The wisdom is old, “You are what you eat.” But in recent years, doctors and patients alike have begun to recognize more and more how important diet can be in staving off disease.
Rhode Island Hospital dietitians Karen Pasquazzi and Lisa Robinson recently earned national board certification in a new specialty: oncology nutrition. Pasquazzi, who has worked in food and nutrition services at the hospital since 1978, and as a senior dietitian since 1987, answered questions about the role of nutrition in cancer treatment and recovery.
PBN: How did you become interested in specialized oncology training?
PASQUAZZI: Early on in my career at Rhode Island Hospital I was assigned to work on an oncology unit, and I became increasingly interested in the disease and how profoundly it and the treatment can impact a patient’s general health and well-being.
My colleague Lisa Robinson and I began job sharing almost 20 years ago, and have been involved in some aspect of oncology most of our careers. We are assigned to the inpatient oncology unit and Radiation Oncology and Hematology/Oncology in the Comprehensive Cancer Center. The Comprehensive Cancer alone treats hundreds of patients a day.
The credential for Certified Specialist in Oncology Nutrition became available through our professional organization in the spring of 2008, and we sought it to acknowledge our distinctive specialty skill set, practice experience and knowledge base. We passed a national exam last March, becoming the first certified oncology nutrition specialists in Rhode Island.
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PBN: How broad a field is oncology nutrition?
PASQUAZZI: There are a number of different cancer diagnoses and specific treatment modalities. As registered dietitians we will help with every aspect of a patient’s nutritional needs, pre-treatment, during and after treatment to ensure they receive the best and most complete care.
PBN: Can you give me some examples of how a nutritionist can help a patient who is currently undergoing cancer treatment?
PASQUAZZI: We will offer suggestions that will make eating more comfortable based on a specific diagnosis. For example, patients with lung cancer receiving radiation therapy often have difficulty eating due to esophageal burning. We can help to alleviate the discomfort by suggesting certain foods to eat and to preserve nutrition during treatment. This is what we refer to as management of nutrition impact side effects of treatment.
Some patients require feedings by tube because of the location of their tumor, surgery, treatment side effects and/ or inability to eat and we will coordinate a feeding plan and schedule. And patients often experience fatigue, nausea and loss of appetite. We may help make mealtimes easier with preparation, scheduling and food choice tips.
PBN: What role can diet play in helping people in remission from cancer to stay healthy?
PASQUAZZI: The data regarding cancer survivorship is emerging and encouraging but not conclusive to make firm recommendations. Cancer survivors are therefore encouraged to follow the recommendations for cancer prevention.
PBN: There’s been a lot of hype in recent years about diet being important in cancer prevention, but there’s also a lot of debate about it. Is there any evidence that there are, indeed, foods that can protect us from cancer, and is that something you cover with patients?
PASQUAZZI: Last November, the American Institute for Cancer Research and the World Cancer Research Fund released “The Second Expert Report, Food Nutrition, Physical Activity and The Prevention of Cancer: A Global Perspective,” which was the largest report of its kind ever published. The report confirms that nutrition, physical activity and weight can impact cancer. This is an easily interpreted set of guidelines, and we typically provide and elaborate on them for our patients.
The AICR Recommendations for Cancer Prevention are:
The health benefits of moving toward a plant-based diet cannot be overemphasized. Eating at least five to nine daily servings of a variety of fruits and vegetables, whole grains and legumes has been shown not only to reduce cancer risk but also other diseases. Moreover, the public should aim to meet nutritional needs through diet alone.
