Gateshead Health NHS Foundation Trust is breaking new ground by delivering a unique dietetics service for those living with cancer. Diet and nutrition play a vital role in ensuring the effectiveness of cancer therapies and Macmillan Cancer Support dietitians are seeing better outcomes through improved nutrition extending both the length and quality of life for patients.
Dedicated Macmillan dietitians Emma Atkinson and Abigail Garbutt are at the forefront of this service. They deliver it through working closely with Gateshead Health NHS Foundation Trust Oncology service teams, nursing staff, St Bede’s Palliative Care Unit, and community teams to establish how best to support patients.
Emma has a master’s in dietetics and has worked for 18 years as a dietitian, with time spent in a rotational dietetics post including oncology services, before moving to her current specialist Macmillan dietetics community role at the Queen Elizabeth Hospital. Abi is also an experienced dietitian having worked within an acute NHS team at Leeds Teaching Hospitals NHS Trust before coming to the QE Hospital.
Why are dietetics and nutrition important for cancer patients?
“We have patients who are having trouble maintaining nutritional intake for a whole range of reasons,” said Emma. “From the position of the tumour impacting on oral intake through to loss of appetite due to treatment side effects, each case is different.”
Abi said: “Treatment like chemotherapy and radiotherapy does have a profound effect on appetite causing inflammation and pain. It can also cause nausea, taste changes and difficulty swallowing, and lead to extreme fatigue which can have a profound effect on weight.”
The dietitians treat all types of patients from the recently diagnosed to those across the palliative care journey. Their caseload is comprised of people living in the wider Gateshead community with specialist dietetic needs. Emma and Abi are also key members of the multi-disciplinary team (MDT) that holds regular meetings, discussing patients and their care pathways
The MDT is made up of a broad range of healthcare experts, each bringing a different perspective. Expertise includes consultants, Macmillan clinical nurse specialists, clinical psychologists, research doctors, pharmacists, chaplains, and hospital discharge coordinators. In an ongoing collaboration with the dietitians, the MDT looks at innovative care design to identify patient needs early and offer specialised nutritional support for individuals with cancer-related malnutrition.
What nutritional support is available?
Emma said: “Severe weight loss and loss of appetite leading to malnutrition, caused by metabolic changes and chronic inflammation is called cachexia. This can be easily missed or misinterpreted, especially when individuals have many symptoms because of their illness or condition.
“Notable cachexia symptoms include significant weight loss, a struggle to eat orally and loss of muscle mass.
“The psychological benefits that come from the social aspects of eating are important. Often there can be a negative psychological and psychosocial impact on the individual if they are unable to eat socially, for example with family and friends. This needs to be factored into their ongoing nutritional care.
“The care administered is a holistic process that needs to reflect the unique set of circumstances of each individual patient with their needs at its centre. There is such a broad set of circumstances that need to come together the patient cannot do it all on their own, they need ongoing support, including specialist techniques and advice.”
Collaboration is key
Collaboration between dietitians and the rest of the team is the key to a successful outcome for patients. Malnutrition within oncology can often be managed with additional supplementation through oral or enteral (tube fed) means to achieve the best clinical outcomes.
Tina Thompson, Partnership Manager at Macmillan Cancer Support said: “We’ve worked closely with Gateshead Hospitals NHS Foundation Trust to develop an approach that ensures patients and outpatients are getting the very best dietary and nutritional support aimed at improving their experience and maximising the impact of treatment.
“Eating and being able to enjoy food is a basic human experience that promotes good mental health. With expert advice and support from the Macmillan dietetic team those with eating difficulties can be supported to maintain weight, energy levels and quality of life. We are very excited to see where the cachexia work can move forward.”
For information, support or just someone to talk to at Macmillan Cancer Support call
0808 808 00 00 or visit macmillan.org.uk