Aguilar-Clancy on the Importance of Individualized Nutritional Support as a Component of Oncology Care

“We have to see the diagnosis to [inform how we] tailor the nutrition part of [treatment planning] so that can the [patient] can be successful, have low [adverse] effects and have food that is actually going to help them get through their treatment. Food is powerful, and they need the fuel.”

Claudia Aguilar Clancy, FNP-C, AOCNP, a nurse practitioner at Texas Oncology, emphasized the importance of individualized nutritional support as a critical component of oncology care, particularly for patients undergoing treatment for solid tumors.

Nutritional optimization varies significantly based on tumor location, treatment modality, and the patient’s ability to maintain oral intake, requiring ongoing assessment and tailored dietary interventions to reduce side effects and maintain functional status.

In patients with head and neck cancers, nutritional management presents unique challenges. Due to the anatomical location of the disease and associated treatments, patients frequently experience dysphagia, mucositis, or loss of appetite, which may necessitate enteral nutrition. Clancy explained that feeding tube placement—whether gastrostomy or jejunostomy—must be considered early in the disease course. For patients unable to meet caloric needs orally, clinicians often rely on high-protein nutritional formulas. When oral intake is possible, dietary recommendations include soft or pureed foods rich in protein to minimize mechanical irritation and maintain adequate nutrition.

Patients receiving radiation therapy involving the gastrointestinal (GI) tract require further dietary modification. Although dietary fiber is typically beneficial, Clancy noted that during radiation to the GI tract, high-fiber foods may exacerbate gastrointestinal adverse effects such as diarrhea and nausea. In these cases, a temporary low-fiber diet may be necessary to mitigate these effects to ensure caloric and protein intake remains sufficient to support treatment tolerance and recovery.

Clancy highlighted that nutritional support should be proactive and continuously adapted to the evolving clinical context. Early dietary intervention can improve treatment adherence and outcomes by minimizing unintentional weight loss, treatment interruptions, and hospitalization due to malnutrition or dehydration. A multidisciplinary approach—including collaboration with registered dietitians, radiation oncologists, and supportive care teams—is critical to developing effective and sustainable nutrition plans.

Importantly, Clancy underscored the psychological and physical challenges many patients face during treatment, including a reduced desire to eat. Despite these barriers, maintaining adequate nutritional intake is essential for patients’ strength, immune function, and overall treatment response. Clinicians must provide education and practical tools—such as food lists tailored to individual tolerances and preferences—to support patient adherence.