Alice Vanderkooy
Alice Vanderkooy, seen here walking along the shore of Lake Ontario, has worked closely with a team of dietitians at the Princess Margaret Cancer Centre through her healthcare journey. (Photo: Courtesy Alice Vanderkooy)

Alice Vanderkooy remembers the day she was diagnosed with stage four ovarian cancer.

She also remembers when the cancer recurred one year later, resulting in multiple episodes of malignant small bowel obstructions.

"I truly thought the end was near," Alice says.

Put on a restrictive liquid diet when she returned home, she thought her love of cooking and eating was put on the backburner.

But thanks to a dedicated team of dietitians at the Princess Margaret Cancer Centre, that wasn't so.

Through specialized oncology care, the team slowly reintroduced solid food back into Alice's diet.

"To be told what to eat was an adjustment, but this is what will help keep me alive," says Alice.

Registered Dietitians are essential

The development of malignant bowel obstructions during the course of illness is a potential and serious complication for patients with gynecological cancers.

In 2016, the Gynecologic Oncology Clinic at the Princess Margaret opened doors to a unique Malignant Bowel Obstruction (MBO) Program. The specialized program serves to increase patient awareness and symptom management of malignant bowel obstruction.

"Managing a nutrition care plan and meeting patient goals is an essential part of the MBO program," says Nazlin Jivraj, oncology nurse specialist and Leader of the MBO program.

Registered dietitians aid patients who need to be on a low-fibre diet, full-fluid diet, or total parenteral nutrition (TPN). These diets can compromise caloric intake, which is why linking them to a dietitian to monitor and advise their nutrition is imperative.

Registered dietitian Alaa El Danab worked closely with Alice during her care journey. She notes that these specialized diets can be a big adjustment at first.

"Taking into consideration each patient's emotional, physical, and mental well-being, my role is to help provide nutrition education and support for patients while ensuring they are meeting their energy and protein requirements," says Alaa. "It is a complex process, but very rewarding."

"I am surrounded by good people"

March is Nutrition Month in Canada, a time to celebrate individualized nutrition needs, diversity in cultural and personal food choices and that healthy eating looks different for everyone.

Registered dietitians know how essential emotional and mental well-being is in creating an individualized nutrition plan.

"Registered dietitians are an integral part of the interprofessional cancer care teams here at the Princess Margaret," says Shari Mouri, Clinical Nurse Specialist at the McCain Centre for Pancreatic Cancer, Princess Margaret Cancer Centre. "The evidence based knowledge, clinical expertise, and support they provide to patients and families dealing with the effects of cancer treatment are an essential component to comprehensive cancer care."

Today, Alice continues to live with a low-fibre diet while receiving chemotherapy. With support from her care team, she can make almost every meal she loves in a way that supports her healthcare journey.

"I am surrounded by good people here at Princess Margaret and at home," says Alice. "The dietitian's support has been great, even for the person that I live with.

"Knowing that we touch base weekly, helps answer any questions or concerns I have."

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