Dietitian offers tips for navigating nutrition in cancer treatment and prevention

Mary Jo Turner loves being a dietitian, and getting to work with cancer patients on how they can lead healthier lives is the driving force behind her passion.

“The people are what interested me in becoming a dietitian specifically within cancer,” said Turner, who works as a nutritionist embedded within MUSC Hollings Cancer Center. “The patients I have met make me question the priorities in my own life. They’re going through so much — you get them at the worst time in their lives — and they’re so desiring to learn and do better for themselves. I really just want to help them.”

At Hollings, she meets with inpatients and outpatients across the continuum of cancer care to provide proactive, individualized nutrition advice. Her work addresses cancer prevention, treatment, recurrence, palliative care and survivorship as she works with each patient to meet them where they are in their journey and to help them navigate the associated challenges.

 

Turner can provide advice on maintaining weight before, during and after cancer treatments — including radiation, chemotherapy and surgery — and can help patients optimize their nutrition to set them up for better outcomes. She works with patients to help them navigate side effects from cancer and treatment, including common symptoms such as nausea, taste alteration and appetite loss.

She can also assist with eating problems created by difficulty swallowing, possible side effects during radiation and chemotherapy treatments and the need for feeding tubes, which is particularly common for patients with head and neck cancers.

“The type of advice I give varies based on whether the person has active cancer, is currently going through treatment or has recovered from cancer. It also depends on the type of cancer they have and how advanced it is,” said Turner. “Maintaining a healthy weight, diet and physical activity level is important for anyone, as making healthier choices can also lower the risk of developing cancer for people without a diagnosis.”

What is the link between diet and cancer?

Diet and physical activity are important for preventing many diseases, and cancer is no exception. Being overweight and feeding your body unhealthy foods — such as those high in refined sugar and saturated fat — can increase your lifetime risk of developing cancer.

According to the American Cancer Society, at least 18% of all cancers diagnosed in the U.S. are related to excess body weight, physical inactivity, excess alcohol consumption and/or poor nutrition, meaning they could have been prevented. Excess body weight alone is thought to be responsible for about 11% of cancers in American women and about 5% of cancers in American men.

People who want to lower their risk of cancer through a healthy diet should limit or avoid foods like red or processed meats, sugar-sweetened beverages and highly processed foods. The methods used to cook certain foods can also make a difference, said Turner, as overcooking meats or applying high heat to products like olive oil can create carcinogens that otherwise wouldn’t exist.

“There are carcinogens that are created when certain parts of a meat are grilled or blackened. Grilling isn’t necessarily bad, but you don’t want to burn the meat,” said Turner. “The longer you cook a meat, the more you take away some of its properties, so you’re also taking away some of the nutrients or benefits that would otherwise exist when you overcook it.”

 

Turner’s advice is based partly on the work of Hollings researcher David Turner, Ph.D., who is unrelated to her. He has led numerous studies linking cancer risk to the accumulation of advanced glycation end products (AGEs) — or proteins and lipids (fats) that go through a chemical alteration when they’re exposed to sugars through processing or overheating. AGEs are involved in nearly every chronic disease, and having an overabundance of them in the body increases cancer risk.

Because many foods have had chemicals added to preserve their shelf life in stores, she encourages people to learn more about what’s in the foods they’re eating and to be aware of the chemicals they may be putting in their bodies. While fast food and microwavable meals may be convenient on busy days, consistently fueling your body with these types of foods isn’t a great idea.

She also advises that people pay attention to their portion sizes when they do indulge in foods that are processed or high in refined sugars or saturated fats, as it’s important to only do so in moderation.

“I’m from New Orleans — everything is pretty blackened and fried. There’s a fine line between indulging in those foods occasionally versus having them every day,” said Turner. “It’s important to be informed about what you’re eating.”

Navigating diet with a cancer diagnosis

While diet is important to cancer prevention, it’s also important during cancer treatment. For people who already have a cancer diagnosis, gaining a lot of extra body fat through unhealthy dietary choices can actually increase the size of their tumor, as the tumor is a part of their body mass and will grow as their body mass increases.

Because side effects from treatment can cause a patient’s appetite to crash, it’s also important to ensure cancer patients don’t lose too much weight, as being undernourished can make doctors push the “pause” button on treatments.

Turner works with patients to navigate these challenges by encouraging smaller, more frequent meals for patients who don’t feel hungry and by providing recommendations regarding vitamins, minerals and/or nutrition supplements when a patient is having trouble getting in a variety of foods. She can help provide recipes for well-balanced meals based on the patient’s interests and offer tips for prepping meals in advance, which often makes weeks full of treatments easier on a patient’s caretakers.

“You get to learn about patients' personal lives. They’re just great people, and they touch my heart every day. It is an honor to be able to help them.”
— Mary Jo Turner, RD

For patients with taste alterations, she recommends soft, bland foods, such as mashed potatoes or mac and cheese, that can be eaten in small pieces and ingested without the need for much chewing, helping to quickly get foods past the patient’s taste buds.

Turner meets with Hollings patients as frequently as they’d like, and she reviews each inpatient’s medical chart at least once a week to ensure patients are maintaining a healthy weight and aren’t struggling with any eating-related challenges. If a patient hasn’t eaten well in five days or if he or she begins having trouble swallowing, the electronic medical record system will automatically trigger a request for her to stop by to see the patient.

While Turner has always been passionate about her time at Hollings, the circumstances created by the COVID-19 pandemic have offered her a reminder of how much she enjoys connecting with Hollings’ patients on a personal level.

“When the pandemic began, Hollings never shut down. I was talking with patients over the phone who had been strictly locked up in their house and would only interact with other people when home health workers came to visit. They had limited visitors, so I was talking with them at a time when they really just needed someone to talk with,” said Turner.

“You get to learn about their personal lives. They’re just great people, and they touch my heart every day. It is an honor to be able to help them.”

Scheduling a consultation

Hollings patients who are interested in a consultation with Turner should ask for a referral from a member of their care team to see the dietitian at MUSC Hollings Cancer Center. Once the referral is submitted, an appointment will be scheduled at their convenience. Follow-up visits do not need additional doctor’s referrals. Appointment times are available Monday through Friday. Patients can be seen before or after a regularly scheduled clinic visit or during an infusion visit as available.

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