CancerCare: Barriers to Proper Nutrition are Both Financial and Physical
As part of our series on Food and Transportation Disparities, Real World Health Care reached out to Leeann Medina-Martinez, LCSW, CancerCare’s Disparities Program coordinator. CancerCare is the leading national organization providing free, professional support services and information to help people manage the emotional, practical and financial challenges of cancer.
We asked Medina-Martinez about the nutrition-related barriers cancer patients face when being treated for cancer and where they can seek help.
Importance of Proper Nutrition for Cancer Patients
Real World Health Care: Why is proper nutrition so important for people living with cancer?
Leeann Medina-Martinez: Nutrition is an important part of maintaining strength and weight. It helps patients keep their bodies fueled and better manage treatment side effects. Lack of proper nutrition can impact treatment plans. For example, if a patient who is on chemotherapy loses too much weight and isn’t able to maintain weight, there is a possibility the oncologist might decide to stop chemotherapy.
Barriers to Proper Nutrition
RWHC: What are some of the common barriers cancer patients face in terms of getting the proper nutrition?
LMM: The barriers cancer patients face in getting proper nutrition are usually financial and physical. On the physical side, it can be difficult for some cancer patients to stomach certain foods. Depending on the specific cancer diagnosis and treatment, patients may experience a change in appetite – typically a decreased or complete lack of appetite that leads them to skip meals. Some cancer treatments create food aversions, dry mouth and mouth sores that make eating a challenge. Nausea, fatigue and pain can also serve to dampen appetite or create an aversion to food.
The financial barrier is not having enough money to purchase recommended foods, such as fresh fruits, vegetables and lean proteins. Or, these foods may not be readily available to them at their local store. Getting to a grocery store with nutritious and affordable food is especially a barrier for patients living in “food deserts” (urban areas without close access to affordable and healthy foods) or even rural areas, when patients lack access to public transportation, a car, or family and friends who can help with grocery shopping.
RWHC: How are those barriers compounded if the patient lives with food insecurity?
LMM: If a patient lives with food insecurity, the barriers I mentioned earlier are intensified because they are less likely to be able to travel to get food. Patients may not be able to afford food that is both palatable and provides the nourishment their bodies need. Moreover, they might not want or be able to eat the foods that are available because of the side effects of treatment on their body.
Better Nutrition Starts with a Conversation
RWHC: How can cancer patients improve their nutrition? Are there any common tips for increasing their appetite or finding foods that will be more palatable?
LMM: Patients should discuss their nutrition needs with their oncology team, including the nutritionist on the team. These discussions are important because there are medications and recommendations (including taking vitamins and supplements) that can be made based on the patient’s health history that may assist in increasing appetite. Most suggestions are to eat fresh vegetables, whole grains, fruit, and protein with a focus on high-protein snacks, and sufficient hydration. Some tips for increasing appetite or finding foods more palatable are to eat favorite foods at any time of the day – having breakfast food for dinner as an example, or adding lemon juice or fresh fruit to water to improve its taste.
If their care team does not include a nutritionist, patients may want to start by reaching out to their insurance company to find an approved provider. If that is not an option, patients can reach out to CancerCare for help finding a nutritionist, identifying a nutritionist at their hospital or provider, and connecting them with nutrition-related educational resources. Another avenue is to try Ina®, the Intelligent Nutrition Assistant. A partnership with CancerCare and Savor Health, Ina provides nutritional support and guidance 24/7 through text messaging.
Financial Assistance May be Available
RWHC: What can cancer patients or their loved ones do if they are having problems affording nutritious food during their treatments?
LMM: Nutrition plays an important role in the patient’s well-being. Patients and caregivers should put a plan into place for finding, accessing and affording nutritious food. If they find themselves in a situation where they are deciding on whether to go without certain foods, or food in general, then they might be facing some food insecurity. Patients who are food insecure may be eligible for financial assistance for food and transportation services, including Meals on Wheels, food pantries, government benefits and other community groups available to help. The financial cost of cancer treatment may also create additional financial burdens for patients who can no longer afford, or have the energy to buy and prepare, nutritious foods. They should know support is available and there is no shame in asking for assistance.
RHWC: What services and support does CancerCare offer to help people who are concerned about their nutrition or having nutrition-related problems during their cancer treatments?
LMM: CancerCare offers several services such as publications, Connect Education Workshops, resource navigation services, as well as A Helping Hand resource database. CancerCare also offers limited financial assistance that can assist with transportation concerns. In addition, CancerCare has partnered with Magnolia Meals at Home, a meal delivery program that aims to help patients by providing nourishing meals to households affected by cancer available in a few states. We also offer My Cancer Circle, a free, private community for caregivers to organize support, including meal deliveries and transportation, for their loved ones with cancer.