How a Registered Dietitian Nutritionist (RDN) Can Help During and After Cancer Treatment

Hello @muradangie and others reading this great blog about RDN and cancer.

I would so like to share how RDNs have helped me. I have had three surgeries of the upper digestive tract for carcinoid cancer. It has not been easy adjusting to a new normal. Eating has been difficult, often because I really don't feel hungry like I used to. I also feel full quickly. Since my surgeries, I have had two visits with RDNs and they have been most helpful.

I was given great information about why my appetite was not like it was prior to the surgeries and great information about how to get as much of the important nutrients into my diet.

The work that RDNs have done have given me insight and guidance. As a mentor on Mayo Connect, I've recommended their services to others who have had problems with developing good eating habits after surgeries and cancer treatments.

I am so glad you found working with RDNs helpful. It sounds like your cancer journey was a difficult one in regard to getting adequate nutrition. Has your appetite improved?

The staff dietician visited me during one of my chemotherapy infusions. She had a great diet plan already mapped out, just not for me. Apparently reading my medical record and seeing my allergies did not occur to her. I mentioned that I could only eat about 10% of the food on the plan, she said she would get back to me and never did. Last year I had another health issue, I tele-visited another hospital with yet another registered dietician and I did see her multiple times to my detriment. This last visit was about the 5th in 20 years, for different issues. I am too out of the box for most apparently, and the right one is out there, my patience is wanting, at this point. Sorry, that this is not a glowing review of capabilities, this is not a comment on the person.

@muradangie
No, my appetite has not really improved all that much but I do eat because I know I need to😊.

I told one RDN, in jest, that I thought that the surgeon had tampered with my appetite control switch, and she said that given the area of my tumor (duodenal bulb) that my idea might not be far from the truth. She explained that we have two places where our appetite is controlled. One is, of course, in the brain, but the other is in the area of my surgeries. Therefore, my appetite might not come back like it was prior to the surgeries. This understanding helped me to accept a "new normal." It was a great educational experience for me and helped me to understand my situation better.

I also learned to pack in the protein early in the meal. So, I don't make a habit of eating the bread and other carbs first but make the protein a priority. Those are just some of my gleanings from working with RDNs.

I so appreciate the work that you all do. You are an asset to patients and often are not recognized and fully appreciated, but I've found that you are gems!

My husband had the same experience with RD's - both at the local cancer infusion center and at the hospital post pancreatic cancer surgery. He had a pancreatectomy (leaving him a surgically induced Type1 diabetic) as well as his gall bladder, spleen, and 50% of his stomach removed in Aug. 2022. He's had many post surgical complications, but after the required last 4 "clean up" chemos since surgery, he's recovering ok. None of the dieticians he's spoken with have been able to provide an acceptable diet for his surgical status AND Type 1. He's managing with a continous glucose monitor and insulin injections, but I absolutely KNOW he should be managing with diet too. When your digestive system has been "re-plumbed", the average Type1 diet just doesn't work! Like you, my patience is waning with trying to find the "right" RD who can actually help. I agree, s/he has to be out there, but it's like looking for a needle in a haystack.

It can be challenging when you have food allergies and/or intolerances. I am sorry your experiences did not go the way you would have liked. It can be helpful to track your typical intake for a few days prior to a visit to provide more information about what foods you are able to eat and provide this information at your visit. I hope you can find a dietitian who is able to help you.

@muradangie Thank you for your thoughts. My comment was aimed at the dietician leaving me in the lurch. The idea in life is to face the challenge, not run from it. I was fine with my diet through chemotherapy. When in the hospital I was consistently given food I was allergic to, this became old quickly.

@flashbackfcr,
I am sorry to hear of your husband's pancreatic cancer diagnosis. The treatment, surgery, and complications sound like a long journey. I am not sure where you are getting care but wonder if you have had the opportunity to see a diabetes educator? They can be from a variety of health disciplines, including registered dietitians, nurses or pharmacists. They have additional credentials such as a CDE (Certified Diabetes Educator) that indicate expertise in diabetes. Just wondering if you have access to these professionals who have this additional training.

Thanks for your thoughts, Angie. My husband's surgery was at Mayo in Rochester, MN. We do have a diabetes nurse educator there and he's very good, however he does defer to the the nutritionists when it comes to diet recommendations. And the nutritionist, who I'm sure is also very good, doesn't have suggestions that mesh with both the complicated surgery and diabetes. Basically, it's "eat what appeals to you and cover what you eat with insulin".

It's a good thing I love pickled herring because by the end of the first and second rounds of chemo that's all I could stomach. I just started my third round of chemo and I don't expect it to be any different.