Dietitian Sian Lewis on the special challenges of helping head and neck cancer patients

I qualified as a dietitian in 1993 and have worked as a Macmillan Sian Lewis blog sizeSpecialist Oncology Dietitian since 1999. In 2007 I took up the position as Macmillan Clinical Lead Dietitian at Velindre Cancer Centre. With this I not only manage a team of three but also provide a clinical dietetic service to patients who have head and neck cancer.

As clinical lead I have to ensure that the dietetic team is providing a service to all patients attending the cancer centre – making sure that they have access to the right nutritional information and that their dietary needs are being met. We see patients throughout the cancer centre; inpatients, day cases, out patients and radiotherapy patients. The cancer centre has a long corridor and I walk many steps a day seeing my patients.

A huge part of the role nowadays is to identify future developments for the team that are not only in line with the cancer centre’s vision but national documents such as the Cancer Delivery Plan. As more people are living with cancer we are now looking at services to help people manage the consequences of treatment and meet the goals that matter to them. We also provide healthy living programmes, working with other therapists such as physiotherapy and occupational therapy, to give patients the knowledge and skills to self manage their own health.

As for my clinical work I have for the last nine years specialised in head and neck cancer. Many patients who have head and neck cancer have difficulty eating during the treatment. I attend all the radiotherapy review clinics with the consultant, review radiographer, clinical nurse specialist and speech and language therapist. It’s very intensive treatment that involves the patient receiving radiotherapy every day for six weeks. Many find it difficult to keep their weight up so my aim is to provide them with simple and practical dietary advice to help them maintain their weight. In most instances we need to give food fortification advice, oral nutritional supplements but some patient find they need extra help and have a feeding tube for a short period. I get to review the patients every week, sometimes more, so as you can imagine I get to know each patient and their family well. I really enjoy that part of my role and like to feel that I have helped in some way improve their experience.

As I work closely with the review radiographers we input into the introductory evenings for patients just about to start radiotherapy. On a monthly basis I give a short 5 minute talk to raise the awareness of good nutrition during radiotherapy and answer any questions to help patients feel better prepared for their treatment.

Over the years I have held various committee roles for the British Dietetic Association Specialist Oncology Group. Presently I am the chair of the group. I enjoy being part of the committee as not only does it help me with my own professional career but I feel that I am more aware of best practices and national documents that will help me locally in ensuring I give the best care and support to my patients. Currently the group is working on developing an oncology specific outcome tool for dietitians to use to show the effectiveness of their work. Future plans include developing information for thyroid patients who require a low iodine diet.

I feel it’s very important as a Macmillan healthcare professional to establish and maintain strong links with Macmillan. I am a member of the Macmillan Allied Health Professional Forum and have worked on the Eat Well Feel Good Toolkit with Jill Scott. This led to me being awarded a role of honour by the BDA – an achievement I feel very privileged to have received. I have also been part of the working group who worked on the production of a set of ‘Top Ten Tips’ resources on nutrition for the different stages of cancer: During cancer treatment; Post-treatment and recovery; Advanced cancer/ End of Life; Living with and Beyond Cancer.

So as you can my life as a Macmillan Clinical Lead Dietitian is very varied and is not only face to face clinical work. Over the years I have provided dietetic care for some lovely patients and meeting them makes my job so rewarding.

Twitter: @SLewisRD

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One thought on “Dietitian Sian Lewis on the special challenges of helping head and neck cancer patients

  1. Pingback: Celebrating our Macmillan professionals | macmillancymruwales

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