COLUMBUS, Ohio – Few cancer patients have access to registered dietitian nutritionists (RDNs), despite an estimated 80% of patients becoming malnourished at some point during cancer therapy. Cancer nutrition experts at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James) say this represents a significant barrier to treatment tolerance, effectiveness, progression and overall survival that prompts a need for urgent action to better integrate medical nutrition therapy into standard-of-care guidelines for cancer patients. In a national survey of 215 outpatient cancer centers, researchers found that the ratio of dietitians to cancer patients is 1 to 2,308, indicating a significant gap in access for oncology patients in need of nutritional care. According to previously published studies, malnutrition is associated with poor health outcomes, including decreased tolerance to cancer therapy, greater treatment toxicities, and increased mortality. In the United States, 90% of all oncology treatment is currently delivered in an outpatient care setting. For this study, researchers evaluated dietitian staffing patterns, nutrition services provided in ambulatory oncology settings, malnutrition screening patterns and referral and reimbursement practices specific to outpatient cancer centers in the United States. The survey revealed a significant gap in RDN access for oncology patients in need of nutritional care, specifically noting that: Only 53% of outpatient cancer centers screened for malnutrition among their patients. Roughly 35% of outpatient cancer centers surveyed did not use a validated tool to facilitate malnutrition screening among patients. RDNs were able to counsel an average of seven to 11 patients per day. The majority of cancer centers (76.8%) did not bill for nutrition services because it is not reimbursed through Medicare, Medicaid or most private insurers in outpatient care settings. This limits medical institutions’ financial ability to provide more extensive services. “It is critically important that cancer patients at risk of malnutrition are identified early and receive adequate nutritional care. Dietitians are uniquely trained to support the patient’s unique needs throughout the course of treatment, but they must be part of the care team from the beginning,” says Colleen Spees, PhD, MEd, RDN, associate professor in the Division of Medical Dietetics and Health Sciences at The Ohio State University College of Medicine, and a member of the OSUCCC – James Molecular Carcinogenesis and Chemoprevention Research Program. Spees notes that dietitians have extensive training in the pathophysiology of carcinogenesis as well as medical nutrition therapy and behavioral counseling to aimed at improving adherance to the evidence-based guidelines: “The literature suggests that a staffing ratio of one dietitian per 120 oncology patients progressing through active treatment is effective for reducing malnutrition risk, treatment toxicities, improving quality of life and decreasing treatment interruptions and hospital readmissions.” Results are reported in the November 2019 issue of the Journal of Oncology. This staffing study was led by Oncology Dietetic Practice Group (ON DPG) of the Academy of Nutrition and Dietetics, which included authors from Ohio State, National Cancer Institute, University of Pennsylvania, Roswell Park Comprehensive Cancer Center, Dartmouth and Cambia Health Solutions. Funding support was provided by ON DPG. A new clincal trial led by Spees and OSUCCC – James medical oncologist Carolyn Presley, MD, in partnership with Fang Fang Zhang, MD, PhD, of the Friedman School of Nutrition Science and Policy at Tufts University offers remote nutritional counseling sessions with a dedicated registered dietitian to lung cancer patients. Once the dietitian had determined the optimal diet for each patient, medically tailored meals are delivered straight to patients’ homes. Trial accrual is expected to begin in August 2020. To learn more, visit cancer.osu.edu. About the OSUCCC – James The OSUCCC – James strives to create a cancer-free world by integrating scientific research with excellence in education and patient-centered care, a strategy that leads to better methods of prevention, detection and treatment. Ohio State is one of only 51 National Cancer Institute (NCI)-designated Comprehensive Cancer Centers and one of only a few centers funded by the NCI to conduct both phase I and phase II clinical trials on novel anticancer drugs sponsored by the NCI. As the cancer program’s 356-bed adult patient-care component, The James is one of the top cancer hospitals in the nation as ranked by U.S. News & World Report and has achieved Magnet® designation, the highest honor an organization can receive for quality patient care and professional nursing practice. At 21 floors and with more than 1.1 million square feet, The James is a transformational facility that fosters collaboration and integration of cancer research and clinical cancer care. For more information, visit cancer.osu.edu Media Contact: Amanda J. Harper OSUCCC – James Media Relations Direct Line: 614-685-5420 Central Media Relations: 614-293-3737 Amanda.Harper2@osumc.edu