Nurse-Led Discussion on Diet During Radiation May Boost Quality of Life

Time-restricted eating—commonly known as “intermittent fasting”—may be a feasible way to improve quality of life in patients with cancer who are undergoing abdominal-pelvic radiotherapy, according to an ongoing phase II trial presented at the 2024 Society for Integrative Oncology 2024 Conference.

“There's a lot of clinical and pre clinical studies that have shown the intermittent fasting, like time-restricted eating diets can help reduce the ROS, which is reactive oxygen species, and also reduce the DNA damage,” study author Ziyi (Zoe) Huang, MD, research fellow at City of Hope said in an interview with Oncology Nursing News. “So that overlaps with the R radiation mechanism of radiation cause cell death.”

The trial includes 48 patients with high-risk/node positive or locoregionally recurrent prostate cancer, locally advanced rectal or cervical cancer who were randomized to receive either nutritional counseling alone (control group) or nutritional counseling with time-restricted eating.

The time-restricted eating group is asked to fast for 12-14 hours on days when they receive radiation: 6-8 hours before and then 4-6 hours after. They are provided with “rescue foods” that have fewer than 50 calories and no added sugar, when needed.

Also in an interview with Oncology Nursing News, another study author, Yun Rose Li, MD, PhD, Assistant Clinical Professor, Department of Radiation Oncology, discussed how oncology nurses can play a critical role in educating patients about intermittent fasting—and general dietary practices—when undergoing radiation therapy.

Transcript

Patients really value the opportunity to have these conversations and have the opportunity to be engaged in these conversations, because they often want to know, ,”What can I do to help improve my outcomes?” And often we just say, “Just show up for your treatments.” And that's not very satisfying.

I think part of that is, is that patients really seek that out. And I think it's important that the whole care team is on board and counseling patients. And a lot of the questions that patients has it can totally be answered and supported by our nurses and our dietitians. … A lot of times in radiation oncology, we completely change the diet of the patient during the course of, say, pelvic radiation or head neck radiation, because [patients] can't tolerate the kind of foods they typically eat. Or it's just that the kind of food that they eat needs to be adjusted over the course of treatment, maybe softer foods, or foods that are more easily digestible or less like less rich in fiber, and so forth.

So the nurses actually do almost all of that education in the radiation oncology department, I sort of fill in the blanks. Or when patients have additional issues like come up, but the baseline education is actually done often by our nursing staff.

The way we structured our study was an added dietitian intervention as a part of that education process. But actually our nurses to the majority of that so I think in going forward, you know as a study, you know when we try to expand the study into the phase III setting, it would be actually a great opportunity to engage our nurses as part of the study, because I do think that they can provide the bulk of that education, because a lot of that is what we do as standard of care. We just tend to try to do it. We try to do it profile prophylactically. And when we talk about fasting, we also try to preempt that patient so they're aware and they're prepared. And I think that staff the battle is that they walk in the door prepared for what's to come, and that really lessens their anxiety and stress.

Reference

Huang Z, Feng Q, Abuali T, et. al. Early Feasibility Results from the TIDIER Trial: a Randomized, Phase II Clinical Trial of TIme-Restricted Eating Versus Dietary Counseling to Improve the Effect of Radiotherapy. Presented at: 2024 Society for Integrative Oncology Conference. October 25-27, 2024.