Nutrition Services

Recommendation:

Nutrition services are available for patients and their families and caregivers offering surveillance, education, and coordination of services needed to maintain hydration, weight, and nutritional status, as well as dietary and lifestyle guidance associated with reduced cancer risk.

Overview

Proactive nutrition services help patients thrive, with better adherence to cancer treatment and supportive care goals, improving their continuity of treatment. Nutrition has quickly become a service that patients expect, and one that can determine their choice of treatment center.

The Commission on Cancer requires accredited programs to have a referral system for nutrition services.  While this can be on- or off-site under current standards, the strong preference would be for easy/on-site access for patients. The National Accreditation for Breast Centers standard 2.15 lists nutrition counseling as a support service, though again not as a requirement.

Dietitian responsibilities:
  • Collaboration and coordination of care in a multidisciplinary team setting, managing issues impacting the patient’s nutrition and hydration status through appropriate nutrition screening, assessment, and intervention across the care continuum.
  • Addresses and integrates side effect management amd integrative medicine issues in the context of evidence-based nutrition care and services.
  • Provides nutrition and diet information about reducing cancer risk and cancer recurrence risk through direct education, educational materials, and services to the community.

Standard

Certification

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN), who has worked in clinical practice for at least 2 years, including 2,000 hours working with oncology patients during the past 5 years, can sit for an exam to become a board certified as a specialist in oncology nutrition (CSO) This credential is offered through the Commission on Dietetic Registration (CDR), on successful passing of this exam. As of 2016, there were 744 CSOs in the U.S., with representation in every state. Learn more.

Resources to Help

Certification

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN), who has worked in clinical practice for at least 2 years, including 2,000 hours working with oncology patients during the past 5 years, can sit for an exam to become a board certified as a specialist in oncology nutrition (CSO) This credential is offered through the Commission on Dietetic Registration (CDR), on successful passing of this exam. As of 2016, there were 744 CSOs in the U.S., with representation in every state.

Insurance Considerations

Coverage for nutrition services is limited under Medicare to those with a renal or diabetic diagnosis, but is often available for patients with commercial insurance. At this time, most cancer program report that they do not bill for nutrition services, in order to eliminate any financial barrier to care. Nutrition is considered supportive care, keeping patients on therapies that are reimbursable and improving the cancer program's bottom line by attracting patients with the “added value.” Additional information can be found at eatright.org, under medical nutrition therapy, with information on templates, forms and reimbursement issues.

 

ACCC Member Program: Good Samaritan Regional Medical Center, Samaritan Pastega Cancer Program, Corvallis, Oregon.

In 2014 the Samaritan Cancer Resource Center, the local free medical clinic, and Samaritan Health Services’ dietitians collaborated to pilot That’s My Farmer, a program specifically for cancer survivors. This research-based nutrition and wellness program educates cancer survivors through hands-on learning about anti-inflammatory nutrition, healthy food shopping and preparation, the benefits of eating local fresh fruits and vegetables, and the positive impact these foods can have for patients recovering from cancer.

Samaritan Cancer Resource Center leadership championed the program, successfully engaging other organizations and support throughout the Samaritan Health Services system to provide local cancer survivors with research-based information to help improve their overall well-being. Cancer survivors (participants) were invited to bring their spouse or caregiver with them to weekly classes and trips to local farmers’ markets. Learn more.