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September 15, 2020 | 3 minute read

Improving Access to Nutrition Counseling After a Cancer Diagnosis

As a specialist in oncology nutrition, I often hear from people getting ready to start cancer treatment, “I can stand to lose a few pounds” or “this [cancer treatment] gives me an opportunity to lose the extra weight I’ve been carrying.”

What many people do not realize is that significant weight loss (about five percent or more from normal weight) can reduce the chance of surviving a cancer diagnosis. People undergoing cancer treatment are at risk for malnutrition, a condition caused by not getting enough calories or the right amount of key nutrients (like vitamins and minerals) that are needed for optimal health. Treatment can cause many different side effects that impact the desire to eat and the ability to chew, swallow and digest food. Absence of key nutrients in the diet can lead to malnutrition, which is estimated to occur in up to 80% of cancer patients at some point during or after treatment. Malnutrition can cause:

  • Reduction in chemotherapy dose
  • Delayed treatment
  • Hospital admission(s)
  • Increase mortality

Nutrition interventions

Treating cancer-related malnutrition can improve outcomes for people with cancer. Timely nutrition intervention by a Registered Dietitian Nutritionist (RDN) can improve treatment tolerance, reduce treatment delays, help with weight and lean body mass maintenance and improve overall quality of life. People who can receive their full treatment without delay are more likely to survive their cancer diagnosis.

Malnutrition is under-recognized and therefore under-treated. Increasing access to a registered dietitian can reduce the development of malnutrition. A recent study found the current patient to RDN ratio at cancer centers in the US is one RDN for every 2,308 patients. The current ratio is far from the desirable ratio of one RDN to every 120 patients.

One of AICR’s goals is to improve access to diet, physical activity and weight loss counseling and other treatments following a cancer diagnosis. To help reach that goal, AICR has taken the following steps:

  • Participated in a malnutrition screening project to improve malnutrition screening throughout cancer treatment facilities in the US.
  • Supported the Medical Nutrition Therapy ACT of 2020 that will allow Medicare beneficiaries to access the care they need by providing Medicare Part B coverage for medical nutrition therapy delivered by a registered dietitian for people with a cancer diagnosis. You can read more about our support of this bill and lend your own voice to the cause here.
  • Endorsed and continues to advocate for increased access to insurance coverage for evidence – based interventions to promote a healthy lifestyle before, during and after cancer treatment. You can read more about this policy priority here.

How to find a registered dietitian

  • Ask your healthcare provider to refer you to a local dietitian.
  • Search for a dietitian on the Academy of Nutrition and Dietetics website. Many registered dietitians are available in tele-health platforms making it easier and more convenient to book appointments.


  • Dewys W. D., Begg C., Lavin P. T., et al. Prognostic effect of weight loss prior tochemotherapy in cancer patients. The American Journal of Medicine. 1980;69(4):491–497. doi: 10.1016/s0149-2918(05)80001-3.
  • Trujillo EB, Claghorn K, Dixon SW, et al. Inadequate Nutrition Coverage in Outpatient Cancer Centers: Results of a National Survey. J Oncol. 2019;doi:10.1155/2019/7462940
  • Marín Caro M. M., Laviano A., Pichard C. Nutritional intervention and quality of life in adult oncology patients. Clinical Nutrition. 2007;26(3):289–301. doi: 10.1016/j.clnu.2007.01.005.

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