Pathways to Prevention (P2P) Program

Rhone Levin, M.Ed., RDN, CSO, LD, FAND

Ms. Levin

Florida Cancer Specialists & Research Institute

Presentation Abstract

Cancer Treatment Side Effects and Nutrition Impact Symptoms: Are Oncology Patients Receiving Adequate Nutritional Care?

Malnutrition of cancer patients is associated with worse outcomes and increased cost of care. The cancer itself, and/or oncology treatment, lead to complex side effects and Nutrition Impact Symptoms (NIS) that develop rapidly and change in character and intensity throughout treatment, which can interfere with adequate intake, and lead to malnutrition. Early identification of declining nutritional status and appropriate nutritional intervention is key to successful oncology care. Despite malnutrition’s detrimental effects, few patients who present with increased risk of malnutrition are identified, and many do not have access to Registered Dietitian Nutritionists (RDN) to provide nutrition assessment and intervention. There are a paucity of guidelines and standards of care regarding malnutrition screening of oncology patients, and a lack of access to timely and adequate oncology nutrition care. The oncology RDN is trained to provide in depth nutrition assessment and medical nutrition therapy to prevent and address the modifiable aspects of nutrition impact symptoms and nutritional decline during cancer treatment. Additionally, cancer survivors benefit from individualized evaluation and counseling to promote wellbeing through weight management and risk reduction diet. Yet most cancer facilities do not provide oncology nutrition services or are under-staffed and unable to provide adequate levels of oncology nutrition services. This presentation will review the current status of oncology nutrition practice and suggest areas of future research that support the development of guidelines to bridge the gap between patient needs and provision of adequate oncology nutrition care.

About Ms. Levin

Rhone Levin is a Registered Dietitian Nutritionist, and board-certified specialist in oncology nutrition, who has provided direct patient care for oncology patients in a variety of settings, including: acute, ambulatory, adult, pediatric, and transplant. Ms. Levin received her B.S. from University of Wisconsin-Madison, and M.Ed. from Pennsylvania State University. She has held an executive committee position in the Academy of Nutrition and Dietetics’ Oncology Nutrition Dietetic Practice Group for 16 years, furthering her interest in developing the oncology nutrition skillset among Registered Dietitians and oncology nurses. She held a leadership role in the development of the Board Certification examination for Oncology Dietitians, was an original team member involved in the publication “Standards of Practice and Standards of Professional Performance for Oncology Dietitians,” and was a workgroup member for the Academy of Nutrition and Dietetics’ Evidence Analysis Library development of Guidelines on Oncology Nutrition. Ms. Levin was a workshop committee member and presenter at the National Academies of Science, Engineering, and Medicine Workshop: Examining Access to Nutrition Care in Outpatient Cancer Centers, in 2016. She has co-authored several journal publications and book chapters, and is a current author of chapters Malnutrition screening and nutrition assessment of the oncology patient, and Symptom management in the oncology patient in “Oncology Nutrition for Clinical Practice” (2021).

Ms. Levin disclosed the following conflict of interest for this workshop: oncology nutrition consultation for NutriCare ongoing study (Bristol Myers Squibb grant).

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