A cancer diagnosis is often the first milestone along a sometimes confusing road. The nutrition program at the Simms/Mann UCLA Center for Integrative Oncology is designed to simplify at least some of the journey, helping patients to empower themselves by optimizing their nutritional wellness during cancer treatment.
Eating healthfully not only strengthens a patient's body, it can help reduce side effects from treatment, prevent treatment delays and improve quality of life. That's why Sarah Washburn, MS, RDN, CSO, was drawn to this area of nutrition and why she joined the Simms/Mann Center in November 2024.
Based in the Santa Barbara clinic, Washburn, a board-certified specialist in oncology nutrition, brings with her more than 30 years of experience as a dietitian nutritionist, the last 20 years dedicated to working with people with cancer.
"Once I started working with cancer patients, I knew this was the field for me. Nutrition can be a critical part of the treatment process, and a lot of people haven't really focused on eating during treatment, which may be different than their usual eating habits, so we need to quickly provide them with personalized recommendations to help them handle their chemotherapy and other treatments," Washburn said.
The nuances of these recommendations take into consideration the patient’s specific cancer and cancer treatment, current laboratory values, medications, other medical conditions the patient may have, food preferences and socio-economic influences, among other factors.
She said patients tend to embrace and rely on the expertise of the staff with the Simms/Mann Center nutrition program. Nothing gives her more satisfaction, she said, than when patients tell her the program has helped them get through their treatment feeling as strong and well as possible.
"I am completely humbled by working with people who are going through a significant struggle in their life,” Washburn said. “It is a privilege to work with these patients, when they allow us to come into their worlds and help them.”
Providing tools for optimal nutrition
Washburn, one of four dietitian nutritionists with the Simms/Mann Center, meets with patients in-person or via telemedicine as soon as possible after a diagnosis, to help them and their families/friends – who may assist with meal preparation – with tools for eating optimally during treatment.
This can make a big difference in patients being as comfortable as possible, said Julian Davis, MD, a hematology-oncology specialist at the Santa Barbara Cancer Care clinic.
"By the time of diagnosis, many of these patients are behind, nutritionally, from the cancer itself and decreased appetite,” Dr. Davis said. “Especially with gastrointestinal cancers and gynecologic cancers, decreased appetite can lead to significant weight loss and even malnutrition, before we even see them. That makes their body more fragile, and it makes treatments like chemotherapy much more challenging, in their weakened state.
"With our nutritionists like Sarah, we hope to start a dietary plan early to prevent further weight loss in patients, or even improve their nutritional status," Dr. Davis said. "Having this specialty training and skill sets that the dietitians have, especially when it comes to oncology, can make a critical difference in how treatment progresses. With some of these patients, nutritional status is actually the limiting factor, or bottleneck, where we can't even proceed with treatment until that improves."
Ongoing consultation
After the first consult with a patient, Washburn may see the patient several times during their treatment course, depending on the patient’s medical condition, side effects and questions they may have.
"Side effects may require a change in food choices during treatment,” she said. “For instance, if a patient has nausea, getting vegetables from a cup of vegetable soup may be better tolerated than from a salad. Often, digestion is impacted by treatment and cooked foods tend to be more preferred and tolerated than raw foods.”
Washburn also evaluates the nutritional supplements patients may want to take during their cancer treatment.
"I've had patients bring me bags of supplements that they have been taking, sometimes for years. So our first priority is to determine if they are safe and compatible with the patient’s specific medical condition and cancer treatment," she said. "The supplement industry is like the Wild West. We first try to make sure we know what exactly is in a supplement, then determine if it is safe."
But for optimal nutritional health, it's hard to beat whole foods and natural ingredients, she said.
"We definitely recommend to our patients that the best way to get the metabolic benefits of nutrients, such as vitamins, minerals and phytonutrients, is from real food. Those nutrients play a key role in how the immune system works, how the GI tract works, how muscle mass is preserved and how people recover from treatments," she said.
Dr. Davis emphasized the importance of this role of dietitians in oncology, noting that even the most advanced cancer treatments are effective only if the patient is strong enough to withstand them.
"We are so blessed to have these registered dietitian nutritionists on our staff, and the impact they make,” he said. “When a patient can continue to eat well and have good caloric intake, that allows us to kind of stay on schedule with the therapy plan. The RDNs provide a very critical dimension of the actual cancer treatment plan for many patients. That along with services like social workers and counselors allows us to provide complete cancer care all under one roof. That's the goal."
Washburn said that kind of teamwork is one reason she is so happy to be with the Simms/Mann Center.
"It is such a collaborative effort with everyone here,” she said. “We have amazing doctors and staff, all working together to help these patients. It really is an honor to have the opportunity to help them.”
