Tool Helping UC Cancer Institute Identify Patients At Risk for Malnutrition

A person needs nourishment from food to live and flourish.

However, people undergoing cancer treatment are often plagued with nausea, a lack of appetite, gastrointestinal issues, dry mouth and swallowing difficulties, among other issues, which make it hard to complete this seemingly simple task.

“Malnutrition in patients undergoing cancer treatment is correlated to decline in function as well as treatment intolerance, increased infection rates, and increased hospitalization,” says Tammy Ward registered dietitian and specialist in oncology nutrition for the UC Cancer Institute. “When these patients are losing weight because they can’t or don’t want to eat, they’re losing fat and muscle mass as well as stores for vitamins and minerals to support healing and health.”

With the importance of nutrition’s role in better outcomes for patients known, the American College of Surgeons Commission on Cancer requires that all cancer programs create policies and procedures for assessing the nutritional wellbeing for those with cancer and determine best ways to intervene.

At the UC Cancer Institute, Ward and colleague Kelly Guthrie, registered dietitian, have begun the process of screening patients to identify those who are at risk of malnutrition. “The tool we are using is called the Malnutrition Screening Tool Questionnaire, which includes three simple questions about a patient’s weight loss and appetite,” she says. “If the patient has a score of 2 or more, a consultation with a dietitian is warranted.”

Currently, this screening tool is being implemented in the gastrointestinal, surgical oncology, Esophageal Disease Clinic, hepatobiliary (liver and gallbladder) and lung cancer clinics.

“This tool is only given to new patients at this time, and we’re still trying to determine the best way to catch existing patients who may be at risk for malnutrition,” Ward says. “However, our efforts are working. As of the last week in October, 75 percent of new patients in these clinics were screened, 40 percent of whom were identified as being at-risk.”

Ward and Guthrie work closely with the cancer care team and the patient as part of the treatment plan to provide individualized education about good nutrition, adequate protein intake and nutritional management of treatment-related symptoms.

“As part of an initial nutrition assessment we identify eating habits and cultural preferences for each patient,” Ward says, adding that patients are seen by dietitians one to two times per week once the patient begins treatment to provide ongoing education about altering diet to manage symptoms.

“We are happy to see that our assessments are working, but there is a lot more to be done, and we hope to roll this screening tool out further in coming months. Food is such an important part of life— both physically and socially. We’re happy to provide these services and will work to continually help patients have better outcomes and quality of life.”

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