Friday, June 3, 2011

Action Alert: Please write NOW to support nutrition in cancer centers

I have recently learned there is an opportunity to provide input/comments about new standards the American College of Surgeons is proposing for their Cancer Program Standards, which cancer centers will need to meet in order to receive accreditation. The deadline is tight (the new standards will be published July 1, 2011 with implementation January 1, 2012) so this is the time to act.

My letter follows. It has already been sent. Please do not copy it word for word but feel free to use it for ideas. I would suggest writing a personal paragraph of how including nutrition as a component of your cancer care did help or would have helped you or a loved one.

Now or ?????? who knows when another opportunity will arise again, at least from this aspect of care. Every possible open door is critical to try to get in. Yes, as I stated in my letter, it is inaccurate and incomprehensible that any cancer center could call itself 'patient-centered' or 'comprehensive' without providing proactive nutritional care as appropriate for all people diagnosed with cancer.

Please send the letter to the following email address
UPDATE: The committee meeting to review last comments is Wednesday, June 8, 2011. Please send in a comment before that date. Please feel free to share this opportunity widely. 

I should be working on the million+ details for my son's wedding, but this oversight or omission is too important for the 1.4 million people who will be diagnosed with cancer this year in the US. Please take a few minutes to share your thoughts on this urgent issue! 

Thank you very much,
Diana Dyer, MS, RD

June 3, 2011

To Whom It May Concern:

It has come to my attention that the changes The American College of Surgeons is proposing for their Cancer Program Standards that must be met in order to achieve accreditation do not include a standard that requires an accredited cancer center to provide nutritional counseling, or even more appropriately, nutritional intervention (i.e., Medical Nutrition Therapy, MNT) as indicated by proactive nutritional screening.

To be able to say that an accredited cancer center is providing "patient-centered care" and/or is providing "comprehensive cancer care" without including the professional expertise of a Registered Dietitian (RD) as a full-functioning member of the oncology team of professionals is both inaccurate and incomprehensible.

Cancer never/rarely happens in a vacuum, and nearly all newly diagnosed cancer patients already have a host of nutritionally related diagnoses that can compromise the effectiveness of cancer therapies and the quality of life (pre-existing diabetes being just one example). In addition, breast cancer patients frequently gain weight during cancer therapies, which is now well documented to increase the risk of a recurrence and death from breast cancer. Providing this type of information and appropriate proactive nutritional intervention and support by an RD (preferably an RD who is also a Certified Specialist in Oncology Nutrition, CSO) should be required for accreditation by all cancer centers.

It has also been estimated that up to 40 % of all cancer deaths are caused by malnutrition, not the cancer itself. Malnutrition as an expected outcome of cancer treatments is an "outdated" belief. Research continues to demonstrate that maintaining adequate nutritional status during cancer treatments (proactively and individualized interventions) is critical to optimizing the best outcome from those treatments.

Lastly, it has also been well-demonstrated that late intervention (the "crash and burn" scenario) happens all too often when the only nutritional intervention a cancer center provides is the bare minimum standard of having the  staffing and expertise of an RD be "available" (and typically reactive) but not proactively as a full-functioning member of the oncology team. This type of intervention is simply "too little, too late" and so sad to say, usually wasted time, expertise, expense, and hope.

I will end by rewording a statement I made earlier in this comment. All accredited cancer centers that strive to provide "patient-centered care" and/or "comprehensive cancer care" without question need to include the professional expertise of a Registered Dietitian (and preferably one that is also a Certified Specialist in Oncology Nutrition, CSO) as a full-functioning member of the oncology team of professionals.

Your patients will benefit from having a strong standard that includes proactive nutritional oncology care as an expectation of true comprehensive cancer care, and they will also thank you.


Diana Dyer, MS, RD
Ann Arbor, MI
• Registered Dietitian and multiple-time cancer survivor
• Author: A Dietitian's Cancer Story (1997, in continuous publication with 13 reprints)
• Proceeds donated to the Diana Dyer Cancer Survivors' Nutrition and Cancer Survivorship Research Endowment at the American Institute for Cancer Research (funding research projects since 2000)
• Former Elected Board Member of The Oncology Nutrition Dietetic Practice Group of the American Dietetic Association (Initiated the Survivorship Subunit, Standards of Professional Practice and Standards of Professional Performance, Certification Specialty for Oncology Nutrition)
• Invited Speaker to the American Society of Breast Surgeons Annual Meeting, 2007, 2005
• Website:
• Blog:


Jessica said...

Hi Diana,

Whom should we submit our letters to? This college or to our representatives?


Jessica Butcher

Jessica said...

Wow, just saw your note as to where to submit our own comments. Thank-you!!! :)

Good luck with your wedding plans! Our wedding is not until August 27th... so fun :)

- your adoring fan

Diana Dyer said...

Thanks for your comments. I just highlighted the email address in red to make it easier to see. Enjoy your wedding and the 'lead-up'. I just wrote about some of my thoughts in that regard this morning's post (Keeping my eyes open).
PS - I am more comfortable thinking 'friend' versus 'fan'. :-)

Jessica said...

Thank-you, Diana. I am very happy to call you a friend though I will always look to you as an incredible source of inspiration in my own life.

I am also still hoping to make it out for some garlic farming this July!