Nutrition promotion in community-based cancer care - a qualitative investigation of cancer support services’ perspectives, experiences and needs

Previous research has shown that cancer patients greatly value nutritional advice, particularly from health care professionals⁽¹⁾. Unfortunately, this is not widely available due to a lack of dietitians in Ireland. It is estimated that there is only 1 oncology dietitian per 4,500 cancer patients in Ireland⁽²⁾. Currently, a very small minority of cancer patients (39%) are assessed by a registered dietitian⁽³⁾. Consequently, information is often sought elsewhere, usually from non-evidence-based sources including the internet⁽¹⁾. Cancer support centres which individuals frequently utilise at various points throughout their cancer journey could provide a route for the provision of evidence-based advice. The main goal of this project was to determine the current practices of cancer support centres as well as the challenges they face in relation to delivering dietary support to cancer patients as there is very little research carried out on this topic to date. This qualitative study involved interviewing those who work in cancer support centres (n = 7) in Ireland between October and November 2021. The interviews were recorded and transcribed. The data was thematically analysed. There were four main themes which emerged: (1) need for nutrition, (2) role of nutrition, (3) role of cancer support services and (4) barriers. Evidently, there is a huge interest in nutrition information among cancer patients as participants specified that they frequently ask about it. A lack of dietetic support and widespread misinformation was also noted. Nutrition was reported to have a variety of roles. Participants mentioned that nutrition can provide patients with a sense of empowerment over their diagnosis. The dual role of nutrition i.e., benefiting both the cancer patient and the career was also emphasised. Furthermore, it was discussed how nutrition can cater to specific needs of patients depending on the cancer type, treatment type and symptoms. Participants reported that cancer support centres play an important role in providing evidence-based information using a shared learning approach as well as signposting to external resources through provision of leaflets. Lastly, there were two barriers noted which disrupted the promotion of nutritional information within cancer support centres: covid and lack of funding. Participants mentioned how covid resulted in screen fatigue in patients as majority of workshops/nutrition talks had to take place online. Lack of funding for dietetic support within cancer support centres was frequently voiced by participants as a barrier in the provision of nutritional support. Although cancer support services play a significant role in providing evidence-based information to cancer patients, there is still an increasing need for additional support. Access to dietetic input was specifically noted.