Closing the Gap in Nutrition Care at Outpatient Cancer Centers: Ongoing Initiatives of the Oncology Nutrition Dietetic Practice Group

Nutrition guidance for cancer patients and survivors—A review of the websites of Irish healthcare and charitable organisations and cancer centres

“…Patients can experience a range of detrimental side effects such as sore and dry mouth, pain, fatigue and taste changes which can all impact on dietary intake (Boltong & Keast, ; Coa et al, ). This is associated with readmissions to hospital and increased hospital stays for cancer patients (Trujilo et al, ). Cancer patients are recognised as the most malnourished of all patient groups (Bozzetti et al, ).…”

“…impact on dietary intake (Boltong & Keast, 2012;Coa et al, 2015). This is associated with readmissions to hospital and increased hospital stays for cancer patients (Trujilo et al, 2018). Cancer patients are recognised as the most malnourished of all patient groups (Bozzetti et al, 2009).…”

“…After treatment, there are also unique nutritional challenges with excessive energy intake among cancer survivors being associated with weight gain, overweight and obesity (Trujilo et al, 2018). This has been associated with poorer outcomes and reduced disease-free survival and can potentially result in increased rate of cancer progression (Trujilo et al, 2018). In addition, cancer survivors have a poorer dietary quality than the general population, putting them at increased risk of developing additional chronic disease (Zhang et al, 2015).…”

Opportunities for Quality Improvement Programs (QIPs) in the Nutrition Support of Patients with Cancer

“…The Evidence Analysis Library of the Academy of Nutrition and Dietetics (Academy) has documented strong evidence (Grade 1) of an association between poor nutrition status in adult oncology patients and decreased tolerance to radiation treatment, decreased tolerance to chemotherapy treatment, increased length of hospital stay, lower quality of life, and mortality [9]. Malnutrition in patients with cancer is also associated with higher healthcare costs [10].…”

“…Malnutrition interventions, including nutrition support through dietary counseling, diet fortification, oral nutrition supplements (ONS), and enteral and parenteral nutrition, can help improve health outcomes [11]. However, in the American outpatient setting, where nearly all oncology patients receive treatment, ambulatory nutritional care standards and interventions for cancer are ambiguous and inconsistently applied [10]. This is further complicated by the fact that registered dietitian nutritionists (RDNs) are not routinely employed in outpatient cancer centers and the medical nutritional therapy that they provide is not consistently a part of multidisciplinary outpatient cancer care or adequately reimbursed [12].…”