The role of Dietetics in oncology

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As part of a series focusing on the various roles of Allied Health Professionals, University Hospitals Sussex NHS Foundation Trust, Consultant Oncology Dietitian, Mhairi Donald, shares her insights as an AHP supporting patients along their cancer journey.

She showcases the Sussex Cancer Centre foodbank initiative, which she instigated to support people affected by cancer during the Covid pandemic, as well as the cookery skills workshops and specialist cookbooks she has developed.

Mhairi has been a Consultant Oncology Dietitian at the Sussex Cancer Centre for the last 13 years, providing expert face to face and telehealth dietetic support for people affected by cancer from diagnosis, prehabilitation and treatment through to survivorship and palliative care.

She is passionate about, and dedicated to, the provision of dietary advice, nutrition counselling and the treatment of the nutritional impact symptoms. Nutritional status plays a significant role in supporting the efficacy of cancer treatment and quality of life throughout the cancer journey.

Mhairi Donald, Consultant Oncology Dietitian

Supporting patients through the Covid pandemic – the Foodbank initiative

The conditions for cancer patients during the lockdown were challenging and those having treatment were regarded as clinically extremely vulnerable and were told to strictly shield, with many of them only leaving their house for treatment.

During this time some patients found getting any and the right food very challenging. Treatment for cancer can change a person’s appetite, the taste of food and even the texture, so finding the right food can be difficult.  In addition, reduced support from friends and family who were unable to deliver shopping, cook and eat together resulted in food insecurity for many patients managing cancer. Other patients found themselves in food poverty unable to work because of their illness or because of reduced household income as family members were furloughed or lost their jobs.

With the support of Macmillan, I lead a Foodbank initiative to support patients coming to the Sussex Cancer centre for treatment. I collaborated with FareShare and a local support group Brighton Together to provide  food supplies, fresh and non-perishable from the repurposed café area of the centre.

At the height of the pandemic, I offered over 75 different kinds of foods and, to date, I have provided over 1,500 food packages and recipes, often personalised to meet the patient’s specific dietary needs and home circumstances.

One patient having treatment for ovarian cancer said: “It has been a tremendous relief to receive good, helpful, essential food from Mhairi’s stock. It is a lifeline for patients like myself who are going through chemotherapy. It has been like a great weight being lifted off my shoulders” another said “Such a big help in hard times. The foodbank was great. I’ve lost hardly any weight!”

So successful, the Foodbank initiative has now become a permanent feature of our cafe at the Macmillan centre and continues to provide parcels to any of our patients who need them.

Cookery Skills Workshops launch

I believe that providing practical tools for patients and their families is a key component to support changing nutritional and dietary behaviours. In collaboration with our Eat Well Be Well manager, I launched the cookery skills workshops. Using healthy recipes and fresh ingredients, the workshops give people the skills and confidence to cook healthy and nourishing meals and snacks.

Paused during Covid, workshops resumed in September 2021 and feedback has been even more positive because of the interaction and sharing of experiences which so many patients missed during the COVID period. One patient summed up her experiences –“it was such a lovely event to attend and I’ve learned a lot, plus gained confidence in an area I really lacked it.“

Across December, I have been running a Christmas edition workshop– creating alternatives to traditional Christmas recipes so people affected by cancer can enjoy food over the festive period.

My cookbooks for people affected by cancer

My dedication to create bespoke and practical solutions for people having trouble eating, led to publication of my cookbooks; “Every Mouthful Counts” and “Whizz it up” and a new cookbook, currently in publication, designed for patients with advanced cancers – “Don’t ask me what I’m eating”. The books are designed to provide information on how cancer and its treatment can affect what people are able to eat and give practical tips on dealing with the side effects. Now in their third edition they are available to buy via the Sussex Cancer website .

National and professional impacts

I am a longstanding and active committee member of the British Dietetic Association Oncology Specialist Group and collaborate with Nutrition and Diet Resources UK (NDR-UK) to develop resources to support cancer patients including a series of booklets on oncology and palliative care. During lockdown we continued our work, meeting virtually to create the latest booklet in the series – “How do I have a Nourishing Plant based Diet?” providing information on how to safely follow a plant-based diet throughout the cancer journey. All leaflets are available via the NDR-UK website

Mentoring the next generation of dietitians

Because good nutrition in oncology can help treatment efficacy and quality of life it’s important to support the next generation of specialised oncology dietitians. While face to face teaching and sharing of knowledge and experience has been challenging during lockdown, as part of my involvement with the oncology specialist group of the British Dietetic Association, we developed a course on Nutrition and Cancer for new dietitians or for those with an interest in cancer. This has since been adapted to run online. This tier 1 course is on-going and any dietitians who would like to learn more about nutrition and cancer can sign up!