SVCCC's registered dietitian specializes in helping cancer patients with their unique nutritional needs and issues. The dietitian works closely with the myeloma team, and is available throughout the course of treatment for consultation, support and guidance. For those undergoing chemotherapy, the dietitian designs a personalized nutrition plan to help patients manage their side effects and better tolerate their treatments. Meal and snack suggestions and simple recipes will be provided.

In addition, the dietitian meets with stem cell transplant patients to ensure they are nourished enough for the transplant procedure. The patient is provided with information on the supplements they need to take before transplantation and the special diet they need to follow during their stay in the hospital.

Q&A with Shayne Small, RD - SVCCC Registered Dietitian

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Q: How important a role does good nutrition play in fighting cancer?

A: Patients that are better nourished tend to have fewer side effects from the treatment—meaning they tolerate their treatments better. They also have a better response to treatment.

Q: How do you design personalized meal plans for myeloma patients undergoing chemotherapy?

A: I design meal plans to help manage treatment related side effects. With myeloma patients, we see constipation, a lot of different bowel issues, poor appetite, weight loss and weight gain, and nausea. What I usually do is work with the patient to find foods that they like that are also good for helping to manage their side effects. The way I work is very individualized and personal. Quite often, if somebody is having problems, I will sit down with them and go over exactly what they eat throughout the day. Essentially, I go over their entire dietary routine. Then we look at ways we can make improvements. We discuss the different food options that will help to make them feel better, maintain a healthy weight and reduce the risk of cancer and other chronic disease.

Q: How soon are you brought in to meet with the patient?

A: I can be brought in any time over the patient's course of treatment. It's a decision made by the patient and their physicians. If a patient asks to see me on his or her first visit, I see him or her on the first visit. Otherwise, the physician usually waits until the patient has a need. I try to meet all patients who are receiving their chemotherapy for the first time. I also meet all of the stem cell transplant patients to evaluate their nutrition status for transplant. I also give them information on the supplements they need to take before the transplant and the special diet they're going to be on in the hospital after transplant.

Q: Food shopping and cooking can be difficult when you're in the midst of treatment. What can patients and their families do to help make mealtime easier?

A: It's tough, because our patients' cravings and what they like changes. One of the common things with cancer is that foods you liked before treatment, sometimes you don't like after treatment, and the foods you didn't like before treatment sometimes are preferred during treatment. I try to be proactive and suggest foods, and approaches to food, that other patients have found helpful. I also provide patients with meal and snack suggestions and simple recipes.

Q: What are the best foods for cancer risk reduction?

A: A good cancer prevention plan is a plant-based diet. This means when you look at your plate two-thirds or more of the plate should be foods of plant origin (fruits, vegetables, whole grains, beans, nuts, tofu). The other one-third of the plate or less should be foods of animal origin (poultry, fish, dairy and meats). You want to have a variety of fruits and vegetables, a good source of whole grains, and lots of fluid. Patients with myeloma need to drink plenty of water to stay well hydrated. Staying hydrated helps to keep the blood from clotting, may help the kidneys function better and helps keep the bowels regular. Patients should choose portions that help maintain an ideal body weight.

Q: How does treatment affect patients' appetites?

A: Myeloma is one of those diseases that really run the spectrum. Myeloma patients can have any sort of problem ranging from weight loss to weight gain. Some patients can develop side effects from treatment and the disease that makes it difficult to eat. Other patients who are doing really well can have no problem eating and gain weight, especially when they are on steroids, which stimulate the appetite. The steroids cause some fluid retention, but eating more then their body needs is what causes most of the weight gain.

Carrying around extra weight on compromised bones can be very difficult and increases the risk of diabetes and other chronic health conditions. Patients that are going into remission—and we're seeing a lot of that since we're doing so well in treating the disease—have a lot of trouble with weight gain and diabetes. These are things we usually see at a primary care clinic, but I find myself focusing on this here with myeloma patients.

Q: How often do you meet with patients?

A: That's individual. If the patient wants to meet with me frequently, I'll meet with them frequently. If I'm just educating somebody and they don't have any problems, I let them follow up with me as they would like. If I see a patient for a specific problem, where I have to change something or put them on a special diet, then I would follow up at his or her next treatment.