To Feed and Be Fed With Cancer

Feeding people is hard, and doing it “right” is even harder. I recently wrote a piece on what I refer to as nutrition-ism. Nutritionism describes the ideas and ideals we have surrounding food and nutrition which are largely driven by admired charismatic personalities and consumer media that are largely based on bits and scraps of evidence, bias, pre-conceived notions, anecdotes and probably a lot of psychological traps that we fall into over the best empirical efficacious evidence. This eminence vs evidence based nutrition is what often leads to unfounded and even obsessive notions that burgeon into worry and food-related neuroses within cancer culture.

At times like this, it hardly feels like a golden age of food, especially when you find yourself wandering the supermarket aisles trying to remember whether you should be buying organic or pastured or pasteurized. To feed and to be fed has become a guilt-ridden operation.

It is hard to cook whole, healthy and balanced meals, and there are many excuses to not do it. Whether it’s being too busy, having a kitchen that’s too small, or a store that’s too far away, or maybe you may not be confident in the kitchen or know where to start. So it becomes much easier to outsource this essential part of life to a restaurant. Cooking is hard.

And yet there’s a beautiful and often fearless giving that happens around a table where food is shared. It takes time to think of a dish or a menu, shop for ingredients, prepare the food and then clean up. It also takes money and patience. It takes dedication to learn what requirements need to be met and a commitment to learn individual preferences. All of which is confounded further when dealing with the eating difficulties that so often accompany cancer treatments.

To feed and to be fed is an act of generosity and love. Sometimes this is an expression of the support patients need. Sometimes this is an expression of the support caregivers need to provide. Sometimes this expression can be overpowering, and even desperate. Yet it’s coming from a good place. For many patients, shifting from the “to feed” to the “to be fed” role can be challenging. Some people don’t want to feel like patients, and this transition is hard. Allowing oneself to be cared for is hard.

The solution is to communicate. As an oncology dietitian, it is part of my job to foster a productive exchange between patients and caregivers about food and about how to feed and be fed is so much more than the food itself. It’s about the things that food represents. It’s about healing and support but also frustration and illness. The solution is to communicate, in a nonjudgmental way, to identify needs of all parties including those food and nutrition ideas and ideals, and comprise to reconcile them.

Many times has history shown us that practices that we believed to have been legitimate, like blood-letting or even mercury administration, were really proven to be non-therapeutic or downright toxic. I don’t think patients shouldn’t try certain food/nutrition interventions that he/she may believe to be therapeutic. On the contrary. I believe that trying something that has strong patho-physiological basis is what spurs scientific discovery. The only thing in medicine and wellness that is dishonorable is when someone believes that they do not have the potential for being wrong and they do not have the desire to inquire further about whether something may or may work. The most important thing is to communicate with family members and the medical team to avoid risk of reducing the efficacy of treatment.

Eating isn’t easy. Feeding someone else is even harder. Nutrition science isn’t perfect and it remains important to maintain a healthy skepticism about everything we believe and do. I strongly encourage every cancer patient or caregiver to enlist the assistance of an oncology registered dietitian to help spur the best communication to feed and be fed.

Amanda Bontempo, M.S. R.D. C.D.N.

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