LEXINGTON Betty Simms, MAEd, RD, LD, outpatient oncology dietitian with Baptist Health Lexington, graduated from the University of Kentucky with a bachelor’s degree in dietetics, followed by a master’s degree in education. Her interest in advanced nutrition studies inspired Simms to complete a nutrition internship.
Simms started working at Baptist Health in 2005, just as the budding Baptist Health Cancer Center discovered a growing need for a dietitian that could provide specialized nutritional services for patients during chemotherapy, radiation, and certain types of cancer surgeries. In 2007, she received a grant from the Lexington Cancer Foundation and started a nutrition-focused service line for adult cancer patients.
Simms developed her program to optimally provide for all cancer patients, but especially those with types of cancer that make them more vulnerable to certain types of nutritional risks. These include head and neck (tongue, tonsil, larynx, esophageal, etc.) and gastrointestinal (stomach, pancreas, colon, etc.) malignancies. These cancers usually require radiation, chemotherapy, and surgery, causing a variety of nutritional impact symptoms that may include nausea, vomiting, constipation, diarrhea, sore mouth, painful swallowing, and taste changes; all symptoms which discourage patients from eating. Consequently, one of the greatest risks of cancer patients is rapid weight loss.
Consultative, Patient-First Service
Simms assesses all patients to determine risks before creating an individualized plan by identifying what patients are currently eating. She then works to rectify nutritional issues, as well as assisting the patient with management of any nutritional impact symptoms they may experience. Simms interviews patients for a comprehensive look at their lifestyle, including their support system, nutritional needs, and appetite changes. “Every patient is treated as an individual, even though the course of treatment may be similar and present many of the same symptoms. Every patient is an individual and should be treated as such,” says Simms.
Cancer treatment modalities like chemotherapy lose some of their efficacy when patients have nutritional issues.
During the consult phase, Simms also makes informed suggestions and recommendations to help educate patients regarding what they may do to maximize their nutritional status for improved outcomes during treatment. For example, she might address lack of appetite with what she calls “grazing,” where a patient eats small meals more frequently. She recommends foods that are “protein-rich, high-calorie, and most importantly, calorie-dense, since patients in treatment are often overwhelmed by large quantities.”
Simms follows patients from diagnosis to post-op and beyond to ensure that their nutritional needs are met throughout their treatment. Patients often suffer lingering and even worsening effects after treatments, so it is vital that nutritionists track their progress every step of the way.
Simms withholds strenuous exercise programs and lifestyle diet modifications until the brunt of the patient’s treatment is over. “What we want to do at that point is prevention— preventing a recurrence or the development of other types of cancer or diseases such as diabetes and heart disease, and guiding their nutrition for the rest of their life.” Though many cancers are linked to our national obesity epidemic, Simms focuses more on weight maintenance during treatment and reinforcing the importance of maintaining or improving their nutritional status.
When Nutrition Facilitates Treatment
Of course, cancer treatment modalities like chemotherapy help, but they lose some of their efficacy when patients have nutritional issues. “We have definitely seen improvements in response to treatment based on the services we’ve provided these patients,” says Simms. For example, she cites fewer treatment breaks, better management of the nutritional issues, improved weight stabilization, and increased patient satisfaction after nutrition therapy.
Despite initial misunderstanding of nutrition’s role in treating patients, physicians eventually took note. “A decade ago,” states Simms, “nutrition of oncology patients was not at the forefront. We have made great strides at Baptist Health, and doctors are very much aware of how important nutrition status is to patient’s quality of life, their response to treatment, and their outcome.”