What should nurses know to support their patients if an oncology nutritionist or clinical dietitian is not available to counsel a patient? — Name withheld on request

There are many websites to offer patients for managing eating issues during cancer treatments, but first you need to know what the issues are. Talking to the patient and family members is where to start. Ask the patient to keep a food diary to get a real feel for what they can or cannot eat. Ask family members to aid the patient in this but remember that both sides of the discussion usually are fraught with personal bias: “Mom’s not eating enough” vs “I’m really full after eating 5 to 6 small meals a day.” And this bias can be cultural!

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The usual issues are appetite changes (not hungry or overeating), changes in taste and smell, problems with chewing or swallowing, constipation or diarrhea, dry mouth, fatigue, nausea and/or vomiting, mouth sores, and weight loss or gain. Nurses with years of experience can rattle off many suggestions for these issues but having something that patients and family members can refer to anytime of the day or night makes life just a little bit easier. Websites are great, but having a handout is a plus. 

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Here are a few recommended websites and printed materials for patients:

Cancer Support Community: Diet & Nutrition

American Cancer Society: Survivorship: During and After Treatment www.cancer.org/treatment/survivorship

National Cancer Institute: Eating Hints: Before, during, and after Cancer Treatment

National Cancer Institute: Nutrition in Cancer Care (PDQ®)–Patient Version

Cancer Dietitian

Oncology Nutrition: Eat Right to Fight Cancer