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Dr. Debu Tripathy is a professor and chairman of the Department of Breast Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, in Houston.

Dr. Debu Tripathy discusses the FDA approval of Enhertu in unresectable or metastatic hormone receptor HR+, HER2-low or -ultralow breast cancer.

An Expert Explains the Enhertu Approval in HER2-Low and -Ultralow Breast Cancer

One of the many issues that patients with cancer face is food insecurity and malnutrition, according to Dr. Anna Arthur, who added that based on this gap in the treatment space, investigators launched the NOURISH trial (Nutrition Outreach in Systems of Healthcare) which will investigate the impact of addressing these needs among patients with blood cancers undergoing transplant or cellular therapy.

“We know that individuals who are diagnosed with cancer and going through treatment are at higher risk of compromised nutritional status and malnutrition compared with healthy individuals without cancer,” said Arthur,   the study’s primary investigator, in an interview with CURE®.

In the interview, Arthur delved into insights on the NOURISH trial and highlighted the importance of addressing food insecurity and malnutrition in patients with cancer. She also shared what types of foods are most important for patients with cancer to consume during their treatments.

Arthur is currently the Director of the Medical Nutrition Science Program, as well as a tenure-track Assistant Professor in the Department of Dietetics and Nutrition at the University of Kansas Medical Center.

: How does food insecurity impact cancer treatment outcomes overall for patients?

: Patients [with cancer] who start treatment malnourished, or who become malnourished during their cancer treatment, are at higher risk of several different negative outcomes. These [outcomes] include reduced quality of life; increased susceptibility to infection and illness; increased hospital admissions, as well as increased time spent in the hospital if they're admitted; and reduced tolerance to cancer treatment. This could lead to things like treatment breaks, delays in initiating their treatment, dose reductions in the treatment that they're receiving, or even in severe cases, early cessation of treatment.

These factors also put these individuals at higher risk of morbidity and mortality. When a patient [has] a cancer diagnosis and [is] going through cancer treatment, [they are more likely to be] at a higher risk of compromised nutrition, if they are also food insecure and unable to afford or access the food that they need to help maintain their nutritional status during treatment. This [is] an added obstacle in the prevention of malnutrition and optimizing nutritional status.

What types of foods are most important for patients with cancer to consume during their treatments? Which nutrients might act like fuel for the body to recover during treatment?

There are recommendations that we give to patients with cancer during treatment for dietary intake, as well as how we prioritize types of medical nutrition therapy interventions that we provide. [These recommendations are highly] individualized; [they] vary depending on what type of cancer patients have, what stage the cancer is when diagnosed, the type of treatment that they're going to receive and other health conditions that they may be presenting with.

For patients with cancer that are at high risk for malnutrition, focusing on foods that are high in calories and high in protein are often prioritized to help minimize weight loss and with maintenance and prevention of muscle mass loss. We know that weight loss, especially in the form of muscle loss, during cancer treatment, is associated with those [poor] outcomes. Therefore, maintaining the adequate intake of calories and protein during cancer treatment can help reduce the risk of those negative outcomes, minimize that weight loss and preserve muscle mass. [This is] so that the patient can better tolerate their treatment, enhancing their recovery after treatment.

How does the NOURISH trial aim to simplify the process of accessing nutritious foods for these patients?

We'll be providing patients with bags of food that are provided by our food bank partners at each of the four cancer centers that we are doing this trial at. We're working in Kansas City with Harvesters Food Bank, and these food bags will provide enough food for two to three days of balanced nutrition for one person. When patients come into clinic for their cancer treatment, they'll receive their bags in a discrete manner, and they'll also be receiving bags two times per week.

We anticipate, by providing the food bag when they come in for their cancer treatment, we're ensuring that they have the food that they need to maintain their nutritional status, and that avoids having to procure the food themselves, either at a grocery store or at a food pantry, which can be a really major burden during a very stressful time in their life, when patients are not feeling well. Additionally, [if the patients are] food insecure, they may also lack resources like money and transportation to be able to go out and get food on their own.

In addition to the food bags, we’re providing patients with recipes and video cooking demonstrations in the bag and on a centralized website so that patients and their care partners can know and don't have to figure out on their own how to use the content of the bags that they receive. [This] helps them manage the side effects they may be experiencing so that they can get the nutrition that they need, even if they are experiencing symptoms and side effects.

How do you envision it influencing cancer care and health system policies in the future, particularly regarding food insecurity and malnutrition in these patients?

I'm hopeful that we will be successful in demonstrating positive outcomes; the positive outcomes that we're mainly looking at are cost effectiveness as well as reduced malnutrition or preventing malnutrition.

This trial could then pave the way for other health systems and cancer centers around the country to provide a similar program to patients who need it as part of their standard of care. That would be beneficial for food insecure patients, and maybe even someday, we could reach a point where we could provide food for all patients with cancer, regardless of food insecurity.

Why is it important for patients with cancer undergoing transplant or cellular therapy to prioritize calorie and protein intake, even if it means adjusting their normal, healthy diet?

As a registered dietitian and nutritionist, I am trained to prioritize nutrition problems that patients come to us with based on what the most urgent need is the. During cancer treatment, often the most urgent need is to prevent or treat malnutrition and help manage side effects, preventing the loss of muscle mass.

Cancer treatment is not the time to focus on losing weight. While we still must be attentive to other nutrition-related issues that the patients may present to us with, like diabetes or high cholesterol or micronutrient deficiencies, minimizing weight loss and muscle mass loss during cancer treatment is the highest priority, even in patients who are overweight or obese.

There's quite a bit of data showing that somebody can be malnourished and have low muscle mass, even if they're obese. It is really important that we prioritize preventing malnutrition and weight loss. A lot of times in patients who are diagnosed [with cancer] who are overweight or obese, they think, ‘I'm losing weight so easily now, great,’ but it is really not, especially if that's muscle.

How can patients advocate for themselves if they're experiencing food insecurity or malnutrition?

In patients experiencing food insecurity or malnutrition that haven't been identified and addressed by their care team, I would encourage the patient themselves or their care partner, if they have social support with them, to speak up about their concern to one of the members of their care team, whether it be a physician, a nurse, a registered dietitian, social worker, or someone else. That care team member can help refer them to the appropriate health care provider, like a dietitian or a social worker, which would be the most common types of providers that could help refer them and connect with resources that would help address those needs.

Oftentimes food insecurity and malnutrition are overlooked, especially malnutrition among individuals who are overweight or obese. If they're having a difficult time consuming a regular diet, as much food as they consumed prior to their diagnosis, or if they are having trouble accessing food, affording food, they should not be afraid to advocate for themselves and ask for help with those things.

Transcript has been edited for clarity and conciseness.

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Addressing food insecurity and malnutrition is crucial for cancer patients, particularly those undergoing transplant or cellular therapy. The NOURISH trial aims to assess the impact of providing nutritious food to these patients, potentially improving treatment outcomes and reducing negative effects like increased hospital admissions and treatment delays. High-calorie and high-protein foods are emphasized to prevent weight and muscle loss. The trial also seeks to simplify food access through partnerships with food banks, offering food bags and educational resources. Success could influence future cancer care policies and standard practices.

Dr. Anna Arthur discusses how the NOURISH trial is addressing food insecurity and malnutrition in patients undergoing treatment for their blood cancers.

Understanding Food Insecurity and Malnutrition During Cancer Treatment

The recent American Cancer Society’s Cancer Statistics, 2025 report was released revealing a sobering trend for pancreatic cancer. Despite increases over the past three years, the five-year relative survival rate for pancreatic cancer remains flat at 13%, and just 8% for people diagnosed with the most common form of pancreatic cancer, pancreatic adenocarcinoma. 

According to the American Cancer Society’s Cancer Statistics, 2025, report, an estimated 67,440 Americans are expected to be diagnosed with pancreatic cancer in 2025, and an estimated 51,980 are predicted to die from the disease this year.While overall cancer mortality is decreasing, the annual report highlights that pancreatic cancer remains the third-leading cause of cancer-related deaths in the United States. Evidence suggests that it is on track to become the second-leading cause in the coming years. The five-year relative survival for Black people with pancreatic cancer is lower at 11%, consistent with the disparities seen for cancer overall.

As one of the five most lethal cancers, pancreatic cancer, unlike lung, breast, prostate and colorectal cancer, is the only one that does not have a standard screening strategy. The lack of progress highlights the need for focused research efforts to narrow the gap between outcomes from pancreatic cancer and other major cancer types. 

There is good news. Overall, cancer mortality rates are decreasing. Although pancreatic cancer continues to lag behind, successes in other cancers can provide a roadmap and highlight focus areas that may have a positive impact on outcomes for patients with pancreatic cancer in the years to come.

“While we’ve seen incremental progress in the treatment of pancreatic cancer, it’s sobering to know that pancreatic cancer survival has not increased and remains the only major cancer with a five-year survival rate below 20%,” said Anna Berkenblit, M.D., MMSc, Chief Scientific and Medical Officer at PanCAN. “The minimal improvement in survival in recent years is in part related to more people being diagnosed with incidentally detected, well differentiated neuroendocrine tumors, which are less aggressive than pancreatic adenocarcinomas. This highlights the need for screening and surveillance strategies for pancreatic adenocarcinoma as well as the need for better therapies, which will require more research funding.”

The bad news is that there continues to be a lack of research funding for an early detection strategy and better treatments for patients.

Dr. Berkenblit added, “I am hopeful that with the approval of new drugs for the treatment of diabetes and obesity, both of which are risk factors for pancreatic cancer, and the development of targeted therapies like RAS inhibitors for pancreatic cancer, we will begin to see improved outcomes in the years ahead.” 

Learn more about how you can help by reading the article: 

A Call to Action: Progress for Pancreatic Cancer Depends on You.

Pancreatic cancer remains a significant challenge, with a stagnant five-year relative survival rate of 13%, and only 8% for pancreatic adenocarcinoma. The American Cancer Society's 2025 report estimates 67,440 new cases and 51,980 deaths in 2025, highlighting its status as the third-leading cause of cancer-related deaths in the U.S. Despite overall cancer mortality declining, pancreatic cancer lacks a standard screening strategy, underscoring the need for focused research. Promising developments in diabetes and obesity treatments, and targeted therapies like RAS inhibitors, offer hope for future improvements.

The recent American Cancer Society’s Cancer Statistics, 2025 report was released revealing a sobering trend for pancreatic cancer.

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Pancreatic Cancer Diagnoses and Mortality Rates Rise 

An expert spoke with CURE® about the emotional bonds that can develop while treating patients with cancer.

Kate, Princess of Wales, ‘Got So Attached’ to Her Port During Cancer Treatment

Kate, the Princess of Wales, has announced that her cancer is in remission, but revealed in a candid moment that she felt connected to her port mechanism through which drugs were administered.

During a Jan. 14 visit to Royal Marsden Hospital in London, where she’d received treatment, the princess said of her port, “I got so attached to it,” with the Associated Pres noting that she joked that she had been almost reluctant to have hers removed when told she no longer needed it.

Dr. Frank J. Penedo of Sylvester Comprehensive Cancer Center, in an interview CURE®, said that he doesn’t often hear of patients becoming attached to their port, but he is familiar with patients developing an emotional connection with their care teams.

“It's not uncommon… for the patient to have a sense of loss and disconnection from their care team, because they become such a critical part of their lives and such an emotional connection occurs with them,” said Penedo, Associate Director, Cancer Survivorship and Translational Behavioral Sciences; Director, Cancer Survivorship and Supportive Care; and Director, Biopsychosocial Mechanisms and Health Outcomes (BMHO) Lab, at Sylvester Comprehensive Cancer Center, in Miami, Florida .

While at the Royal Marsden, Kate thanked the medical team for their support and spoke with other patients, the Associated Press reported.

“I wanted to come and show my support for the amazing work that’s going on here, and for those who are going through treatment and having such a hard time,” she said.

Kate announced in March 2024 that she had received a 

. The type of cancer has never been disclosed.

Penedo spoke with CURE® about the emotional bond that can form between patients with cancer and their care teams.

I do hear [about] a lot of emotional attachment to the care teams. It's not uncommon, even when it's good news and the patient is told, ‘You're in remission, the treatment has worked, we'll see you in months,’ for the patient to have a sense of loss and disconnection from their care team, because they become such a critical part of their lives and such an emotional connection occurs with them.

These are individuals — and I have to really give credit to not only the physicians, but the nursing teams, the social workers, the psychologists — the entire care team that works with these patients really are invested in not only making sure that the treatments are set up so that the patient can develop an optimal response, but also that they can live their best possible lives.

So it's [about] adjusting to the new normal, and of course, these patients are going to develop a connection to those individuals that are helping them navigate the challenges of living with cancer.

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An expert explains the new phase of Princess Kate’s cancer journey as she enters remission.

Kate, Princess of Wales, Enters ‘Survivorship Care Period’ of Cancer Journey

Kate, the Princess of Wales, has announced that her cancer is in remission.

“It is a relief to now be in remission and I remain focused on recovery,” the princess, born Kate Middleton, 43, wrote on Instagram on Jan. 14. “As anyone who has experienced a cancer diagnosis will know, it takes time to adjust to a new normal.”

“What Kate is moving into is what we refer to commonly as the ‘survivorship care period,’” Dr. Frank J. Penedo of Sylvester Comprehensive Cancer Center, Miami, Florida, explained in an interview with CURE®.

Penedo, Center Associate Director, Cancer Survivorship and Translational Behavioral Sciences; Director, Cancer Survivorship and Supportive Care; and Director, Biopsychosocial Mechanisms and Health Outcomes (BMHO) Lab, at Sylvester, spoke with CURE® about cancer survivorship and the importance of patients maintaining a long-term relationship with their care team. Penedo also serves as a Professor of Psychology and Medicine, at the University of Miami.

What Kate is moving into is what we refer to commonly as the survivorship care period. The [National Cancer Institute] defines a cancer survivor as somebody from the day of diagnosis through the balance of their life. Survivorship care is the care that a person is receiving in addition to their medical treatment post-completion of their primary treatments. In that survivorship care, it's really critical that the patient remains very involved with their care team for a variety of reasons.

Patients with cancer, even if they go into full or partial remission, have a greater chance of developing secondary cancers, for example. There's the issue of recurrence as well, which is critical. There has to be ongoing monitoring, whether it's through blood test, through imaging and so forth.

There's also the issue of the treatment-related side effects, and those side effects can be persistent, they can be chronic and they can be debilitating. It's really important for an individual who's been treated for cancer, even if they're in remission, to have that engagement with the care team, so the care team can monitor their levels of fatigue, pain, sleep difficulties and other lifestyle factors that are impacted by cancer.

When Stacy Deems received a diagnosis of breast cancer in September 2019, her first concern wasn’t about her health, it was how she would afford treatment. The divorced mother of two teenaged boys worked for a nonprofit organization with a basic health plan.

“When I brought up (costs) to the oncology team, they were like, ‘You don’t have to worry about that. We’ll discuss it later,’ ” says Deems, 51, of Reisterstown, Maryland. “That’s not how my brain works. I need to know.”

In an initial conversation with the office manager, Deems discovered that although she likely didn’t earn enough to afford her medical bills, she made too much money to qualify for some grant programs. So, she got to work: Deems ensured her doctors all were in the network covered by her health plan and focused on her out-of-pocket maximum cost because she knew she would hit it.

She met with an insurance counselor at the hospital, who recommended a different plan to choose and advised her to get short-term disability insurance in case she needed it. She also used a flexible spending account to cover some bills and medications.

Deems also told family and friends about her plight. Over the past several years, as she underwent chemotherapy and radiation, a mastectomy and reconstructive surgery, she changed jobs and health plans, a family member covered her out-of-pocket maximum costs, and she found other sources of assistance, such as a copay card from her pharmacy. She followed up on any leads for organizations providing grant assistance.

“I just realized I can’t be shy or proud, and I need to just ask for everything and look for any free services that I could get because of what I’m fighting,” she says.

Deems’ financial concerns are common among patients with cancer, says Dr. Fumiko Chino, a radiation oncologist at Memorial Sloan Kettering Cancer Center in New York City whose research is focused on affordability and patient costs. Financial toxicity, a term used to describe financial problems and stress caused by medical costs, affects anywhere from 15% to 65% of patients, she says.

Each person’s financial impact will look unique from factors including the type of cancer they have, what their insurance will cover and the complexities of their treatment plan. 

“If you need chemotherapy and surgery and radiation, you’re going to generally be at a bigger risk for financial toxicity than if you just needed one of those treatments,” Chino says. Costs can add up both from medical and medication expenses as well as from lost income if people have to miss work.

Chino personally understands the patient and family perspective on cancer costs. Her late husband, Andrew, died from a neuroendocrine cancer in 2007. At the time, his insurance company would cover up to half a million dollars in expenses for a lifetime, which his treatment easily exceeded. At one point, he interviewed for and accepted a different job just to have a new health insurance plan, she said, yet she was still left with debt after he died. The experience inspired her to switch careers from art to medicine.

There are several ways to lessen financial costs, says Daniel Sherman, an oncology financial navigator at a Michigan hospital, and president of the NaVectis Group, an organization that trains health care providers on patient financial navigation services.

Ideally, discussions about cancer finances should begin on the day
of receiving a diagnosis, before any treatments occur, says Sherman: “The earlier that a well-trained financial navigator can get involved, the easier it is to mitigate not all but a lot of the financial distress that patient is going to experience.”

When Sherman sits down with patients, he first assesses the person’s insurance coverage to see if there are any opportunities for insurance optimization, or plan adjustments. Often this can happen outside of traditional open enrollment times, especially if there will be a decrease in income due to the diagnosis or if a patient falls below 150% of the federal poverty level.

Beyond that, there are several other resources where patients can receive assistance. Nonprofit hospitals all have charity programs where patients could qualify for free or reduced care. Pharmaceutical companies often have patient assistance programs to help cover drug costs. A variety of patient assistance foundations exist that help cover assorted medical costs, transportation to treatment and other items such as wigs for those who lose their hair.

Out-of-pocket costs for Health Insurance Marketplace plans, which are plans run by the federal government for individuals, families and small businesses, cannot exceed $9,100 in one calendar year, he says. For members of Medicare Advantage plans, those costs cannot exceed $8,300. For people covered by commercial insurance plans or Medicare Advantage plans, these out-of-pocket maximums are not uncommon.

Some people think they’re not going to qualify for assistance, so they don’t even ask. “That’s a mistake. There is no harm in asking. Most people qualify for something,” Sherman says.

Financial toxicity is a significant concern for cancer patients, impacting 15% to 65% of them. Patients often face challenges in affording treatment due to high medical costs and lost income. Early financial navigation and assistance can mitigate these issues. Resources include insurance optimization, nonprofit hospital charity programs, pharmaceutical assistance, and patient assistance foundations. Patients should review medical bills carefully and seek financial aid proactively. Denials of insurance coverage are common, but appeals can be successful. Community organizations provide essential support for managing treatment costs.

Healing should be the primary focus of patients and survivors. But for many, the effects of high medical costs can become a burdensome challenge. Care providers, experts and family work to provide assistance.

Dr. Debu Tripathy

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