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Review our enhanced safety measures. Learn about our appointment types or call 913-588-1227 to schedule.

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Nurse Navigators

A cancer diagnosis can leave you feeling stunned and overwhelmed. But at The University of Kansas Cancer Center, you don’t have to navigate your cancer journey alone.

While our physicians and staff use the best technologies to tailor treatment to each person's individual needs, our nurse navigators steer patients and their families through an unfamiliar world of appointments, resources, fears and questions.

Nurse navigators guide cancer patients

From initial diagnosis until your treatment plan is established, our nurse navigators guide you through initial testing and appointments, answering questions and providing emotional support every step of the way. Your navigator then remains an additional resource for you throughout your cancer journey.

Nurse navigators make sure everything is ready for you to see a specialist, including collecting medical record information for the doctor’s analysis, getting orders for additional tests when needed and identifying support services.

Nurse navigators also:

  • Talk to you when you're unclear about your diagnosis
  • Answer questions you may have about your diagnosis and treatments
  • Prepare you for your first visit with a physician
  • Provide emotional support for you and family members

Connecting you with resources

Nurse navigators also connect you with community resources to help with issues you may have. For instance, they can help patients traveling from a long distance connect with lodging options or schedule an appointment with a nutritionist. They provide emotional support and clinical expertise, as well.

The University of Kansas Cancer Center launched its nurse navigator system in 2011 as a way to help improve the patient experience and increase overall patient satisfaction. Nurse navigators are responsible for working step by step with new patients to help make their cancer journeys a little easier.

For information on our nurse navigator program, please call 913-588-3671 or send a fax to 913-588-7799.

Innovative partners, programs

Established and expanded by Tom and Teresa Walsh, with generous support from the Joe and Jean Brandmeyer Family Foundation, the Allen J. and Gloria Block Family Foundation, the Gerson Family Foundation and Treads & Threads, the nurse navigator program now has more than 30 disease-specific navigators – the largest in the region and one of the most extensive in the nation.

“We’re connected for a lifetime,” says Teri Banman, director of nurse navigation, who’s also developing professional standards on a national level for the Oncology Nursing Society. “I love getting to know my patients and their families – answering questions, filling in gaps and solving the puzzle.”

Thanks to a groundbreaking gift from Uhlig LLC, patients receive a set of personalized appointment and treatment guides via overnight mail. Using the most advanced software, information technology and production capabilities, the company develops, produces and distributes custom guides that make an overwhelming amount of data relevant to each patient. The guides, part of a pilot program partnership, feature:

  • Disease-specific information
  • Directions
  • Schedules
  • Notes of hope from survivors with similar cancers
  • Photos and messages from individual treatment teams

“With a cancer diagnosis, all brain activity stops, so having the right information at the right time is so reassuring,” says Tom Walsh. “From our navigator to our guidebooks – a load was taken off our shoulders.”

Support the nurse navigator program

Double your impact thanks to:

  • A dollar-for-dollar matching grant of up to $100,000 provided by the Gerson Family Foundation. Funds will provide continuing education for nurse navigators. Contact Hospital Fund Development at 913-588-2800.
  • A dollar-for-dollar matching grant of up to $300,000 provided by the Walsh family to grow the nurse navigation program. Learn more.

 

Care designed around you

The nurse navigator program at the University of Kansas Cancer Center provides personalized care to help patients navigate through their cancer journey from diagnosis to survivorship.

Speaker 1: Welcome to Bench to Bedside, a weekly series of live conversations about recent advances in cancer from the research bench to treatment at the patient's bedside.

Speaker 2: 58-year-old Bryan Mann is prepping food for the week.

Bryan Mann: This is my go-to.

Speaker 2: But 80 pounds ago, his choices or much different. Cabbage and carrots weren't on the menu.

Bryan Mann: A lot of processed foods, lots of fried foods, cakes and cookies and donuts. When I would travel, donuts would be my go-to.

Speaker 2: But a prostate cancer diagnosis changed all that.

Bryan Mann: Cancer is always a word that you don't want to hear.

Speaker 2: But when he heard it more than a year ago, he was 316 pounds.

Bryan Mann: I realized that if I did a journal on my eating, I wouldn't be writing all day long. I just ate because I enjoyed eating.

Speaker 2: And not just cancer. High blood pressure, diabetes and the nutritionist at the University of Kansas Health System made him rethink what he was putting into his body, which now includes more fruits and vegetables and a new appreciation for water, less sugar, salt, and portion control.

Bryan Mann: It finally clicked, if you eat this, this is what you get. If you eat something else, then this is what you can have.

Speaker 2: Bryan is a married father of three and heads up the congregation at Bethel Church.

Bryan Mann: I think it really had to do with a combination of, how do you want to spend the rest of your life?

Speaker 2: Since his diagnosis, the link between nutrition and cancer is clear.

Bryan Mann: Nutrition helps. Even if you haven't been diagnosed with cancer, maybe you have a family member that has been diagnosed. It's time to make changes.

Speaker 2: Especially for the grandkids.

Bryan Mann: Nutrition is really important. If you have been diagnosed, give your body a fighting chance.

Dr. Jennifer K.: We have all heard that eating a well balanced diet, nutrient-rich with foods that include fruits, vegetables and proteins are good for our health, but undergoing cancer treatment can complicate that. At a time when optimal nutrition is so important, treatments like radiation therapy and chemotherapy can cause patients to lose their appetite. Good morning. I'm Dr. Jennifer Klemp sitting in for our Cancer Center Director, Dr. Roy Jensen. And with me is Dr. Jill Hamilton-Reeves, a certified oncology dietician and our co-director of the Nutrition Shared Resource at the University of Kansas Cancer Center.
Today we are talking about the importance of nutrition and diet during cancer treatment, and thank you for joining us today on Bench to Bedside.

Dr. Jill H.: It's great to be here. It's good to see you too.

Dr. Jennifer K.: You too. Not only is Dr. Hamilton-Reeves, a well known researcher, but she's also a good colleague and so I'm excited to talk to you about why nutrition is so important to cancer treatment today.

Dr. Jill H.: Do you want me to take that as a question?

Dr. Jennifer K.: Sure, go in.

Dr. Jill H.: Well, as you had mentioned a cancer treatments place a demand, an extra nutritional demand on the body. And certain treatments actually create more of a specific nutritional demand. So getting patients ready so that they have the nutrients that they need at the time of treatment is really important. And then more generally, there's a lot of data suggesting that people that lose muscle mass and strength have consequences in the way that we can treat them. So they might have more side effects from chemotherapy, or they may not be resilient and strong enough to take the full dose of the medication so they have dose reductions. It's associated with more postoperative complications if people don't have enough muscle mass and strength at the time of their surgery. So, yeah, that's why we're here. That's why we want to help build resilience and help people undergo their treatments and get on with their lives.

Dr. Jennifer K.: That's great. And I think one of the most common things that we hear from patients, especially during treatment, is that sometimes things just don't taste the same. Sometimes it's hard to deal with some of the side effects or even some metallic tastes or they're not getting enough water. What are some of the tips that you and your team would give to patients as they struggle to find those nutrient-rich foods and hydration?

Dr. Jill H.: Yeah, absolutely. I'm going to go back to a comment you made in the introduction about appetite. So just speaking really generally about appetite, one of the things that we work on first with patients that are struggling with that is to stay ahead of the hunger and stay ahead of the appetite. Because once that sets in, then people actually become a little bit more nauseous and it's harder for them to eat.
So one of the strategies that we use is having them eat smaller, more frequent meals, maybe five to six times a day. And if they're still struggling to focus on protein first, again, going back to that comment about really wanting to keep people strong and keep their muscle mass and that protein is going to help sustain those muscles.
And then you had talked about some of the side effects from very specific treatments. You mentioned the platinum drugs and how they can make a metallic taste. There are some really simple things to do. So using plastic silverware or wooden silverware instead of metal silverware actually kind of helps with reducing that taste. Other things that we've done is tart foods seem to go over really well. So we had a participant on study once that he was really struggling and I was helping him brainstorm tart foods. And once he discovered the clementine, he was like, "They're so easy to peel." And so he'd keep a bag of them with him everywhere.

Dr. Jennifer K.: His go-to snack.

Dr. Jill H.: Right, right.

Dr. Jennifer K.: Great.

Dr. Jill H.: And it's not just to go into all of those would take a lot of time, but we'll be talking about some of the services that are offered here, so that can get lined up with someone that can help them troubleshoot.

Dr. Jennifer K.: But what I do hear you say is we should be tracking and encouraging our patients to track some of these effects.

Dr. Jill H.: Absolutely.

Dr. Jennifer K.: So anything that they're experiencing, they just probably need to share that with their dietician or their provider.

Dr. Jill H.: Right. Good communication is so important and being curious if nutrition could play a role.

Dr. Jennifer K.: You bet. You bet. And so that kind of ties into what most cancer patients have is someone who's sort of their right-hand or their caregiver. How do you encourage caregivers to really address or identify some of these issues and be part of that process?

Dr. Jill H.: And getting ready for the show and thinking about what messages are important to share, I think caregiving is exhausting. And so I know you come at this more from a psychology lens, and so I'm actually going to steal from your field.

Dr. Jennifer K.: Perfect.

Dr. Jill H.: And just remind people that they really need to take care of themselves so they can take care of others.
And then focusing on the food. Again, approaching with curiosity, what are your favorite foods right now? I mentioned Mr. Clementine guy. If somebody could have kept bringing him clementines he would've loved that. So what are your favorites? What kind of things are you craving right now? I also think that just generally speaking, a lot of times we have these meal trains and things to bring foods.

Dr. Jennifer K.: We call it cards and casseroles.

Dr. Jill H.: Yes.

Dr. Jennifer K.: And it's the joke we make but yes,

Dr. Jill H.: And it's so loving.

Dr. Jennifer K.: It is loving, yes.

Dr. Jill H.: One of the things that I think might help take that to the next level is reminding people to put those foods into individual portions that people can heat up. Because the appetite and how people eat, it's just so sporadic at this time. And so if they're in the freezer and waiting for them, I just think that's so much more helpful.

Dr. Jennifer K.: Yeah, that's a great idea.

Dr. Jill H.: Thank you. And then also the caregivers coming to the visits with the nutritionist if possible. They might hear different things and then like we're talking about the tips and tricks for cancer treatments, they could go home and kind of line some of those things up for their loved one.

Dr. Jennifer K.: And so that can be part of their homework. Because I think that so many caregivers are trying to figure out, "Well, what do I do?" And they feel somewhat they need some instruction. So being kind of that teammate and helping to get the nutrition planning going and maybe going to the grocery store would be a good task for a caregiver.

Dr. Jill H.: It's a great way to channel that nervous energy.

Dr. Jennifer K.: Yes. All right. Well, if you guys are just joining us, we have Dr. Jill Hamilton-Reeves here talking about cancer treatment and healthy nutrition. We also have Megan Peters, who's manning our questions here in the studio. So if you guys have any questions, please use the link and use the hashtag Bench to Bedside and ask Dr. Hamilton-Reeves any of your questions that you have about dietetics or lifestyle during or post-treatment. She is an expert and lives the lifestyle as well, which is very commendable. So any questions so far, Megan?
Megan Peters: None so far.

Dr. Jennifer K.: All right. I know you guys have them. Dietetics is always a hot topic for our patients and their supporters.
You're also leading a lot of efforts nationally and one of the things that you're doing is how nutrition influences surgical outcomes. Can you tell us a little bit more about that study?

Dr. Jill H.: Yeah, well it's an incredible privilege. It's not just me, this is leveraging the NIH and how they fund research, and then the Clinical Trials Network across the United States in order to see this question through and see if we have an answer.
Essentially what we're doing is, I had mentioned at the beginning how cancer treatments increase nutritional demand. And and different treatments have different specific demands on the body. So surgery itself, we're getting cut open and the body is going to respond to that as it should. And so we want an immune response and then the immune response then talks to the the body to get inflammation and then you're supposed to resolve that and heal. One of the things that we have found is with some of the major surgeries that immune response might be a little over-reactive, the inflammation hangs on a little too long, and then that makes patients more susceptible to developing infections and getting complications.
The other thing that we see in some major surgeries, bladder cancer surgeries, one of them, that's what our project is focused on, is we see that after these major surgeries, people lose a lot of weight without trying. And it's not the good kind of weight. It's the wasting away, losing their muscle and their strength, and it's really hard to watch. And so we did a small pilot study here at KU at the Medical Center, where we looked at two different kinds of drinks to meet the nutritional demand of patients at surgery. One is kind of your basic drink before and after surgery-

Dr. Jennifer K.: Like a protein/nutritional [inaudible 00:10:53].

Dr. Jill H.: Yes, protein, calories, some good vitamins and minerals, good stuff. There's nothing bad in it. And then the other drink is essentially that same type of drink, but we've spiked it with some additional nutrients that we think are very specific to the immune system's needs and the resolving the inflammation and preventing the body from eating up its own muscle and fat after the surgery to heal.
And when we did the small study, we did find clues along the way that that perhaps we are supporting the immune system better. Inflammation is resolving faster. People kept their muscle on a little bit better. And really the part that got the national attention and some international attention is that we found fewer infections and fewer complications after the surgery. So right now we have this national trial where we're trying to see, what we found here in this small setting, is this real, is it worth asking people to get these doctored up drinks that do cost a little bit more in order to have better outcomes from their surgery?

Dr. Jennifer K.: Great. And that's a practical approach to using the body to enhance that immune response. But I think from the patient perspective, shorter times maybe in healing, nutritional value at the same time, that's a real positive study. So I know you got a lot of patient input on that. It's at how many sites across the country now do you have this study open?

Dr. Jill H.: Yeah, that's a great question. So I think last I looked, we are around 20 or 30 sites.

Dr. Jennifer K.: That's great.

Dr. Jill H.: We're still getting things revved up to get sites open. So you and I go to Chicago here in a week or so. And so when you're at meetings, if you can talk it up, I'll be talking it up. And for listeners, if you know someone that is having a surgery to remove their bladder, have the mask.

Dr. Jennifer K.: Absolutely.

Dr. Jill H.: Because this trial should be open to everyone that has access to clinical trials.

Dr. Jennifer K.: Right. And the great part is this is a study that was built here at KU and is now helping patients across the country. So congratulations.

Dr. Jill H.: Yeah, we're a hub for this. Can you believe it? It's so great.

Dr. Jennifer K.: It's fabulous. I think Megan has a few questions for us. So great.
Megan Peters: True, I have quite a few questions. The first one is how do you increase hemoglobin white cells and red cells through treatment through nutrition?

Dr. Jill H.: Oh yeah. So that's a great question. I have a feeling that that might be related to some of our people that are dealing with a recovery from bone marrow transplant or some of the other cancer treatments. So I think working with a dietician is probably going to be my first go-to because really understanding what's behind the pathology of that is going to be super, super important.
I think two of the very general things that I could say on the line is really thinking about food safety. So making sure that that you're washing your foods and keeping the food safe if you are in a vulnerable place as far as your immune system goes. And then the other piece I had mentioned protein. I really think that's going to be an important part of being able to support those red blood cells because of the iron that that contains and some of the other minerals. But again, if this is a very specific scenario, which it sounds like maybe they're going somewhere there, reach out and get a clinical dietician that's credential to help.

Dr. Jennifer K.: Great. Okay.
Megan Peters: Another question I have, for those who do not have caregiver support and do not feel well enough to prepare meals, what resources are available for patients to receive healthy meals?

Dr. Jill H.: Oh, that is a great question.

Dr. Jennifer K.: It's a very good question.

Dr. Jill H.: Yeah. And maybe you can help with some of these too.

Dr. Jennifer K.: Sure.

Dr. Jill H.: Getting a social worker involved is extremely important. Especially if the person asking this question might have limited resources as far as funds go. For seniors, there are lots of different meal delivery services, so Meals on Wheels is a popular one, but there's many others that again, if you're plugged in with a health care team and a social worker, they can really help line up those resources in a way that astounds me and I love social workers. They're just so caring.
The other piece is for people that might have a little more means, there are a ton of meal delivery services out there and without endorsing any one, there are some that are even very specific to the side effects from cancer. So a Google search, reaching out to us maybe offline-

Dr. Jennifer K.: Correct.

Dr. Jill H.: ... afterwards. Because again, I don't want to sound like I'm endorsing any kinds of companies. But I do want listeners to know that that is an option that's out there.

Dr. Jennifer K.: And there's also local kind of regional grocery store chain that the dietitians work with our patients and they also do delivery to the home. I know you have to hit a certain threshold, but that could be another good solution for someone who has limited caregiver support.

Dr. Jill H.: Great idea.

Dr. Jennifer K.: Good.
Megan Peters: Our next question is from Joe who has prostate cancer and he would like to know about milk products. He wonders if the hormones could be passed along.

Dr. Jill H.: That's kind of-
Megan Peters: That's a little deep question.

Dr. Jill H.: That's a deeper question. Just to bring the whole audience into some of the controversy with dairy and prostate cancer is that for about a decade or so, there's been an association as you look at population studies of increased dairy consumption, increasing the risk of prostate cancer. And so several researchers have spent some time looking at that to look at mechanism of why could that be. And essentially it comes down to some people have more of a genotype or a blueprint in their DNA that makes them a little more susceptible to increased risk of prostate cancer with dairy consumption than others. And what that looks like if you don't have your genome, typically people of color have the genotype that increased the risk of dairy and prostate cancer risk and then you had asked about hormones.
So hormone... Wait, before we go onto hormones, one piece that's really important with dairy is that if men can have prostate cancer, they get treatment, the prostate cancer comes back and they go on to get hormone treatment. One of the side effects from hormone treatment is actually losing bone mass. And so at the expense of scaring people away from dairy, I think really talking with someone about your history individually is very helpful to know if dairy is something you want to continue consuming or not consuming. Many of our patients with prostate cancer do continue consuming dairy, but they do avoid taking high dose calcium supplementation because over the daily value, which is two grams of calcium, really isn't going to be necessary for healthy bones. And could be associated with that signal that we see with increased risk of prostate cancer and dairy. Is that calcium component.
Now going to the hormonal piece, which is a whole another story. So prostate cancer is often a hormonally dependent type of cancer as far as the hormones in dairy. There really isn't compelling strong evidence that the hormones in milk are going to lead to cancer. That being said, if you are concerned about the byproducts and milk and the farming industry and what you support, going to a milk that might be produced in a farm where they don't use exogenous hormones is something that you can absolutely do, but it's not necessarily something that is evidence-based or part of our advice.

Dr. Jennifer K.: I support it, right.

Dr. Jill H.: Was that clear enough or did I go all over the place?

Dr. Jennifer K.: No, that's a hard question though. It's a very loaded question.

Dr. Jill H.: It had a lot to it.

Dr. Jennifer K.: It is. So what you're talking about too is the need for that individual dietetics sort of assessment. And I think that probably is a good segue into some of the resources we have available at KU Cancer Center. Do you want to talk a little bit about what's available and how folks would potentially access that if they have additional questions?

Dr. Jill H.: Yeah, absolutely. KU Cancer Center is a bigger entity, I think than many people on the outside may realize. So there are those of us that get the luxury of discovery and having research teams and doing all of those types of things. But then there are those of us that see patients day in and day out.

Dr. Jennifer K.: Correct.

Dr. Jill H.: So our team that sees patients day in and day out at the KU Cancer Center, there's spore dieticians, three of them are board certified in oncology nutrition as well. And I'm sure that fourth one we'll get there someday. She's a newer dietician.
One of those dietitians is actually a person that we coauthored with.

Dr. Jennifer K.: Oh, good.

Dr. Jill H.: She was one of my first master's students and you were on that paper and really helped us. So that's very fun that she is really kind of grown. They grew up so fast.

Dr. Jennifer K.: They do grow up so fast. We started when we were 12.

Dr. Jill H.: Yeah, back to [inaudible 00:20:15] again, she's definitely getting experience and really kind of leading the way in that team. The dieticians are available to everyone at all of the Cancer Center sites. They see patients that are going through their treatment. They also see survivors and they even have open times to see people that are at higher risks. And so that is an option.
Some of the things that they're focused on right now, they've really become a lot more involved in BMT, so bone marrow transplant. They're getting more and more involved in the surgical setting somewhat because of the conversations we have back and forth from research to clinic that they are seeing what we're doing on this national study and trying some early adoption of that as well.
For dietitians, just to be quite frank is not enough. So if you don't get in right away, please be patient. Keep asking. It's something that our health system probably needs a little more volume about that this is important in order to sustain our patients.

Dr. Jennifer K.: Absolutely. And I think some of the unique things they've been building is we do have a new women's cancer program. And through that, there's a dietician on the multidisciplinary team with a medical oncologist, a gynecological oncologist, a dietician to talk to high-risk women with genetic mutations. So there's a lot of unique services that are being provided through dietetics. And then, like you said, everyone needs some information. So I know we're working hard to develop some online and digital tools to help our patients as well. So I think that there's more to come and the first part is assess what is going on, talk to your provider, and get a referral to see the dietician. Or ask for the referral.

Dr. Jill H.: Right. Absolutely.

Dr. Jennifer K.: Megan, did you have any other questions for us?
Megan Peters: I do have a few more questions. So this is from Tammy. She says, "I am stage 1A hormone positive. I've had a lumpectomy radiation and Tamoxifen for five years. I heard Tamoxifen can make us gain weight. How can I prevent that from happening?"

Dr. Jill H.: Actually this dovetails into some of the work we've done together and that you've led for years. Yes. So at the beginning of the show, they saw the video of Bryan. Bryan was one of our research participants in prostate cancer where losing weight was actually important for the time that he was at. So we've been talking about building resilience, but that's not a blanket statement. So we wanted to keep muscle on him and keep him strong, but losing some of that excess fat was important for what we're trying to do. Same thing with our breast cancer patients.

Dr. Jennifer K.: Correct.

Dr. Jill H.: After breast cancer treatment, a lot of times women do really struggle with keeping excess weight off. And so we've had several investigators, Dr. Klemp, as well as Dr. Fabian, Dr. Nye, working in a specific program to help women manage their weight and survivorship.

Dr. Jennifer K.: And a portion, about two thirds of those women were on anti-hormones. Like our question asked about Tamoxifen. And I think the interesting thing of Tamoxifen is, as clinicians and when you anecdotally look at the population, you do see weight gain, but the research says that you don't. But when your patients are gaining weight, when they're uncomfortable, when their body changes, those are things we have to pay attention to. So I think once again, each person's individual, but all of that slows down the metabolism. So from that specific question about Tamoxifen, it's so effective for cancer treatment, we want patients to stay on it, but we want to help them lose weight at the same time. And the research is a little wishy washy in regards to whether Tamoxifen really is causing that weight gain.

Dr. Jill H.: And it's part of embracing a new normal too. So sometimes I think particularly women as far as societal pressure, we focus so much on what the number on the scale might be as far as weight. But there's lots of ways to be healthy, not necessarily what that scale is telling us. So really focusing on the things that you can, so more activity, really thinking about non-starchy vegetables, eating a high quality diet. And then if you are frustrated, reaching out to someone. Because you may think that we're doing everything that we can possibly do, but people outside ourselves can see some of our blind spots and really help us troubleshoot.

Dr. Jennifer K.: Absolutely. We need support.

Dr. Jill H.: And then credential professionals are there to help.

Dr. Jennifer K.: Absolutely. Megan, did you have another question?
Megan Peters: Yes, I do. This one is from Julia. She says, "I had a really toxic reaction to Opdivo. In addition to losing my hair and extreme fatigue, I lost my appetite. I'm on hydrocortisone two different dosages twice a day now, and although I'm able to eat a little, I don't eat much and I've lost a lot of weight and muscle mass and I'm always tired. Any suggestions?"

Dr. Jill H.: Yeah. It would be really great if you could work with a dietician. That's the first comment and I feel for you. I really do. One the first thing that comes to mind when I think about that storm of just all kinds of things happening and the physiology working against us, one of the underlying issues is this issue of fatigue. And I think in zooming way out and helping patients, thinking about movements and movement therapy is, is a way of getting in touch with the body, listening to the body and what the body needs. Again, I'm not saying do that instead of reaching out to a credential professional, but not being afraid to get up and move around. That tends to help reset our appetite. It helps engage some of the muscles so they're more prime to use the nutrients that you're giving the muscle to store some glucose, to rebuild your muscle and have ample protein stores to do so.
So that is a way simplistic answer to something that sounds complicated, but I really do encourage you to reach out to a credentialed professional. And then if there was the kind of the first step I would suggest a first step. So I'm getting some movement.

Dr. Jennifer K.: Right, keep moving. And then I think also making sure that your provider knows that you're experiencing nausea.

Dr. Jill H.: That's so true.

Dr. Jennifer K.: Because there are a lot of new sort of high-powered anti-nausea meds, but those could be used short term and that could help reset that. And then like you'd talked about earlier, sometimes nutritional drinks and supplements are a good gateway-

Dr. Jill H.: They're a great tool.

Dr. Jennifer K.: ... and we encourage that, especially during those times where the appetite is not as strong, but we know we need to get some protein and nourishment.

Dr. Jill H.: Yeah, great idea.

Megan Peters: Actually building on that comment, the next question was how do I know what vitamins and supplements I need or that could be helpful during treatment?

Dr. Jill H.: A great question.

Dr. Jennifer K.: Another loaded question.

Dr. Jill H.: It is, yeah. The canned response to such question is that we don't recommend nutritional supplements for cancer prevention or cancer survivorship as far as just like a blanket statement. Instead we really think about working with an individual to get them in an optimal range for all of their different nutrients. One of the very tough lessons that nutrition science has learned over the decades is that using individual supplements, one at a time or high doses, not only does it not prevent cancer like we thought it might because we had some mechanisms that we thought we could chase, but actually in some instances we increase the risk of cancer.

Dr. Jennifer K.: Correct.

Dr. Jill H.: And so I'm not saying that to scare anyone as far as supplements go, but I'm going to go back to the healthcare provider here, and making sure you're very transparent about the supplements you all ready take. Really asking yourself are you sure, "Is this something that I need to take?" And then working with someone to really only take the things that are necessary.

Dr. Jennifer K.: Absolutely. I think so many patients don't think about telling us some of the medications or alternative therapies that they're on. And some of them are actually contra-indicated are actually bad or make the chemotherapy or the immunotherapy or whatever treatments we're giving. They don't make them as effective. So we do need to know about that. And as you said, we supplement based on a need that we identify, and I think since I work so much in women's cancers, vitamin D tends to be one of the big questions we get and that would be informed off of a blood test where we see what the levels are and we use therapeutic types of of regimen. So once again, like building on what you said, this has to be informed by the provider and certain types of blood tests and so forth that we would do.

Dr. Jill H.: Right. Great.

Dr. Jennifer K.: Great.
Megan Peters: So the last question we have for now from Ron just recently diagnosed with CML, taking Gleevec for a month and fighting extreme fatigue combined with leg numbness and weakness. His doctor thinks the meds are killing off by bad blood cells faster than he can produce new ones. Is there anything he can do to speed up red blood cell production?

Dr. Jill H.: That's actually very similar to the first question we had. Again, I encourage them to reach out to a professional.

Dr. Jennifer K.: I think that would be the best.

Dr. Jill H.: Do you have anything?

Dr. Jennifer K.: No, that would be the best because he's probably someone that could benefit even from things like chair exercise in addition to some dietary modification. I think so many people think, "Well, if I can't get up and do like formal exercise, that's not going to help." But like you highlighted, the movement helps us with the nutrients and we have a whole series of handouts on chair exercises. So that is something that your providers have access to.

Dr. Jill H.: Right. The piece that we're trying to avoid is bed rest.

Dr. Jennifer K.: That's correct.

Dr. Jill H.: Extended bed rest. So anything outside of bed rest is-

Dr. Jennifer K.: Is good stuff. Absolutely.

Dr. Jill H.: ... movement that counts and celebrate that for sure.

Dr. Jennifer K.: Absolutely. And it will get better. That's the part that if things aren't getting better, we need to know about that as well. So there should be sort of that ebb and flow and that's part of the cancer journey. But tracking that, being an engaged patient is part of that process. I can't emphasize that enough. It's so important. Because without our patients reporting what their symptoms are and how they're ebbing and flowing, we can't help and support them. So our patients have to be their very own advocate as well as the caregiver.
As we sort of end today, we've had some great dialogue. We've learned about the amazing research that Dr. Hamilton-Reeves is doing and she has many other projects going. So in the future, what can we look forward to? What else do you have going on"

Dr. Jill H.: This is where I can monologue for a long time.

Dr. Jennifer K.: Well, we have about a minute for your monologue.

Dr. Jill H.: Okay. Well, we featured Bryan so stay posted for the results on that study because we are really curious. 13 different cancers are associated with obesity. We're really curious if we can develop a regimen that disrupts that link.

Dr. Jennifer K.: Absolutely.

Dr. Jill H.: So I wanted to come back to that. We also have a couple of new studies that are really exciting. One of them is going to be opening up in palliative care. We're looking at bitter taste. And it's a sensory study so that we can help people deal with these altered taste changes during therapy by better describing it and then perhaps using some off label medications to improve those side effects. We have a study that just got accepted for publication where we looked at a carb controlled diet in order to prevent bladder cancer from coming back.

Dr. Jennifer K.: There you go.

Dr. Jill H.: Dean Maliski, the School of Nursing dean, she has a study, an androgen deprivation therapy that-

Dr. Jennifer K.: With prostate.

Megan Peters: Yeah, in prostate cancer. We've all ready completed enrollment, but we're waiting on the results. I could go on, but I can see from your eyes [crosstalk 00:00:32:08].

Dr. Jennifer K.: I hope everyone's hearing. Is that we have... You just listed off like six different research opportunities. So, so many of our patients, maybe they don't qualify for a treatment trial, but we do have lifestyle trials. There's trials looking at nutrition, exercise, movement. So those are things that we want our patients to ask about too because that could be something available to a longer term survivor as well, or someone like you mentioned in palliative care, patients who have metastatic disease. So we want across the continuum to know that we possibly have something, so make sure that you're asking and we're evaluating you just in case you qualify.

Dr. Jill H.: That's a great comment. So if you're asking your care provider if nutrition could help in a curious way and they say, "Ah, there's really not much." Then ask, "Well, is there a clinical trial?"

Dr. Jennifer K.: [inaudible 00:32:57].

Dr. Jill H.: Because there might be, because if we don't have evidence to have it in clinical care, we might be working on building that evidence.

Dr. Jennifer K.: Exactly. Exactly. So to learn more about nutrition and cancer, visit kucancercenter.org/nutrition. We are so thankful that you came and shared the morning with us. We want everyone out there to join us next week at 10:00 AM for Bench to Bedside. And thank you all for watching.


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