Background: Patients with upper gastrointestinal cancers face significant nutritional challenges that can lead to malnutrition, decreased quality of life (QOL), and surgical complications. This study explores patient perspectives on dietitian-led nutritional care during curative treatment, focusing on dietetics care, nutritional status, QOL, and symptoms.
Method: From July 2019 to March 2022, semi-structured interviews were conducted with patients undergoing neoadjuvant therapy and surgery for oesophageal or gastric cancer. Each patient was interviewed at the end of neoadjuvant therapy and again three months post-surgery. The interviews were audio-recorded, transcribed verbatim, and analysed thematically using a phenomenological approach.
Outcomes: Thirteen patients participated (92% (n=12) with esophageal/gastro-oesophageal junction cancer, 62% (n=8) male). Five key themes emerged: “Role of the dietitian,” “Experiences with a feeding tube,” “Perceptions of nutrition,” “Strategies to maintain nutrition,” and “Lived experience of treatment and recovery.” Patients viewed dietitians as ‘vital’ and a ‘gateway’ to the surgical team. Patients found the nutritional advice ‘essential’ to their treatment, but they experienced significant nutritional issues and functional decline. Nutrition maintenance strategies, such as oral supplements and feeding tubes, were viewed as a “necessary evil” and significantly affected daily life. In their lived experience of treatment and recovery, patients heavily relied on family and friends for support, integrating nutrition maintenance into their ‘new routine,’ which became easier over time post-surgery.
Significance: This study offers valuable insights into patient experiences with nutritional care during curative treatment, which will inform dietetics practices to enhance nutritional status, QOL, and patient experience within the nutrition care pathway.