Nourishing Hope: A Dietitian’s Role in Breast Cancer Care

We round up October with this article on how dietitians can help with navigating a breast cancer diagnosis. Breast cancer remains one of the most prevalent malignancies globally, with an estimated 2.3 million new cases diagnosed annually. Receiving a breast cancer diagnosis can be overwhelming, and navigating treatment options, managing symptoms, and making lifestyle changes all present unique challenges. The complexity of breast cancer treatment necessitates a multidisciplinary approach which should include nutritional care. However, an often overlooked but crucial part of a breast cancer care team is a dietitian, specifically one with expertise in oncology (cancer) nutrition. Cancer patients face an elevated risk of malnutrition due to the impact of both the disease and its treatments. Malnutrition is recognized as an issue for 15% to 20% of all cancer patients, and for 80% to 90% of those with advanced disease. A research work conducted at the Department of Dietetics, University of Ghana found that, only 5% of women undergoing treatment for breast cancer had consulted with a dietitian. The role of registered dietitians in breast cancer care extends far beyond basic dietary advice, encompassing evidence-based interventions that directly impact treatment outcomes, recovery, and long-term survival.

How a Dietitian Can Help

Early nutritional intervention has been shown to reduce the incidence of treatment-related complications. This reduction in complications translates to improved treatment adherence, better response rates, and enhanced recovery outcomes. During breast cancer treatment, maintaining good nutrition is vital. However, side effects like nausea, changes in taste, and fatigue can make eating difficult. A dietitian can help in various ways including the following: performing nutritional assessments and developing a care plan that meets clients’ needs, understanding the changing nutritional needs through all stages and types of treatment (surgery, chemotherapy, immunotherapy, and radiation). The management of treatment-related side effects represents a primary focus of nutritional intervention in breast cancer care.

Cancer treatments such as chemotherapy, radiation, and surgery can lead to side effects like nausea, loss of appetite, taste changes, and difficulty swallowing, which may result in unintentional weight loss or malnutrition. The dietitian can provide education about the treatment-related side-effects and information about potential nutritional and dietary supplements during cancer treatment.

Malnutrition and muscle loss (sarcopenia) are common in cancer patients and can negatively affect treatment outcomes. Dietitians conduct regular nutrition assessments and create interventions that ensure adequate protein and calorie intake to combat malnutrition and muscle wasting.  A healthy diet can support the immune system, making it more resilient during treatment and reducing the risk of infections. Dietitians encourage the inclusion of foods rich in antioxidants and phytochemicals, like fruits and vegetables, to aid in cellular repair and recovery. Additionally, they can dispel myths around certain foods ensuring patients feel confident in their food choices

For patients with breast cancer, weight management is critical as excess body weight, particularly after menopause, is linked to increased cancer recurrence risk. Dietitians can help patients achieve and maintain a healthy weight by providing evidence-based recommendations for a balanced diet that emphasizes plant-based foods, unpolished cereals, tubers and lean proteins. They also offer support in adopting a physically active lifestyle, which is known to reduce the risk of breast cancer recurrence.

Specific Nutritional Considerations

Micronutrient requirements during breast cancer treatment require careful attention and evidence-based supplementation protocols. Vitamin D has emerged as a particularly significant factor, with research supporting maintenance of adequate levels. Calcium requirements become especially crucial during hormone therapy due to increased risk of bone density loss. Omega-3 fatty acids have also demonstrated promising results in managing inflammation and improving treatment tolerance. A dietitian can work with the multidisciplinary care team to ensure adequate intake of these nutrients.

 Emotional aspects of eating

Food is often tied to comfort, celebration, and social connection. Changes in eating habits, body image, and overall lifestyle following a breast cancer diagnosis may contribute to feelings of anxiety or depression. A dietitian can help navigate changes in clients’ relationship with food and suggest ways to continue enjoying meals and social eating experiences despite the challenges of treatment. Dietitians offer a supportive environment to discuss these challenges, provide coping strategies, and suggest mindful eating practices. They work closely with the broader healthcare team, including psychologists and social workers, to ensure comprehensive care.

Long-term Survivorship Nutrition

Current research shows that many patients diagnosed with breast cancer are beating the disease and living longer. Nutritional support during survivorship of breast cancer requires a transition from active treatment protocols to sustainable, evidence-based dietary patterns. The World Cancer Research Fund and American Institute for Cancer Research both emphasize the importance of plant-based dietary patterns, optimal protein intake, and reduction of alcohol consumption. These recommendations are supported by extensive epidemiological data demonstrating improved survival rates and reduced recurrence risk among survivors who adhere to these dietary patterns. Implementation of these guidelines requires careful consideration of individual patient factors, including treatment history, current health status, and personal preferences. Successful long-term adherence often depends on the development of personalized meal plans that balance nutritional adequacy with practical implementation strategies by a dietitian. Regular monitoring and adjustment of these plans ensure optimal outcomes throughout the survivorship period.

In summary, every client’s experience with breast cancer is unique. A dietitian can provide personalized nutrition advice tailored to specific needs, preferences, and treatment plan. Do you know anyone, or are you yourself navigating a breast cancer diagnosis? Please do not hesitate to ask your healthcare team about working with a dietitian as part of your comprehensive care. You can also send a mail to fullproofnutrition@gmail.com or send a WhatsApp message to 0530542013. We will help to link you up with a dietitian in your vicinity.

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Written by Dr. Laurene Boateng (PhD, RD) and Pearl Kudexa (MSc, RD)

Laurene Boateng (PhD, RD) is a Registered Dietitian and Senior Lecturer in the Department of Dietetics, University of Ghana. She is the founder and editor-in-chief of www.fullproofnutrition.com , a website committed to providing reliable, evidence-based, and practical healthy eating advice.

Pearl Kudexa (MSc, RD) is a Registered Dietitian and contributing writer for www.fullproofnutrition.com

References

Laryea, E., Boateng, L. (2018). Estimation of body composition among breast cancer patients at a teaching hospital in Ghana [Unpublished undergraduate dissertation]. University of Ghana.

Clinton, S. K., Giovannucci, E. L., & Hursting, S. D. (2020). The World Cancer Research Fund/American Institute for Cancer Research Third Expert Report on Diet, Nutrition, Physical Activity, and Cancer: Impact and Future Directions. The Journal of nutrition, 150(4), 663–671. https://doi.org/10.1093/jn/nxz268

Lake, B., Damery, S., & Jolly, K. (2022). Effectiveness of weight loss interventions in breast cancer survivors: a systematic review of reviews. BMJ open, 12(10), e062288.