Friday 30th September 2016
Mac Voice, the magazine for Macmillan professionals: Autumn 2016
Heather Owen is a specialist dietitian for people with oesophageal, stomach or bowel cancer
My title is Macmillan Gastrointestinal (GI) Dietitian and I work in our local chemotherapy unit and at outpatient clinics trust-wide, supporting people with oesophageal, stomach and bowel cancers.
Up to 80% of patients diagnosed with a cancer of the GI tract can have problems eating, swallowing, digesting food and maintaining weight. Preventing and addressing malnutrition is my priority, as malnutrition increases length of hospital stay, increases risk of infection, decreases tolerance to treatment and reduces overall survival rates.
I see all patients with oesophageal and stomach cancer from the time of diagnosis as many already have difficulty eating and also weight loss at this early stage. I ensure these patients, along with those diagnosed with a bowel cancer, have prompt dietetic input throughout their cancer journey as required.
How I can help
My priority is to ensure patients have adequate nutrition to prevent or reverse weight loss and address cancer-related symptoms, which can often be improved by altering the diet. Nutritional supplements are often required and if swallowing problems are significant, tube feeding may also be necessary.
Not being able to eat and not knowing what to eat, can not only impact psychologically on patients, but also on family and friends who may be providing meals for patients. Instead of being enjoyable, meal times can become a source of worry, stress and frustration. In providing dietary advice, I aim to address not only the physical symptoms but also the emotional concerns around nutrition and cancer.
Being the only Macmillan GI
Dietitian in the trust and managing large numbers of patients with significant nutritional needs is challenging, but also rewarding.
I saw a gentleman recently who had been diagnosed with bowel cancer and lived alone. He had loose bowelmotions that were so severe he could not leave his house. He felt worried about the surgery that lay ahead, confused about what to eat, concerned about weight loss and isolated due to his symptoms preventing him continuing with social activities. After listening to his concerns and advising on a suitable diet plan, after two weeks his weight stabilised, symptoms significantly improved, and he was able to leave his house and spend time with friends. In addition, he felt prepared for the upcoming surgery.
In just under two years, I have set up the Macmillan GI dietetic service. Waiting times and weight loss which were seen previously have now both been significantly improved as a prompt and specialist service is now available. I have been working to identify best practice across the UK and am gradually implementing aspects of this within the Northern Trust to improve the nutritional care for our patients with GI cancers.