it is that patients need under their belt and so that they have the tools they need to go and accomplish whatever it is that they are being asked to accomplish. And that gives them that sense of pride that also makes it usually a success story, right? At least for that small piece of their treatment, they can say, I was able to do what it is that you asked me to do. That’s great.

And healthcare providers, like I said, are the first line of defense. They’re the ones that are checking in and asking the questions and so making sure that we’re always asking, but also listening to what it is that patients are saying. So if they’re saying, no, I didn’t really get around much today. Maybe we need to tailor what it is that your homework is going to be for the next week or whatever, to make sure that you are getting what it is that you need from us. 

Lisa Hatfield:

Okay. Thank you. And I appreciate that you talked about even celebrating the smaller, what seems to be smaller accomplishments. Like, sometimes if you can walk even five feet a day, you’re trying to walk again, even that, Yay, that’s exciting. Instead of thinking, well, before I used to be able to walk a half a mile or whatever. I think celebrating those small, those smaller steps are just as important. So thank you for bringing that up. It does give patients a sense of pride. You’re right.

Nicole Normandin Rueda, LMSW:

Absolutely.

Lisa Hatfield:

Well, you heard it here directly from the experts. Thanks for joining this RESTORE program. I’m your host, Lisa Hatfield. 

Dos and Don’ts of Supplement Intake During Cancer Treatment

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What are the dos and don’ts of supplement intake during cancer treatment? Registered dietitian and oncology nutritionist Julie Lanford discusses potential issues and strategies to help ensure the best care if taking nutritional supplements during cancer treatment. 

Download Resource Guide

See More from RESTORE

Related Resources:

How Is Hydration Managed During Cancer Treatment?

How Is Hydration Managed During Cancer Treatment?

 What Are Practical Tips for Managing Taste Changes During Cancer Treatment?

What Are Practical Tips for Managing Taste Changes During Cancer Treatment?

 How Do Nutritional Deficiencies Impact Cancer Treatment?

How Do Nutritional Deficiencies Impact Cancer Treatment?

Transcript:

Lisa Hatfield:

Navigating supplement intake during cancer treatment could be complex. Knowing what to include and what to avoid is crucial for supporting your health and enhancing treatment outcomes. As part of the Patient Empowerment Network RESTORE program, we’re exploring the best practices for supplement use during treatment. 

Julie, what are the key dos and don’ts when it comes to taking supplements during cancer treatment, and how can patients ensure that they’re choosing the right supplements without interfering with their treatment? 

Julie Lanford:

Yeah, well, I guess the number one do is to make sure your medical team knows what you’re taking. And the number one don’t would be, don’t hide what you’re taking from your medical team. Maybe the number two do is follow their advice. A lot of us in oncology care are very cautious about supplements, and the reason we’re cautious is kind of twofold. One, there’s not a lot of great data suggesting that taking nutrients in pill form is beneficial.  

When you have a nutrient deficiency, that’s when you need to take a supplement, and you take it for a period of time and monitor that clinical outcome to see is it helping? And do I need to stay on it or not? The things that I don’t want people to do are to just take supplements because someone told them it would be good for them, and they just take it, and they don’t even really know what they’re taking. Those are, to me the situations where we’re like, eh, let’s not do that.

The supplement industry is not regulated in the same way that food and pharmaceuticals are, so they’re sort of free-range industry. They don’t have to show the same kind of data that pharmaceuticals do. They don’t go through the same quality standards that food does. So my biggest concern is actually that a supplement would be contaminated with something harmful, which we have seen happen many times. But you won’t know necessarily that what they say is on the bottle is what’s actually in it.

So what I want to do with people is to make sure that they’re only taking, nobody wants to take extra pills. Especially people who are already taking lots of medication, they don’t want to take extra pills. So let’s not take extra pills if we don’t have to. So a lot of times, we’ll actually take people off any regular supplements that they’re taking if we don’t think that they’re necessary, or if we think they might be harmful. So really pairing it down can be helpful. And then always showing the bottle to your treatment team, so they can find, look, and just see if there’s anything questionable in it that you want to be concerned about.

Lisa Hatfield:

All right, thank you. Are there any specific supplements that should definitely be avoided or carefully monitored? We hear a lot of cancer patients, and I hear a lot of suggestions. Take turmeric or tauroursodeoxycholic acid (Tudca). Are there any that you would say not to take in general? 

Julie Lanford:

Yeah, antioxidant supplements are generally things we don’t want people to take. And then things like St. John’s wort can commonly interact with a lot of different oncology medications. So those are kind of two major ones that we often tell people not to take. I don’t think that it’s necessary to take anything more than just a regular multivitamin if you want to be taking something. And most treatment centers will kind of have that as their policy that during treatment they don’t want you to take anything except a multivitamin.

And then after active treatment is over, then you can have a discussion about what might be safe to sort of restart if you feel like you really need them. So those are the ones that we would want to be cautious with. But then again, if somebody is deficient, so if you’re low in iron or low in vitamin D, you do need to take a nutritional supplement. Sometimes you can get pharmaceutical versions of those, which I think is nice because then it guarantees a safety standard but sometimes, then the price is off the roof. So definitely, in partnership with your medical team is what you really need for those supplement and sort of herbal strategies. 

Lisa Hatfield:

You heard it here straight from our expert. Thanks for joining us on the RESTORE program. I’m your host, Lisa Hatfield.

How Do Nutritional Deficiencies Impact Cancer Treatment?

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Registered dietitian and oncology nutritionist Julie Lanford discusses nutritional deficiencies for cancer patients, monitoring of deficiencies, and advice to help address nutritional deficiencies for optimal patient wellness. 

Download Resource Guide

See More from RESTORE

Related Resources:

How Much Protein Should I Consume While Undergoing Treatment?

How Much Protein Should I Consume While Undergoing Treatment?

 What Are Practical Tips for Managing Taste Changes During Cancer Treatment?

What Are Practical Tips for Managing Taste Changes During Cancer Treatment?

Dos and Don’ts of Supplement Intake During Cancer Treatment

Dos and Don’ts of Supplement Intake During Cancer Treatment

Transcript:

Lisa Hatfield:

Nutritional deficiencies can significantly impact your health and treatment outcomes, but identifying them early and managing them effectively is key. As part of the Patient Empowerment Network RESTORE program, we’re exploring how to recognize these deficiencies and the role of regular follow-up with a dietician.

Julie, how can patients identify if they are experiencing a nutritional deficiency, and what tests or assessments are typically used? 

Julie Lanford:

Yeah, so it really depends on what type of cancer, what type of treatment and sort of each person’s medical history in terms of what we might monitor. In general, first of all, we want people to maintain their weight. We want them to get enough calorie and protein needs.

So, that’s one sort of major thing that we look at. But when it comes to nutritional deficiencies, most people think of sort of micronutrients, so vitamins and minerals that their body needs to function. If they don’t have enough of it, your body just doesn’t function as well. And there are some common deficiencies that we do see with various types of treatments.

So, that’s a great question for your nurse, your chemo teaching nurse, or your nurse navigator or your physician team is to ask, hey, are there any things I need to know about risk for nutritional deficiency with this particular type of treatment or this particular type of cancer? The general things that I would be watching for, iron is a big one.

And I recently read a study that a lot of people are sort of underdiagnosed in the oncology population regarding iron deficiency. So, that can be picked up on with regular lab work. Just hemoglobin often can give that picture. But if there are some physical signs of iron deficiency and hemoglobin is normal, you can still ask for an iron panel if it’s warranted.

So you can always mention that to your doctor. The signs I would be looking for is, if you have a lot of fatigue, which…that’s always another thing. How do you know if you have more fatigue than the normal person getting cancer treatment? But you should kind of know yourself and if you’re adequately getting enough calories and enough protein and hydrated, but you still really feel like something is off with your energy, I think it’s a valid reason to at least check into an iron panel and see if that’s contributing to it.

So that’s one thing. A lot of the other labs are being checked pretty regularly for most people who are currently under treatment. Now, if you’re somebody who’s on like an active sort of maintenance treatment or you’re done with treatments or on a treatment break, you may not be getting lab work nearly as often.

And so really paying attention to whether if something off, you can always ask for lab work and typically it’s paid for if there’s a good reason to do it. So oh, I’m having a lot of fatigue or I’m feeling muscle soreness or things like that where it might trigger a thought that, hey, is your potassium low? Is your magnesium low? They’re pretty easy to check for though.

So most of the time, what I find with oncology active treatment people is that they are getting lab work done regularly, and they can look over their labs if they don’t see some of the things they want to see. They can always have a conversation with their medical team to say, hey should I have an iron panel checked? Should I have vitamin D checked? How is my just general lab work? And they can go through it with you, so that you have an idea. Usually it’s, people are pretty on top of it, but I also say that asking is always a good idea.

Lisa Hatfield:

Okay. Thank you. Julie, what role does regular follow-up with a dietician play in managing and preventing nutritional deficiencies? And if I did want to see a dietician and my oncologist has not recommended that, can I just ask for a referral to the dietician at our cancer center? 

Julie Lanford:

Yeah, so it really is going to be cancer center-specific. A lot of the larger cancer centers tend to have full-time dietitians, more than one available. A lot of times, they specialize in certain types of cancer. But if you are at a smaller cancer center, they don’t always have the resources to pay for a full-time dietician. They may have dieticians in other parts of the hospital that they can sort of pull on when they need it. So it can be challenging just depending, but I always tell people to start with their treatment center. 

Even in my area, there are two treatment centers here, and I work at a local nonprofit, so I’m not even part of any of the treatment centers. And both of our treatment centers here have two or three dieticians on staff for their treatment center. So whenever somebody local to my area comes to me, I always point them back say, have you asked at your treatment center? Because they may not even know they have a dietician available.

So definitely asking even if the doctor has not recommended it, you can still ask if nutrition consults with a dietician are available, and they should be able to answer that question. And then if you don’t have access to one at your treatment center, you can look for a local dietician. There are a lot of dietitians in private practice. They may or may not have oncology experience, but they probably can help troubleshoot some things.

Like all dietitians should be able to help you meet calorie needs with some various food ideas. So those are also, I think, good options. And eatright.org is also a national organization of all types of dieticians, and they have a find an expert search as well. So I would start with your local treatment team, and if they can’t find you somebody there, then you may have to kind of dig around a little bit.

Lisa Hatfield:

Well, you heard it here from our expert. Thanks for joining this RESTORE program. I’m your host, Lisa Hatfield. 

What Are Practical Tips for Managing Taste Changes During Cancer Treatment?

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Registered dietitian and oncology nutritionist Julie Lanford discusses common taste changes that may occur during cancer treatment and practical strategies and resources for managing taste changes for patients. 

Download Resource Guide

See More from RESTORE

Related Resources:

How Can I Stimulate My Appetite During Cancer Treatment?

How Can I Stimulate My Appetite During Cancer Treatment?

 How Do Nutritional Deficiencies Impact Cancer Treatment?

How Do Nutritional Deficiencies Impact Cancer Treatment?

Dos and Don’ts of Supplement Intake During Cancer Treatment

Dos and Don’ts of Supplement Intake During Cancer Treatment

Transcript:

Lisa Hatfield:

Dealing with changes in taste perception can make mealtime challenging. What are ways to make food more enjoyable? As part of the Patient Empowerment Network RESTORE program, we’re diving into practical tips for managing taste and appetite changes. Julie, what are some practical tips for dealing with changes in taste perception that can make food more palatable? And do you have any recommendations for flavor combinations or cooking methods that might help enhance the taste of food for those of us experiencing a metallic or altered taste from our treatment? 

Julie Lanford:

Yeah. So there are some different strategies for affecting taste. And different people tend to have different challenges with the taste changes. So like you mentioned, the metallic taste. Some people don’t tolerate really sweet food where they used to. So it all depends on the type of taste change. Some of the common tips that we give people is to sort of clear your palate before you eat by drinking some water with fresh lemon squeezed into it. That tends to somehow sort of reset your taste buds. And then if you notice you don’t like the taste, sweet taste or that sweet tastes off or coffee tastes off, of course, avoiding those foods.

And then doing if sweet is bothering you, you can do things like having more of a sour type of marinade. For people who have to drink the nutrition supplement drinks, they tend to be very sweet. And if you’re not tolerating that taste so well, you can get bitters, drops of bitters, and add those just to help tone that sweetness down a little bit. And then for some people, it’s adding a different flavor to the food. So if something is really bland, and you don’t have much of a taste, the taste receptors aren’t working very well, can you add like an acid, like the lemon juice or tomato sauce? Can you add spices to it that make it a little bit of a stronger flavor so that your muted taste buds can maybe pick it up? 

Or if you have mouth sores or things that are making those types like spicy foods not tolerable, how can you make it more like creamy and bland? So it sort of depends on the taste change. There are some great tips from Rebecca Katz, who’s a chef. So I will say, I find that the chefs tend to have a little bit more expertise around the taste change issue, because that their expertise is like tasting of food.

Like as dietitians, our expertise is the nutritional value of food and how you meet your needs, whereas the chefs look at the taste piece. So Rebecca Katz is sort of a specialized chef for oncology. And she has a whole system that works around fat, acid, salt, and sweet in terms of how you can tweak things in order to meet those needs. So that’s if you need more sort of troubleshooting, I think her resources are really helpful. And she’s got great, very fancy foodie-type recipes for cancer patients, which is fun.

The other thing, though, with metallic, I mentioned squeezing lemon into water is avoiding metal silverware sometimes helps as well. So I think all of us have at some point tasted like a fork that you can just taste the metal in your mouth. And for a lot of cancer patients, that’s just magnified.

So using plastic silverware, or there’s some bamboo silverware or things that don’t involve metal can help with that in terms of trying to avoid that. And then red meats tend to have more a stronger metallic flavor. So probably staying away from having your favorite steak at this moment might be another wise thing to do.

Lisa Hatfield:

You heard it here from the expert. Thanks for joining this RESTORE program. I’m your host, Lisa Hatfield. 

How Can I Stimulate My Appetite During Cancer Treatment?

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Registered dietitian and oncology nutritionist Julie Lanford discusses ways for cancer patients to stimulate appetite and strategies for improving calorie intake to help maintain wellness. 

Download Resource Guide

See More from RESTORE

Related Resources:

How Important Is Calorie Intake During Cancer Treatment?

How Important Is Calorie Intake During Cancer Treatment?

How Much Protein Should I Consume While Undergoing Treatment?

How Much Protein Should I Consume While Undergoing Treatment?

 How Is Hydration Managed During Cancer Treatment?

How Is Hydration Managed During Cancer Treatment?

Transcript:

Lisa Hatfield:

Managing appetite loss during cancer treatment can be a significant challenge, but are there strategies that can help? In this Patient Empowerment Network RESTORE program, we’ll explore practical tips and techniques to help stimulate appetite and hopefully make mealtimes more enjoyable.

Julie, what are some effective ways to stimulate appetite during cancer treatment? And are there specific foods or meal strategies that can help make eating a little bit more appealing? 

Julie Lanford:

Yeah, so I think the most effective way is to allow yourself the freedom to eat what sounds good to you, no matter the time of day or whether it’s a food that typically goes at that time of day. So for people who are facing appetite challenges, remembering that any food is better than no food lowers the bar on your expectations. I think a lot of people get caught up in like, well, I should only eat “healthy foods.”

Well, at this point, if you are in a position where you don’t have much appetite, I just want to remind you that any food is better than no food. So things like milkshakes are okay. If that’s all that sounds good to you, go ahead and eat them. All the things that maybe you historically might not have let yourself or your children consume at breakfast, you could just go ahead and, like, throw the rules out and give yourself the freedom to eat anything that sounds good to you, which can be kind of fun, I think, in a way. It’s not fun to not feel like eating, so I think that is a significant issue.

And then, so I would say don’t eat your favorite foods, thinking that you might not tolerate them so well. But anything that sounds like you could get it down would be my first thing to think of. And then there are some strategies around meals that can help.

If you notice that you tend to be able to eat soft foods better than foods you have to chew a lot, then we might suggest more of a soft food or liquid diet. If you notice that hot foods don’t go so well for you or cold foods don’t, then finding either room temperature foods or hot foods or cold foods, depending on what it is. I think so those are kind of sensory-type things. And then the other thing is just that we know that yellow and red colors can help stimulate the appetite. McDonald’s and Burger King aren’t stupid. They have chosen colors for a reason.

So we will also recommend, like, do you have plates or cups or table, table, I say tablecloths, if you have placemats in that color, so yellow or red, that can sometimes help just, like, give one little extra boost that your appetite needs to get to get that down. There are some medications that can help with appetite. Of course, there are always side effects. And for a lot of people in cancer treatment, it’s like you’re already on so many medications. Do you want to spend one more? 

So I do like trying out all these other strategies first to see if we can sort of put together some kind of formula that works for you, that just gets you enough motivation or your body enough receptivity to the food to get it down and meet your needs. But if those aren’t working, definitely talk to your medical team about what types of pharmaceutical options might be available to help get that food down. 

Lisa Hatfield:

Okay, thank you. And just a side tip that I learned from an occupational therapist, she told me if I either have a bread maker or can borrow a bread maker that the smell of fresh baked bread can sometimes stimulate appetite. So I didn’t have a problem with appetite on my high dose steroid days, but otherwise I did and it did seem to help and maybe just feeling like I was productive and made a loaf of bread helped too.

But anyway, that’s just a tip for patients, they might want to try it also for stimulating appetite.

Julie Lanford:

Yeah. And then you have fresh bread, and that’s amazing. 

Lisa Hatfield:

Great, yeah.

Julie Lanford:

Fresh food itself that can really be much more appetizing than something that’s maybe not so fresh.

Lisa Hatfield:

Right. Yeah. Thank you. Julie, are there specific types of foods or meal patterns that might help make eating more appealing and manageable? 

Julie Lanford:

Yeah, I think that, again giving yourself freedom on the food choice, but also give yourself freedom on the portion sizes of food. So what you might be used to is larger portions on your plate, but maybe you can’t tolerate a lot at a time. Your stomach is just not settling so well, and you need to eat smaller amounts more frequently.

So often setting a timer for every two to three hours and eating a small amount each of those times might be more effective at meeting your calorie needs without causing too much overfullness for your appetite. And then making sure that the foods you consume are as high-calorie as possible. So choosing the higher fat versions of things, choosing the things that don’t have artificial sweeteners in them, because we are going to want all the calories possible in the food choices that you eat, especially if you’re not able to eat as much volume as you have been before.

And then using beverages to get extra calories in is also important. So it can hydrate you, but also provide extra calories. So juices, milk, even some of like Gatorade will give you a little bit of calories in with those electrolytes. So those are types of things. And then, of course, protein shakes or any types of smoothies you can make yourself will help get extra calories in.

Lisa Hatfield:

Okay, thank you. You heard it here from the expert. Thanks for joining this RESTORE program. I’m your host, Lisa Hatfield.

How Is Hydration Managed During Cancer Treatment?

/in , /by

Registered dietitian and oncology nutritionist Julie Lanford discusses general hydration needs, how needs may vary during cancer treatment, and tips for maintaining hydration levels. 

Download Resource Guide

See More from RESTORE

Related Resources:

How Important Is Calorie Intake During Cancer Treatment?

How Important Is Calorie Intake During Cancer Treatment?

How Much Protein Should I Consume While Undergoing Treatment?

How Much Protein Should I Consume While Undergoing Treatment?

 How Can I Stimulate My Appetite During Cancer Treatment?

How Can I Stimulate My Appetite During Cancer Treatment?

Transcript:

Lisa Hatfield:

Hydration is a crucial aspect of supporting your body during cancer treatment. But what should patients know? Can side effects like vomiting and diarrhea make you lose too much fluid? I’ve connected with a leading voice on this topic, and we will get some answers right now on this Patient Empowerment Network RESTORE program.

Julie, it may seem like a silly question, but how much water should patients be drinking each day while undergoing cancer treatment? And can too much or too little trigger side effects? 

Julie Lanford:

Yeah, so we talk in general about water intake. And we often, the guideline is eight to 10 cups per day, which is somewhere between 64 and 80 ounces, if you do your math. And that’s the general good guide.

Now, if you have a treatment regimen, where the doctors are like, Make sure you hydrate really well for the next two days, somesome chemos are pretty toxic to the kidneys. And so they want you to take in lots and lots of extra water to kind of flush that out, then you would want to be doing 10 cups and maybe a little bit more. You know, technically people can consume too much water, it would take a lot, and it would take you consuming a lot at one time in order for you to cause a lot of problems.

The other sort of risk in terms of taking in too much water is if you’re not eating very well, and you’re not getting your electrolytes, and you’re just drinking plain water, sometimes that can cause a balance issue with the electrolytes in your blood. So if you are somebody who’s nauseated, having lots of diarrhea, and you’re just drinking water, I would suggest you have some type of oral rehydration beverage, you can make some yourself. But the easiest thing is something like Gatorade or Pedialyte, or even just diluting juice and adding a little bit of salt to it, something that helps get your body those electrolytes in addition to the water, because that’ll just help everything function better.

But let’s assume that you can eat okay, then generally eight to 10 cups of a beverage a day should meet your needs. You definitely can get too little water, that is always a challenge. And usually a sign of not enough water is when you get lightheaded standing up, or you have lost weight really quick, like, I don’t know, two pounds over a day, or five pounds over a day. That to me is a sign of fluid loss without being replaced, which can happen if you are having a lot of vomiting and diarrhea, which just pulls a lot of water out of your body.

And so those oral rehydration solutions, which have the electrolytes mixed in with the water really can help you from sort of getting overly dehydrated, because the last thing you want to have to do is go over to that hospital. But if you have lost fluids really, really fast, and you are nauseated, you can’t keep anything down, or you cannot stop the diarrhea, you will feel better if you go over there and get hydrated.

That’s what I always tell people, especially if it’s a Friday. Nobody wants to have to deal with the hospital, but you can feel pretty awful if you’re dehydrated, it’s very risky. So it can be challenging. But unlikely to get overhydrated, probably more likely to get dehydrated.

Lisa Hatfield:

Okay, thank you. Julie, are there specific hydration strategies or recommendations to follow? And how can patients address common hydration challenges and ensure they’re meeting their fluid needs effectively? 

Julie Lanford:

Yeah, so I think the challenge often is that you don’t realize how much time has gone by since you’ve had something to drink. So a couple things, monitoring your weight, if this is a significant risk for you, you want to pay attention to if your weight is staying stable. And then the other thing is to go ahead and fill up a big jug.

 So if it’s 64 ounces, or you want to do two jugs a day, and drinking from that, so you know how much you’re having, it is also perfectly fine to get your water from juice, from different beverages, even coffee and tea. I know some people like to say, well, if it has caffeine, it’s dehydrating you. It’s not really that much anyway.

And if that’s all that tastes good to you, it’s better off to get that. So I think spreading your beverages throughout the day. So setting a timer, have four ounces or eight ounces every hour or two, and allow yourself the freedom to choose whatever beverage you think will taste good to you.

If you’re tired of the sweet stuff, let’s say you’ve kind of existed on like Ensure and Gatorade for days, and you’re so sick of the sweet taste. Broths are something that can help hydrate you. Milk is a great option to give you nutrition and hydration. You can get lactose-free if you don’t tolerate lactose, but those also give you  that water along with the nutrition. So those are kind of my basic guidelines for doing that. And then just making sure that you’re letting yourself have things that taste good to you so that you’re more motivated to get it down.

Lisa Hatfield:

Okay, thank you. You heard it here directly from the expert. Thanks for joining this RESTORE program. I’m your host, Lisa Hatfield. 

How Much Protein Should I Consume While Undergoing Treatment?

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Registered dietitian and oncology nutritionist Julie Lanford discusses protein needs during cancer treatment and advice for boosting protein levels for optimal wellness during treatment. 

Download Resource Guide

See More from RESTORE

Related Resources:

How Important Is Calorie Intake During Cancer Treatment?

How Important Is Calorie Intake During Cancer Treatment?

How Is Hydration Managed During Cancer Treatment?

How Is Hydration Managed During Cancer Treatment?

 How Can I Stimulate My Appetite During Cancer Treatment?

How Can I Stimulate My Appetite During Cancer Treatment?

Transcript:

Lisa Hatfield:

How can patients undergoing cancer treatment ensure they are meeting their protein needs when facing taste changes or digestive issues? Are there certain meats or protein drinks that should be avoided altogether? I’m getting some clear answers from a respected expert in this Patient Empowerment Network RESTORE program. 

Julie, what are some practical tips for those of us actively undergoing treatment when it comes to protein needs? And can you share some of the best practices that have been successful, particularly for those of us who have experienced taste changes or digestive issues? 

Julie Lanford:

Yeah, so protein needs can be challenging to meet, because a lot of our favorite sort of comfort foods that we usually go to when we’re sick are not necessarily high in protein. So the first thing to, I think, do is to kind of speak with your medical team to see how much protein you might be needing. Or if you think you’re having enough, they can usually do a simple calculation, or you yourself can actually calculate. And we do this in kilograms, for whatever reason, us dieticians work in kilograms. So if you take your body weight and divide it by 2.2, that will get your kilograms.

And then generally, we would say for people during treatment, aiming for 1 to 1.5 grams of protein per kilogram body weight is something that I think can give an easy range. The typical person, we would actually put more at 0.8 grams per kilogram body weight, but because when people are under treatment or have active treatment going on, that often uses more of our stores, then we sort of bump that suggested range up a little bit. So once you kind of have an idea what that is, then you need to know, well, what are the foods that I’m eating that have protein? So you mentioned meats, you mentioned some protein drinks, so those are pretty easy ways to get quick protein.

There are plant proteins as well, nuts, seeds, and beans. But when you’re talking about digestive issues, sometimes those higher fiber forms of protein are not the easiest to digest. And I know a lot of treatments do cause people digestive issues where they are just not able to sort of break down some of those more complicated foods.

So meats and protein drinks tend to be the easiest to digest, as well as the dairy-based protein, which you can find in milk, yogurt, cheese. Those are ways, as long as you tolerate lactose in the milk, but even if you don’t tolerate lactose, it’s pretty easy to get lactose-free options. Milk is a really simple thing to throw in smoothies that helps to add more. And I think any types of meat are fine, as long as you tolerate them and they taste good to you.

Some of the ones that are just easier to eat will be some of the softer meats, things you don’t have to chew as much, so more like chicken or like shredded meats or anything that might be in a soup where it kind of just goes down with the liquid. Protein drinks are great. I would pay attention to how much protein you can get per, usually they’re in 8-ounce containers, so finding like the plus version, so things like BOOST Plus or Ensure Plus will have higher levels of calories and higher levels of protein, so per 8 ounces, you get better bang for your buck.

And then you can make your own sort of protein drinks at home, like I mentioned, using milk, or you can buy protein powders. The actually most affordable protein powder you could get would be like a dry milk powder that you can just toss in with extra things. So I think those are really simple, easy ways, but the most important thing is that you make sure you’re eating regularly and you’re including protein regularly throughout the day.

So if you’re not eating much, then having something every two to three hours, like with an alarm, and making sure that when you have something, it does include protein, it’s much easier to meet your needs when you’re doing that several times a day than if you’re relying on like one or two sort of eating sessions a day to get them all in.

Lisa Hatfield:

Okay, thank you. Julie, how can patients safely incorporate protein powders or shakes into our diet without disrupting treatment? And is there any risk of getting too much protein? 

Julie Lanford:

Well, you can get too much protein. I don’t see that very often, unless somebody is using a ton of those protein powders, which I just don’t really find feasible for people who are having digestive challenges or appetite issues. So it seems unlikely. I would be cautious with protein powders that you get from like a health food store, because they’re not regulated in the same way that food is regulated. I wouldn’t take that risk if it were me or my family member. If I were going to use a protein powder, I would purchase one, either from the grocery store, like the dry milk powder is regulated and controlled in terms of there’s not going to be contamination. The other challenge with some of the protein powders at the health food stores is that they’re typically not designed for the sort of typical oncology patient.

They’re really more designed for people who want to be like bodybuilders. And so they’ll throw in lots of this other stuff, creatine or different things that they claim are boosting performance that I wouldn’t be comfortable throwing into the mix of my oncology treatment regimen. So I tend to be pretty basic. I just, if I want protein, I want to include things that only have protein. I don’t want to add a lot of extra other stuff. If I’m going to add fiber to my day and I need to use a fiber supplement, I actually don’t want any extra stuff. And I don’t want the flavorings with it. I just want it plain.

And so I feel that way about protein as well. Ideally, you will get it from food sources. If you can’t meet your need from food sources, protein powders from legitimate sort of food-based sources, even if they are, in shake form at the grocery store sold on the shelf, they should be pretty well-checked and monitored. And so that’s what I tend to tell people to look for when they’re trying to make sure to get enough protein. 

Lisa Hatfield:

Okay, that’s great information for patients. You heard it here directly from our expert. Thanks for joining this RESTORE program. I’m your host, Lisa Hatfield. 

How Important Is Calorie Intake During Cancer Treatment?

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Registered dietitian and oncology nutritionist Julie Lanford discusses the impact of calorie intake during cancer treatment, a simple calculation to use for caloric intake, and nutrition advice for common dietary needs for boosting during treatment.

Download Resource Guide

See More from RESTORE

Related Resources:

How Much Protein Should I Consume While Undergoing Treatment?

How Much Protein Should I Consume While Undergoing Treatment?

How Is Hydration Managed During Cancer Treatment?

How Is Hydration Managed During Cancer Treatment?

 How Can I Stimulate My Appetite During Cancer Treatment?

How Can I Stimulate My Appetite During Cancer Treatment?

Transcript:

Lisa Hatfield:

Nutrition plays a crucial role in supporting the body during cancer treatment. Proper nutrition can help manage side effects and maintain strength and energy. What should my caloric intake look like? I’m diving deep into this topic as part of the Patient Empowerment Network RESTORE program to uncover how best patients can best support our bodies through nutrition during treatment.

Julie, how can patients accurately determine their specific caloric needs during cancer treatment considering the increased energy demands and perhaps the patient’s existing treatment plan?  

Julie Lanford:

Well, calculating caloric needs is not an exact science. So as a dietitian, we were trained in this, but even being trained, each person is very different. Treatment regimens are different, and the foods they like are different. So, we often don’t actually calculate someone’s needs, unless there is some kind of problem going on.

So typically the sign to that would be unintentional weight loss either before a diagnosis or after diagnosis and because of treatment. So if people start with losing weight and feeling like they can’t quite keep it stable, that’s when we will go through these calculations.

And someone’s medical team can do this for them, but it’s also a pretty simple sort of range that you can come up with for yourself just to see how you’re doing. So we always calculate things for whatever reason in kilograms, per calorie per kilogram. So if anybody in the audience is wanting to try to figure out some kind of range for what would help them maintain their current weight, they can take their pounds, their body weight in pounds divided by 2.2, and that will give them kilograms. And then what we use for calculations, it can be pretty broad.

So, but let’s just say in general, I might calculate for somebody a range between 25 and 35 calories per kilogram. And that is, it might seem like a lot for some people. Some people might not be familiar with how many calories are in different things. It’s really mostly meaningful if you’re somebody who’s not eating well, and you’re taking a lot of supplement drinks or things like that, that have the calories listed on them. Of course, it’s easier to figure it out that way.

I often use a calorie range to help people like that figure out, well, how many, supplement drinks like Ensure or BOOST or Carnation Instant Breakfast might you need to drink in a day if you’re not able to eat in order to help maintain your weight. So it can be helpful to have that range, but it’s not always easy for patients to figure out how many calories they’re taking in. And that’s just a general guide.

Some people’s treatment regimens or types of cancer will actually put them in more of a hypermetabolic state. And we may even estimate up to 40 calories per kilogram. And then if somebody is a small individual, not very active, and they’re not in a hypermetabolic state, even down to 20 might be something we work with. So it is quite a range, but I do think for some people it’s helpful to really compare those numbers.

Lisa Hatfield:

Julie, what are some practical tips for incorporating high-calorie, nutrient-dense foods into my diet, especially when I’m experiencing a lack of appetite or nausea? 

Julie Lanford:

I’m always encouraging people to just make sure if they are nauseated to the point where it’s affecting their intake of food, then they need to be sure they’re taking nausea medicine. Whatever it is, if it’s a once a day, or the sort of quick-acting nausea medicine, or both, and making sure to take those 30 minutes before they plan to eat. And that way, once they approach the table, the nausea’s sort of settled down, and it’s easier to take those foods in.

The last thing we want is for somebody to not take their nausea medicine, then get to the table, then the smells or the looks of the foods make, they feel nauseated, they can’t eat it, then they take their nausea medicine, but then it’s like another 30 to 45 minutes before it’s kicked in, and now you’ve missed a window of opportunity to put those calories in.

So that’s your first, and I think most important when it comes to nausea. And then the second thing actually ties in very well with the poor appetite challenges, is that you just want to maximize the volume of the food you’re eating. So you may not be able to eat as much as you normally do, but if you can make those meals or snacks as calorie-dense as possible, then that way even if you eat less foods, you’re getting as many calories. And the most dense version of calories is actually fat. So as long as you’ve got  your nausea under control, and your digestive system is basically kind of working okay, you can get more calories per volume by having higher fat foods. So that’s why we’re always telling people choose whole milk, choose the highest fat cheeses, peanut butter, which is a good source of healthy types of fats, heart-healthy fats, avocados.

Anytime you can include those types of things into the foods that you know you like, you’re going to be able to boost their calorie content. Other people find that actually drinking foods or calories is easier than eating them. If you don’t have much appetite, it somehow just feels like you’re eating less if you’re drinking it through a straw.  So making things like smoothies, or cream soups or anything that you can think that you’ll be able to swallow.So even if it’s that you’re drinking chocolate milkshakes all day long, that is going to be better for you than not having enough to eat. Because if your body does not have the calories and the protein to sort of recover from the treatments and the challenges that you’re facing, there’s really not much no tools your body has to help with that. So I always say eating something is better than eating nothing. So don’t take any foods off the table. If you have a wide variety of choices, given your appetite challenges, of course, we want people to consume lots of nutritious, healthy, or traditionally healthy foods.

But if you can’t do that, any food is better than no food. And that’s kind of the bottom line. And remembering that the higher fat versions of things are likely to have higher calories. If you’re choosing a supplement drink, I would look at the calories and the protein to make sure and, it’s going to be higher calorie if it’s using things like real sugar rather than artificial sweeteners. So some of those drinks are kind of tailoring to the people who want to do more keto-type diet for people who are in cancer treatment and just need more calories. You need the drinks with the highest calorie content. So I would not be using those. We want the sugar that will help to add more calories into it. 

Lisa Hatfield:

Okay, thank you. Julie, how often should patients reassess their caloric and protein intake with their healthcare team? And what signs should prompt them to seek adjustments to their nutritional plan? And are there any tools that patients might be able to use for screening and monitoring nutritional intake during cancer treatment? 

Julie Lanford:

So there are some screening tools that treatment centers will often be using. There’s like a three question malnutrition screening tool that a lot of cancer centers have integrated, and they would be using that pretty regularly, maybe not every week, but a few times throughout treatment. But generally, the things that they’re asking on that are things that any patient should, I think, be monitoring for self-monitoring or caregivers monitoring for them, which is just what is your weight status compared to what your usual weight is. And I like to compare to someone’s usual weight, as an adult and before any inkling of cancer came around. So if somebody lost weight, significant amounts of weight before diagnosis, I’m not looking at their usual weight as at diagnosis, I’m looking at their usual weight going back. And so that’s one thing is just change in weight.

If your weight is changing, that is a sign that your nutrition strategy might need a little tweaking. If your intake is not very good, that’s another sign. So those are kind of the key things is just are you able to eat? And are you maintaining your weight? Usually people are getting weighed once a week if they’re coming in for treatments regularly. Now, if somebody is not coming in very often, you probably will need to monitor your weight at home. And yes, you need to advocate for yourself in the doctor’s office, because sometimes they just don’t pick up on those changes or they don’t see them as particularly important.

So I would say that you are somebody as a patient or a caregiver that needs to kind of bring up that conversation. If you have noted a drop, and then it some drops some more, if you’re going down and up and down and up and generally staying the same, that’s okay. But if we’re seeing drops and drops and drops, even if it’s just two pounds here, two pounds there, but you’re not rebounding, then that to me is a sign you need to make a change with your nutrition strategy.

Lisa Hatfield:

Okay, thank you. And are there any tools that patients can use to monitor that? Or do you recommend just basically using the scale and identifying if there’s weight loss and notifying their health care team? Is that the best way to monitor?  

Julie Lanford:

Mainly yes, the scale is the easiest. You can do fancy things like body composition analysis, which honestly, some of those that they’ll sell to you at home probably aren’t very accurate. Perhaps they might be accurate, if you’re always comparing to yourself or if you do any workouts in the gym, and you notice that you’re just not able to do as much, but there’s so many things that impact your strength, given that you’re under cancer treatment, it’s really hard to tell. So weight is kind of the key thing. If your clothes fit differently, sometimes that can also be a sign of body composition changes, or you may notice that your body composition is changing. I would say if your body composition is changing, that also may tip you to think that your sort of exercise approach may need to be adjusted as well.

That’s the pairing of nutrition and exercise is that if your weight staying stable, but your body composition is changing, or you’ve noticed muscle loss, either through strength, or just by looking at how your body looks, you can eat enough protein, but that’s not going to build muscle, what builds muscle is using your muscles. So it needs that combination of both being physically active and perhaps using a trainer or somebody who can help you focus on different areas where you’ve noticed muscle loss, and also making sure to provide your body with those nutrients that need to build the muscles.

Lisa Hatfield:

Okay, thank you. You heard it here directly from the experts. Thanks for joining this RESTORE program. I’m your host, Lisa Hatfield.

Nutritional Essentials: Supporting Behavior Change During Cancer Treatment

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How can diet and lifestyle changes impact cancer care and recovery? Oncology dietitian Dr. Cynthia Thomson from the University of Arizona discusses diet and exercise, comorbidities, self-regulation methods, and oncology dietitian support. 

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What Is an Oncology Dietitian vs. a Nutritionist?

What Is an Oncology Dietitian vs. a Nutritionist?

 Does Diet Adjustment Impact Cancer Care?

Does Diet Adjustment Impact Cancer Care?

 Age-Informed Nutrition and Intervention Strategies for Cancer Patients Across All Ages

Age-Informed Nutrition and Intervention Strategies for Cancer Patients Across All Ages

Transcript:

Lisa Hatfield:

How do patients optimize nutrition during cancer treatment? What are some actionable steps towards supporting behavior change during this critical time? I’m connecting with a respected expert to learn more on this Patient Empowerment Network RESTORE program. 

Dr. Thomson, how can changes in daily habits like diet and exercise really impact cancer care and recovery, and why is this something that patients and care partners should pay attention to? 

Dr. Cynthia Thomson:

Well, importantly, we move every day and we eat every day. And we can make decisions about what we eat and how we move that really can optimize not just our response to cancer treatment, but also our longer-term health, right? And keep that cancer at bay as well as reduce comorbidities, things like diabetes or hypertension that might sneak up on us as we age. And so it really is important to make healthy decisions about what we’re eating and how active we are as cancer patients, but also in general, everyone needs to think about these things.

Lisa Hatfield:

Okay, thank you. And Dr. Thomson, in your study, self-regulation was strongly associated with meeting nutritional and physical activity recommendations. What strategies could be employed to enhance self-regulation in cancer survivors, particularly through mobile app interventions? 

Dr. Cynthia Thomson:

Yeah, so, self-regulation is always a bit of a challenge for each of us, but it’s so important, right? And it starts really with mindfulness and really thinking about the connection between what we eat, how active we are, and how it affects our health. And believe it or not, a lot of people really haven’t given a lot of thought to that. And it’s amazing to me because as I work with patients, what I realize is when they make that connection, when they realize how much better they feel, it makes them kind of self-motivated to continue to self-regulate.

Now there are a lot of different ways you can self-regulate, and one is self-monitoring. And I think that’s probably the most common. Many of us have our watches, right? We have our little devices on our wrist that we use to monitor our activity and perhaps our sleep and maybe even some health outcomes. But in addition, you can do things like think about how you walk through the grocery store. You start in the produce section, right? Instead of going to the cookie aisle. You can think about where you park your car and are you allowing yourself to park further away so that you can walk. So setting some of those self-regulatory behaviors can really help.

You can, in terms of eating, write down what you eat. There are literally hundreds of apps where you can download information about what’s in the food you eat and guide yourself to make better choices. Most people will get tired of writing down what they eat. And so usually if people want to do kind of the written or the app approach, I’ll recommend that they pick a few days of a week or maybe the first week of the month and not burden themselves with doing this day in and day out because over time it begins to lose its excitement. The feedback that you’re getting is not quite as enticing and you begin to feel burdened and you may even change your habits for a lower quality diet simply because you’ve kind of had it with the app.

Lisa Hatfield:

Okay, thank you. Now for patients who are trying to monitor what their intake is and what their diet looks like and maybe they do have access to an app but maybe they don’t, do most cancer centers have a dietitian that a cancer patient can work with on nutritional information surrounding their cancer diagnosis? 

Dr. Cynthia Thomson:

Well, Lisa, I wish they did. But the data that we have suggests there is one dietitian for about every 1,208 patients, which is just dismal. So I do think it’s really important when you’re in care to ask for that referral and try to get in with an oncology dietitian. There are dietitians who practice outside of oncology that certainly can be helpful, but they’re not going to have the insights that you’re going to get from an oncology dietitian. You may have to go to a larger kind of academic or what we call comprehensive cancer center in order to locate a dietitian with this expertise. But I think it’s important to speak up and maybe we’ll get more dietitians on staff if patients advocate for this important information and support during their care.

Lisa Hatfield:

Okay, thank you. Dr. Thomson, how do you think self-efficacy and self-regulation can be effectively promoted in cancer survivorship programs, especially among populations with lower initial adherence to health behaviors? 

Dr. Cynthia Thomson:

Well, I think there’s a number of different ways that we can help people to self-regulate. I think the important thing is to meet people where they are. I think a lot of times as professionals, we’re really quick on giving advice that comes from our own context and our own set of values and beliefs. And most times when we’re asking people to do things that align with our values and beliefs, it doesn’t always work.

And so many times they say it’s really about listening. It’s about hearing the patient and really having patients share what is it that, why are you coming to see a dietitian or why are you interested in nutrition? What motivated you to come here today? What are you expecting to get out of these counseling sessions? And really focusing on having people understand where the gains are for them. I would say that many times it’s important to think about knowledge, right? Because a lot of times people will not have the foundational knowledge to make the right choices.

And certainly we need to support knowledge, but it really is much bigger than that. We have to support self-efficacy. We have to help them build belief in themselves that they can adapt a whole new dietary plan if that’s what is necessary. And so I think it’s really important for us to reward good behavior, support them in any way with information or advisement when they ask for it. And then also to really make sure that we repeat, repeat, repeat. Because I think a lot of times, especially patients in cancer therapy are dealing with a lot. And if you’re trying to work on changing your diet on top of everything else, sometimes it goes in and out and you have to kind of be there to repeat the messaging and support all along the way.

Lisa Hatfield:

Okay, thank you. You heard it here directly from the expert. Thanks for joining this RESTORE program. I’m your host, Lisa Hatfield.

What Are the Benefits of Early Integration of Lifestyle Medicine?

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How can early integration of lifestyle medicine benefit cancer patients? Expert Dr. Amy Comander from Massachusetts General Hospital discusses the importance of lifestyle medicine and the pillars of lifestyle medicine as part of oncology care. 

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Related Resources:

Enhancing Cancer Survivorship Through Wellness Strategies

Enhancing Cancer Survivorship Through Wellness Strategies

 Survivorship Care: Screening and Lifestyle Strategies to Reduce the Risk of Secondary Cancers

Survivorship Care: Screening and Lifestyle Strategies to Reduce the Risk of Secondary Cancers

 Equity in Cancer Care: Accessing Lifestyle Medicine for All

Equity in Cancer Care: Accessing Lifestyle Medicine for All

Transcript:

Lisa Hatfield:

The future of lifestyle medicine and cancer care holds immense potential for innovation. How do we harness the benefits early on? I’m connecting with a Harvard researcher to understand more in this Patient Empowerment Network RESTORE program. 

Dr. Comander, from your perspective, what are the key benefits of incorporating lifestyle medicine early in the cancer treatment continuum rather than solely focusing on survivorship?

Dr. Amy Comander:

When we think about individuals with cancer, who already have a very serious diagnosis, we want to help empower those individuals to improve their health to the best they can to help reduce the risk of other chronic diseases, reduce the risk of cancer recurrence potentially, and just feel better. And that’s why I think lifestyle medicine is so important and that these tools should be accessible to all individuals after a diagnosis of cancer.

And again, just focusing on learning about the importance of physical activity and nutrition and stress management and adequate sleep and social connection and avoiding risky substances. Again, it sounds overwhelming, and I usually tell my patients, just pick one thing that you want to start working on to help improve your health. And I will tell you, it’s amazing the progress that my patients have made. And I would say, like I think of a patient I saw the other day, she would tell you, “There’s no way in the world I ever wanted to get breast cancer.” It was definitely like the last thing on her list that she wanted.

But she did acknowledge that since her diagnosis, it was almost like a wake-up call, or a teachable moment that this is the time that I am now going to take charge of my health and be the healthiest version of me that I can. And I think that was really inspiring. And so I love hearing those kinds of comments from my patients once they have really taken charge and trying to improve their health behaviors in this way.

Lisa Hatfield:

Thank you. Dr. Comander, looking ahead, what innovations or advancements in lifestyle medicine do you anticipate will have the greatest impact on cancer care and survivorship in the coming years?

Dr. Amy Comander:

Well, there are so many exciting research studies coming out that are really further demonstrating the benefits of these lifestyle interventions for patients with a diagnosis of cancer. For example, so much research coming out about, learning about the mechanisms of the gut microbiome, or why exercise is important, or the benefits of achieving a healthy body weight, which I know is very complicated by the way.

So I think the more data we have to really demonstrate the importance of these tools for lifestyle medicine will really result in more widespread adoption of cancer centers around the United States, and around the world, really emphasizing that these tools need to be a key component of oncology care. And that’s certainly something I’m trying to do and I’m so grateful to partner with you to help spread this important message so we know that patients can learn about these tools to help take charge of their health as they’re going through cancer treatment.

Lisa Hatfield:

Well, you heard it here from Dr. Amy Comander. Thanks for joining this RESTORE Program. I’m your host, Lisa Hatfield.

Enhancing Cancer Survivorship Through Wellness Strategies

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How can wellness strategies enhance cancer survivorship? Expert Dr. Amy Comander from Massachusetts General Hospital discusses research on lifestyle interventions, the role of nutrition and gut microbiome, and other impactful lifestyle interventions.

Download Resource Guide

See More from RESTORE

Related Resources:

Survivorship Care: Screening and Lifestyle Strategies to Reduce the Risk of Secondary Cancers

Survivorship Care: Screening and Lifestyle Strategies to Reduce the Risk of Secondary Cancers

 What Are the Benefits of Early Integration of Lifestyle Medicine?

What Are the Benefits of Early Integration of Lifestyle Medicine?

 Equity in Cancer Care: Accessing Lifestyle Medicine for All

Equity in Cancer Care: Accessing Lifestyle Medicine for All

Transcript:

Lisa Hatfield:

Ensuring overall well-being during cancer treatment involves more than just addressing the illness itself. Wellness strategies are key but do they really optimize the health of cancer survivors? I’m getting to the bottom of it with a respected oncologist in this Patient Empowerment Network RESTORE program. 

Dr. Comander, what are some of the most effective wellness strategies you recommend for patients to incorporate during cancer treatment to support their overall well-being?

Dr. Amy Comander:

I’m really excited that over the past few years, we’re seeing more and more research demonstrating the important role of lifestyle interventions in terms of improving our patient’s outcome after a diagnosis of cancer. So I’m a breast oncologist, and of course there’s so much data in the field of breast oncology. But now we’re seeing so much data emerging with regard to individuals with prostate cancer or gynecologic cancers or hematologic malignancies, such as multiple myeloma.

So this is really an exciting time to be paying close attention to this field. So when you say, what are some of the most effective strategies? I have to pick my favorite exercise. This field of exercise oncology is really exciting, demonstrating that individuals who are able to engage in physical activity after their cancer diagnosis have improved quality of life, reduce cancer-related fatigue, and in many cases, improve outcome. And a lot of this data has certainly come from the field of breast oncology, but again, we are seeing it more and more in other types of cancers as well.

In terms of other wellness strategies, we’ve talked a lot about the important role of nutrition and thinking about some of those key concepts of what we consider an overall healthy diet, a predominance of fruits and vegetables, whole grains, limiting red meat, avoiding processed foods, and avoiding sugar-sweetened beverages and alcohol. So that’s kind of all part of a healthy diet that we think about. But more and more research is also demonstrating that diet can actually potentially influence outcome as well. And there’s a lot of research trying to understand the mechanisms of this.

And I think if your listeners are wondering, what’s an area where I can read more about this? I feel like the gut microbiome, learning more about that is really interesting. We know, for example, in the field of multiple myeloma research, or in the field of looking at immunotherapy drugs, a healthy, diverse gut microbiome, meaning those bacteria in your GI tract have favorable characteristics, and they’re very diverse and healthy, that is a reflection of the diet. Lots of healthy fruits and vegetables, fiber in the diet helps result in a healthy, diverse gut microbiome, which in emerging studies is showing that that is associated with an improved microbiome responsiveness to certain drugs, particularly immunotherapy.

So this is an exciting time. The field is evolving, but I’m excited to learn more as we continue to see these studies emerge.

Lisa Hatfield:

Thank you. And, Dr. Comander, how do you see lifestyle medicine contributing to optimizing the health of cancer survivors, particularly in reducing late effects and improving overall well-being?

Dr. Amy Comander:

I’m a strong advocate that these tools from lifestyle medicine should be a part of every patient’s cancer treatment. And these are pretty basic things when we think about, again, physical activity, encouraging exercise, following a healthy diet pattern, getting adequate sleep, social connection. Actually, let’s talk about social connection. I feel like that’s one when I first started getting to this field, I’m kind of like, yeah, social connection, that’s important.

But I will tell you, as I’ve been doing this more and more and working with groups of patients, focusing on providing education about diet and exercise and stress management and sleep and all of these important things that we’ve been talking about, I’ve noticed that the support from other individuals who truly get it, if you bring a group of patients together who are all going through treatment for multiple myeloma, or prostate cancer, or breast cancer, or whatever it may be, that support piece, talking to another person who’s facing the same challenge, who might want to meet you at the YMCA and go to that exercise class, or might be willing to text you, “Hey, how are you doing with those salads you’re trying to have for lunch each day?”

That accountability and support is such an important component of health. And I think we really learned during the pandemic how much social connection and support is so integral to our health. So I think in the field of oncology, the work this organization does, and so many others, that building up community, social connection, social support is really something we should invest more in to help improve the health and well-being of our patients with cancer.

Lisa Hatfield:

Absolutely agree. Thank you. You heard it here from Dr. Amy Comander. Thanks for joining this RESTORE Program. I’m your host, Lisa Hatfield.

Survivorship Care: Screening and Lifestyle Strategies to Reduce the Risk of Secondary Cancers

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What are key lifestyle changes for cancer patients navigating treatment and recovery? Expert Dr. Amy Comander from Massachusetts General Hospital discusses survivorship care and lifestyle advice for coping with and recovering from cancer treatment.

Download Resource Guide

See More from RESTORE

Related Resources:

Enhancing Cancer Survivorship Through Wellness Strategies

Enhancing Cancer Survivorship Through Wellness Strategies

 What Are the Benefits of Early Integration of Lifestyle Medicine?

What Are the Benefits of Early Integration of Lifestyle Medicine?

 Equity in Cancer Care: Accessing Lifestyle Medicine for All

Equity in Cancer Care: Accessing Lifestyle Medicine for All 

Transcript:

Lisa Hatfield:

Navigating cancer treatment and recovery is a journey that involves more than just medical care. Lifestyle choices play a crucial role too. What other factors play into this journey? I’m getting to the bottom of it with a respected oncologist in this Patient Empowerment Network RESTORE program. 

Dr. Comander, many patients often worry about secondary cancers. What are key lifestyle changes you recommend for cancer prevention and how do they differ from those recommended for post-cure recovery or post-treatment?

Dr. Amy Comander:

So an important component of survivorship care, which is care of the patient, certainly at the time of diagnosis and beyond, but in that follow-up phase as well, is screening for secondary cancers. And what does that mean? That means that a cancer that can develop after the diagnosis of the primary cancer. And I know to some listening that sounds really overwhelming. “You mean I can get another cancer?” But unfortunately, none of us have a crystal ball and that could happen. So what are strategies we can use to help reduce the risk of someone getting another cancer down the road?

And I first want to emphasize the importance of cancer screening. So we now have all these great tools for cancer screening; mammograms, breast MRIs, colonoscopy, pap smears, pelvic exams, CT scans for detection of lung cancer, and now we’re having these blood tests that we’re going to learn more about in the next few years. So there’s many screening strategies that are super important. So I encourage my patients to talk to their doctor. About making sure they’re staying on top of that because, my patients who I see in breast cancer follow-up, I always ask them, “When was your last colonoscopy?” And nobody loves getting that, but it’s really important as our major strategy for screening for colon cancer.

In terms of lifestyle recommendations, we know that a lot of the lifestyle recommendations that we talk about with our patients to improve their health during the survivorship phase of their care are also associated with a reduced risk of getting another type of cancer. So we know that physical activity is very beneficial to reduce the risk of many cancers, including breast cancer, colon cancer, and others. We know that being at a healthy body weight is really important in terms of thinking about risk for a future cancer. Again, a healthy diet with a focus of lots of whole grains, fruits, and vegetables is also so important.

So I think all the lifestyle strategies that we’ve really emphasized for cancer survivorship are also really important to optimize health, to reduce the risk of a secondary cancer and other chronic diseases, which I do have to mention, such as heart disease, stroke, type 2 diabetes. All of these things can happen too, because they can happen to all of us here. So we need to think about how can we optimize our health to reduce the risk of all of these potential conditions.

Lisa Hatfield:

Thank you. You heard it here from Dr. Amy Comander. Thanks for joining this RESTORE Program. I’m your host, Lisa Hatfield.

How Can I Maintain a Healthy Diet During Ongoing Cancer Treatment?

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How can cancer patients maintain a healthy diet during and after cancer treatment? Expert Dr. Amy Comander from Massachusetts General Hospital discusses common side effects of cancer treatment and advice for boosting nutrition during and after cancer treatment.

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Related Resources:

How Does Cancer Treatment Impact Nutrition?How Does Cancer Treatment Impact Nutrition?

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Why Is It Important to Address Whole Person Care?

Transcript:

Lisa Hatfield:

As a patient living with cancer where there’s no cure and treatment is ongoing, I’m constantly navigating the challenges of maintaining my health during treatment and avoiding unwanted side effects. Nutrition is a big part of that, but it’s not the whole picture. I’m getting to the bottom of it with a respected oncologist in this Patient Empowerment Network RESTORE program.

Dr. Comander, how can patients manage treatment side effects that affect their appetite or ability to eat? And what role does hydration play in supporting cancer treatment and recovery?

Dr. Amy Comander:

We know that many individuals going through cancer treatment really have a poor appetite, often don’t feel like eating, and this can be due to a multitude of factors. Maybe it’s due to nausea from the medication, or other side effects from the chemotherapy agents or other medications that a patient’s taking. So this can really be a challenge. And I encourage a patient to really talk to his or her doctor about these concerns if really poor appetite is a major problem because, yeah, actually sometimes there’s strategies we can think about, sometimes there’s medications that can be helpful to boost the appetite, or sometimes it’s really thinking about introducing certain foods that may perhaps be appealing, such as making a smoothie.

Sometimes maybe you weren’t a smoothie person before going through cancer treatment, but now that might be a great way to get in some calories. Obviously you can put a lot of healthy things into a smoothie. So this is one strategy that some of my patients employ. But I certainly encourage someone listening to this to kind of talk to their doctor about this, if it’s a real problem like not being able to eat.

In terms of hydration, we know that is so important. Many of our treatments get metabolized by the liver or cleared by the kidneys. So it’s really important to stay well hydrated, especially in the summer months, if it’s really hot outside. So I always encourage my patients to have a trusty water bottle by their side at all times.

There’s so many fun water bottles out there, so I’m like, “Get one that you like. If it has to be pink, that’s great, whatever it is,” but have a water bottle with you at all times. Certainly think about water, other drinks with electrolytes, some people like Gatorade, whatever that might be, but it’s really important to be drinking throughout the day to stay hydrated, to keep yourself healthy as you’re going through cancer treatment.

Lisa Hatfield:

Okay, thank you. Dr. Comander, what strategies do you recommend for cancer patients to maintain adequate nutrition when experiencing treatment side effects such as nausea or taste changes? And additionally, are there specific foods or supplements that can help alleviate these side effects?

Dr. Amy Comander:

Right, so many patients when they’re going through chemotherapy, or receiving other treatments for their cancer, really note nausea, changes in taste, and have a really tough time finding what they want to eat during this time. And I will say, obviously, sometimes it’s playing around with the diet to find what things work and what things don’t work. And often that’s the first thing we might try. But if nausea is the primary issue, I will say we now have such an amazing array of anti-nausea medications that we can use for our patients going through chemotherapy.

And these are really game changers in the field of oncology. I can just see it even over my career how some of the newer medications we have, such as olanzapine(Zyprexa), to use for nausea, are really beneficial. So I think if you’re going through chemo and having a real hard time with nausea and that’s preventing you from eating, talk to your doctor. “What other anti-nausea medication can I consider taking so I can get nutrition into my body?”

Taste changes, it really is something that can evolve often during active chemotherapy treatment. Patients may experience that. It tends to get much better when you’re done with some of these drugs, such as cisplatin, for example, that can cause a lot of changes in taste. So that’s usually something that’s hopefully more of a short-term thing and will get better with time. In terms of specific foods or supplements, I really very much advocate that my patients get nutrition from whole foods with a focus on fruits and vegetables and whole grains. I’m not a big supplement person.

In fact, organizations such as the American Institute of Cancer Research really counsel patients not to focus on supplements as a major way to get nutrition into their body. Of course, there are some instances where supplements are needed. For example, a patient with anemia could have deficiency in iron or vitamin B12. Those are supplements that may be necessary to help boost those red blood cells. Or one of my patients, for example, a diagnosis of breast cancer, an aromatase inhibitor, where she may be experiencing a decline in bone density, she may need a vitamin D supplement because she lives in New England and doesn’t get enough sun exposure, which is how we get vitamin D.

So vitamin D, iron, B12, things like that sometimes are necessary, but there are a lot of supplements out there that people are encouraged to buy and spend a lot of money on, and I really would encourage you to shy away from that. That would be my recommendation.

Lisa Hatfield:

Okay, thank you. And a quick question for those patients who are on the flip side of the decrease in appetite. Sometimes patients going through cancer treatment are on high dose steroids, and they have the increase in appetite and they have certain cravings. Do you have any suggestions or recommendations for those patients?

Dr. Amy Comander:

Yes, we know that we use steroids a lot in oncology to help our patients manage nausea or other side effects related to their treatment. And you’re absolutely right, being on steroids can sometimes really rev up the appetite, make it hard to sleep at night, cause a whole wide array of other side effects. So certainly with my patients who have this problem, sometimes I try to cut down the steroids a little bit, see if we can get away with that to kind of minimize those adverse side effects from the steroids themselves.

But if someone really is having cravings, usually the steroids are used around chemo for just a few days. So I usually encourage them like, again, if you’re craving carbs, try to focus on some healthy carbs, again, focus on whole grains, try to avoid some of the potato chips and other stuff, which we know are not so good for us, but usually it’s a short-term thing, but maybe cutting down the steroids a little bit might be the first step if possible in collaboration with your oncology team.

 

Lisa Hatfield: Okay, thank you. You heard it here from Dr. Amy Comander. Thanks for joining this RESTORE Program. I’m your host, Lisa Hatfield.