A cancer diagnosis comes with many new stresses: extensive treatment, medical bills, time away from work. But for some cancer patients, access to nutritious food is also a major concern. Food to Overcome Outcomes Disparities (FOOD), a New York City-based program of Memorial Sloan Kettering Cancer Center (MSK), is working to decrease food insecurity for medically underserved cancer patients with the hope that no cancer patient has to worry about putting food on the table for themselves or their families.
Understanding and Addressing Food Insecurity
Food insecurity is a critical issue across America. Compound that with a cancer diagnosis and it gets even worse. Proper nutrition is essential for cancer patients, who are weakened by the disease and the side effects of treatment. For low-income patients struggling to afford food, the need is especially dire. Low-income patients who work hourly-wage positions often lose income – or their jobs – when they are forced to take time off for cancer treatment. Others do not complete treatment, instead choosing to work and feed their families. Food insecure cancer patients face barriers to accessing help offered by traditional food pantries. The side effects of treatment, treatment-related nausea, diminished appetite, weakness, and limited mobility can prevent patients from travelling offsite for emergency food supplies. Many pantries are open during the week at short time intervals that conflict with the hours that patients are required to be in clinic. In addition, some patients may be reluctant to use pantries that ask for government issued identification.
In 2010, a team member in MSK’s Immigrant Health & Cancer Disparities (IHCD) Service expressed concern about hunger issues among cancer patients. Staff at IHCD conducted a survey and the results were shocking: more than 60 percent of the cancer patients who responded were considered food insecure, meaning they lacked access to affordable, nutritious food. Subsequent studies have shown that up to 50% of all patients enrolled in cancer treatment in New York City face the choice between receiving treatment or putting food on the table.
In an effort to ensure that low-income cancer patients are able to access healthy food on a regular basis, IHCD developed the Food to Overcome Outcomes Disparities (FOOD) Program. FOOD is a hospital-based pantry program that addresses food insecurity among cancer patients to improve treatment adherence and outcomes. This program, which is now in eight hospitals in New York City, serves 80-125 patients per week in Manhattan, Brooklyn, Queens, and the Bronx. Since its inception, FOOD has provided more than 16,545 bags of food to 2,400 patients and their families. Staff also continue to investigate new approaches to address food insecurity in this vulnerable population.
Innovating, Tailoring and Making a Difference
FOOD takes an innovative approach to ensure that all cancer patients have nutritious meals, and it serves a sizeable number of metastatic breast cancer (MBC) patients. Among FOOD’s MBC patients, more than 90 percent named food emergency resources as their biggest need outside of treatment. Each FOOD patient has weekly access to the pantry. Additionally, FOOD staff work with patients who have specific diet restrictions, and adjust pantry boxes based on patients’ changing palates and capability to eat certain foods (e.g., a medical requirement for soft or low microbial foods).
In 2015, through a grant from the Avon-Pfizer Metastatic Grants Breast Cancer Program, FOOD helped 30 underserved MBC patients in the New York area receive the nutritional resources they needed. Providing food in the same place as clinical care has been an overwhelming success. In just under six months, those MBC patients’ food security scores increased, and the patients reported improvements in their quality of life.
The Power of Education
Through a digital training module, FOOD has taken steps to ensure that staff members at all partner hospitals are educated about food insecurity and the impact it can have on a cancer patients’ health – with an emphasis on MBC. With this comprehensive training, staff is better equipped to identify and screen food insecure patients. They can then provide these patients food resources, nutrition education materials, and food from the pantries on-site.
The fact that hospital personnel are not only aware of this significant problem among many of their patients, but prepared to address it, is an important resource – especially for clinics that may not have a nutritionist available.
While FOOD is already having a tremendous impact on patients, there are important enhancements that can be made. FOOD is working hard to expand its reach and serve more cancer patients. FOOD hopes to identify more eligible MBC patients, partner with organizations to offer bilingual nutrition workshops, and develop a one-one-one nutrition curriculum for patients.
This innovative food service is enriching, nurturing and improving the lives of breast cancer patients. The Avon Breast Cancer Crusade is proud to continue to support the FOOD program in 2017. Funds will bolster the development of a nutrition curriculum on food access for patients and staff, and training on food resources, including the role of good nutrition during cancer treatment, weight maintenance, managing treatment side effects, tips for stretching food budgets, and food safety.