National Cancer Institute
Presentation Abstract
Oncology Nutrition Research and Care: Time to Move the Needle
Malnutrition occurs in up to 80% of cancer patients at some point during cancer care, and the majority of patients exhibit nutritional impairments at their initial oncology visit. Poor nutritional status negatively affects cancer health outcomes, including morbidity and mortality, hospitalizations, readmissions, and other variables that may increase cost of oncology care. Unintentional weight loss of just 5% of body weight decreases survival in cancer patients. Despite the strong associations of malnutrition with poor health outcomes, little is known regarding how nutritional interventions and dietary patterns affect the response to cancer therapies. Although systematic reviews and meta-analyses document benefits for increased micronutrition intake during treatment, gaps in research continue to exist. Unfortunately, the few studies that have attempted to measure nutrition interventions during oncology care have been plagued by poor study design and methodological implementation flaws.
A significant number of patients at nutritional risk remain undetected due to the lack of routine nutrition screening during diagnosis and throughout treatment and fewer than 60% of at-risk individuals receive any nutrition intervention. Hence, the vast majority of cancer patients treated in outpatient cancer centers do not have access to oncology nutrition services. Nutrition services are considered a cost burden and the Centers for Medicare and Medicaid Services and other payers do not reimburse for oncology nutrition services. Research is needed to inform if and how nutritional therapy can potentially improve cancer health outcomes, including infection risk, hospital admissions, tolerance and response to treatments, quality of life and survival.
About Ms. Trujillo
Elaine Trujillo, M.S., R.D., is a Scientific Program Analyst with the Division of Cancer Prevention, National Cancer Institute (NCI), National Institutes of Health (NIH), where she analyzes scientific, programmatic, and administrative data to support research in cancer prevention, early detection, and screening. Additionally, Ms. Trujillo is a nutritionist and is the NCI co-lead of the NIH Office of Disease Prevention’s Pathways to Prevention Workshop: Nutrition as Prevention for Improved Cancer Health Outcomes, which is focused on examining the evidence that providing nutrition screening and nutrition intervention during cancer care improves outcomes. Prior to joining NCI, Ms. Trujillo was a Senior Clinical and Research Dietitian at Brigham and Women’s Hospital, Harvard Medical School in Boston, where she designed and organized clinical nutrition research. Ms. Trujillo is active with the Oncology Nutrition Dietetic Practice Group of the Academy of Nutrition and Dietetics, serving as Chair 2012–2014, and currently as Project Chair of the Nutrition Access and Cancer Health Outcomes Subcommittee. At the state level, she has served as Chair of the Education and Research Division for the Maryland Academy of Nutrition and Dietetics. Ms. Trujillo holds a Bachelor of Science in nutritional science with a minor in biology from University of Delaware. At Texas Woman’s University, she earned a Master of Science and completed a dietetic internship. Ms. Trujillo uses a variety of approaches to share her views and findings about nutrition with others interested in health, including scientific journal articles, book chapters, abstracts, and authoring nutrition cookbooks, such as “The Calories In Calories Out Cookbook: The Toolkit You Need to Make Smart Calorie Decisions Every Day” (Experiment, 2014).