Up to 80 percent of cancer patients suffer from malnutrition at some point during their cancer care and have specific dietary needs, depending on where the cancer is and how it affects their ability to consume sufficient calories or even absorb nutrients.
As one of just 13 registered oncology dietitians in the state, Amanda Bryant, R.D., C.S.O., L.D., works solely with cancer patients at the OHSU Knight Cancer Institute to identify malnutrition risk and provide nutrition support and education to help optimize each patient’s individual cancer journey.
“A patient with an invading tumor of the colon may be focused on a low-fiber diet to reduce their risk of a bowel obstruction, whereas someone with pancreatic cancer may be concerned about the risk of malabsorption because the pancreas plays a vital role in breaking down nutrients so the body can absorb them,” explained Bryant. “On the other hand, a patient with prostate cancer may be struggling with unwanted weight gain, elevated lipid levels and bone health.”
Patients receiving cancer therapy may experience nausea and taste changes, and may be bothered by some odors. Some may have diet restrictions related to surgery, chemotherapy or radiation. In each instance, Bryant creates a tailored treatment plan.
In a recent case, the social work team and Bryant provided a patient with food insecurity a list of nearby food pantries and connected the patient with Meals on Wheels. Bryant also helped him figure out some simple meal options, resolving what could have been a significant barrier to treatment. In instances where patients lack an adequate support system, Bryant comes up with simple food and snack ideas with little cooking involved.
“You have to get creative, but that’s part of what makes my job so interesting,” she said.
Bryant visits patients in the OHSU Knight Cancer Institute’s surgery and medical oncology clinics, and infusion unit. She provides phone consults to OHSU’s five community hematology-oncology clinics and attends a pediatric survivorship clinic where she meets weekly with adults who were pediatric patients at the time of their diagnosis. She estimates she has up to 145 total patient visits per month.
Twice a month, Bryant and a colleague lead a nutrition segment in the Knight’s introduction to chemotherapy class called Infusing Knowledge.
Thursday, December 20, 11 a.m. PT - Join in a special holiday cooking class
Bryant hosts a monthly cooking segment for oncology patients and their families. The live Facebook events cover nutrition questions and teaches viewers how to prepare simple, nutritious meals.
“Navigating the holidays – a time when food is so often a central part of the festivities – can be particularly challenging for cancer patients and their loved ones,” said Bryant. When meal planning for someone going through cancer therapy, she recommends asking whether there are any diet restrictions or limitations.
Bryant recommends the following guidelines to establish healthier eating patterns and lifestyle choices during the holidays and year-round:
- Give yourself limitations but set realistic goals. Bryant cautions against taking an all-or-nothing approach to nutrition. “Don’t say you won’t eat anything sweet or unhealthy. That’s not realistic.” Bryant allows herself one sweet treat every day. “For me, that’s important for my quality of life.”
- Focus on eating a variety of whole foods – especially fruits and vegetables. Rather than focus on a specific superfood, Bryant recommends choosing a variety of nutrient-rich, low energy density whole foods.
- Never skip meals to bank for calories to be consumed later. Instead, eat smaller portions.
- Have a SMART plan (specific, measurable, achievable, results-oriented and time-bound). Pick a strategy to avoid overeating.
- Get moving. Go on a walk after dinner, invite friends and family to do something active around holiday eating!
An oncology dietitian is a registered dietitian with over 1,000 hours of oncology-specific experience who has passed a board examination to be credentialed as a certified specialist in oncology (CSO). Of the 13 CSO dietitians in Oregon, four are at OHSU. Bryant specializes in gastro-intestinal, urologic and gynecologic cancers and sarcomas.