Written by Lizzie Davies.

Lizzie is a final year student dietitian at King’s College London. Her current interests in dietetics include women’s health and cystic fibrosis. In her spare time, she loves to bake and cook, and volunteers in the charity sector. Find her on Instagram @lizziedietetics.

The concept of palliative care can often evoke strong emotions or worry; however, it actually encompasses a holistic approach that aims to improve the quality of life for patients and their families who are facing problems associated with life-threatening illness. The fundamental core of palliative care is to reduce or relieve suffering of patients by addressing the physical, psychosocial or spiritual difficulties that they have.

In a recent webinar titled ‘Nutrition support for palliative cancer patients’, Rachel White, who works as an NHS specialist oncology dietitian and is lead dietitian here at Nutritank, discusses the role of nutrition in palliative cancer patients. In the webinar, Rachel shares lots of valuable experiences that she has had in her years of working in cancer care.

Rachel discusses how there is a lack of dietitians working in palliative care, and how important it is for other healthcare professionals working with these patients to be ready for conversations around nutrition and nutrition support both with patients and the MDT, and be confident in raising questions or concerns around this. There are many factors that can affect food and fluid intake in patients with cancer including:

• Physical- nausea and vomiting, dysphagia, constipation, mucositis, oral problems e.g. thrush and pain
• Psychological- anxiety, difficulty sleeping, depression, family worries and spiritual distress.

Nutrition has many possible roles in palliative care including preventing or treating avoidable malnutrition and establishing normality as nutrition is not purely to nourish the body, but also holds great emotional weight for the patient and their family. Rachel advocates for a patient centred approach, ensuring that the team is aware of what is important to the patient and their family. For example- do they want to improve their quality of life? Do they want to be fit enough for treatment? Or do they wish to be able to eat socially and keep some normality in their life?

In the second half of the webinar, Rachel shares practical advice in regard to nutrition in these patients. These are focused around how to manage poor appetite, when to utilise oral nutritional supplements, managing patient and family expectations as well as how to open up or address conversations around artificial nutrition support like feeding tubes or parenteral nutrition, and some of the practical challenges around this. Rachel also highlights a key difficulty in this patient group which is cancer cachexia that can lead to poorer outcomes for patients.

To learn more about nutrition in palliative cancer care, access the full webinar here