e-Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2020

Exploration of current dietetic practices for patients with gynaecological cancers undergoing radiotherapy in Australia: a cross sectional survey (#220)

Emilie Croisier 1 2 , Kelly D'cunha 1 , Teresa Brown 1 2 , Judy Bauer 1
  1. School of Human Movement Nutrition Sciences , University of Queensland, Brisbane, Queensland, Australia
  2. Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia

Radiotherapy for gynaecological cancers often causes Gastro Intestinal (GI) toxicities, presenting as diarrhoea. However, there is an absence of clear evidence-based guidelines to inform clinical practice for GI symptom management in this patient cohort. This study aims to provide an overview of current opinions and clinical practice of dietitians treating this patient cohort and to examine current models of nutrition care in Australian cancer clinics. A mixed-method, exploratory cross-sectional survey using semi-structured interviews was used. The survey utilised purposive sampling and comprised: demographic characteristics, referral protocol and follow-up pathways, management strategies and interventions prescribed, and attitudes and confidence in service provided. Descriptive analysis was performed on quantitative data and thematic analysis was performed on qualitative data once data saturation was achieved. In total, 17 dietitians participated in the study, from seven of the eight states and territories of Australia. Most centres did not have an automatic referral pathway (94%) or post-treatment pathway (88%). The results demonstrate heterogeneity in dietitians’ opinions and prescription of dietary interventions for symptom management secondary to radiotherapy. The majority of respondents (71%) had either prescribed and/or seen patients who had been prescribed a low fibre diet, however contextualized this as a ‘trial and error’ or ‘last resort’ strategy. Dietitians acknowledge there is a knowledge gap in effective symptom management and that the current dietetic services provided may not be adequately meeting the needs of this patient cohort, and is not standardized within Australia (82%). There is no clear consensus on best practice for dietary management of GI symptoms in patients undergoing radiotherapy for gynaecological cancers. This variation in practice warrants more robust studies to investigate the efficacy of dietary interventions in symptom management to inform the development of a suitable model of nutrition care, in addition to collaborating with patients to effectively determine perceived needs.