Boosting nutritional knowledge with the help of a dietitian specializing in cancer

In a brightly lit kitchen one recent afternoon, cancer survivors Patricia Rhodes and Evette Knight were part of a group gathered around a convection burner and a sauté pan filled with mushrooms. Cancer dietitian Meghan Laszlo, RD, explained why they shouldn't stir quite yet. "We're going to try our best to leave them alone so that they brown," she said.

Even through her mask, Rhodes, whose ovarian cancer was successfully treated a year ago, could smell the savory results. "You are so right about not stirring," she said as she eventually flipped the nicely browned mushrooms. Nearby, Knight chopped scallions for mushroom fried rice and others added milk to a saucepan for a hot chocolate featuring mushroom powder.

Mushrooms, which studies have shown can help cancer-fighting immune cells stay active, were the focus of this Nutrition in Your Kitchen class, part of Wellness, Resilience and Survivorship programming in the Cedars-Sinai Cancer Patient and Family Support Program. Wellness, Resilience and Survivorship recently moved into a new custom-designed facility and resumed many in-person classes for the first time since the onset of the COVID-19 pandemic.

In addition to the kitchen area with its blonde wood cabinets, stainless steel worktable and gleaming appliances, the space boasts gym equipment that is easily moved aside to accommodate yoga classes, as well as additional rooms for other gatherings and a dedicated medical clinic upstairs.

Arash Asher, MD, director of Cancer Rehabilitation and Survivorship at Cedars-Sinai Cancer, joined the academic medical center in 2008. He said that while cancer patients often have a clear plan for their treatment, once they are cancer-free they are given little guidance for navigating the physical, psychological and existential issues their disease and treatment have brought about.

"Somebody once said that one may be 'disease-free,' but it doesn't necessarily mean that they're free of their disease. That's always stayed with me, and one of the primary goals of our programming is to provide a roadmap to navigate some of these challenges."

What began as a simple rehabilitation clinic has grown into a holistic team of cancer rehabilitation physicians, nurse practitioners, exercise physiologists, art therapists, neuropsychologists, social workers and dietitians.

Wellness, Resilience and Survivorship activities, which Asher says focus on "mind, body and soul" cover everything from exercise and gentle yoga to art, mindfulness, purposeful living and healthy habits. There is even a book club, facilitated by a literature professor, that looks at works of literature through the lens of cancer survivorship.

When the COVID-19 pandemic began, Asher and his team pivoted, offering these classes as virtual experiences.

This happened very quickly, and we were able to still maintain some sense of community. And courses like our 'chemo brain' class, called Emerging From the Haze, drew people from all over the country who otherwise wouldn't have been able to participate-;an upside during a difficult season."

Arash Asher, MD, Director of Cancer Rehabilitation and Survivorship at Cedars-Sinai Cancer

Knight, an interior designer and Los Angeles native who completed her radiation treatment for breast cancer in 2020, was referred to Wellness, Resilience and Survivorship by her oncologist in late 2021. She said the art therapy classes and exercise program helped her cope with joint pain, lethargy and other side effects of her treatment.

"Coming in here and doing the workouts has been a godsend," Knight said. "It's pushed me to get up and get out and exercise, and my balance is improved, my endurance has improved, and it has also helped me emotionally."

Knight said the opportunity to connect with others who understand what she has been going through has felt like a lifeline.

"Patients and their families often need support in adjusting to their new normal once they are cancer-free," said Scott Irwin, MD, PhD, director of the Patient and Family Support Program at Cedars-Sinai Cancer. "Resuming favorite activities and finding joy in everyday life are important, and moving Wellness, Resilience and Survivorship to a new facility was an opportunity to maximize our supportive programming."

Nutrition in Your Kitchen is one of Asher's favorite components of that programming.

"It has been a wonderful addition to in-person programming," Asher said. "What we eat can make a major impact on our overall wellbeing, quality of life and recovery, but we physicians generally don't have time to educate patients about the benefits of home-based cooking, of plant-based cooking, and details such as how to integrate turmeric or herbs, pick an eggplant, or even how to chop an onion."

Knight said she appreciated the chance to boost her nutritional knowledge with the help of a dietitian specializing in cancer.

"I know that there are a lot of things that I can be doing to improve my health in terms of nutrition, and I'm not doing it," she said. "So I'm getting that perspective from a group that knows about cancer and cancer survivorship."

As the class wrapped up, students tasted the fruit of their labors and shared their enthusiasm about what they had learned. Rhodes said she would be bringing her new knowledge to her home kitchen.

"It was fun and it was healthy," Rhodes said. "Once you are diagnosed with cancer, it's all about a nutritious plant-based diet and exercise to reduce the risk of recurrence."

Another important aspect of in-person programming, Asher said, is creating a community where participants can learn from and lean on each other, because loneliness has been linked to recurrence for a number of cancers.

"No medication can solve that problem like human connectivity, like sitting with others," Asher said. "The way we live, the thoughts we think, our behaviors, our disciplined actions, really do make a difference, and not just in how we feel. More and more, we're learning that the way we live can make an impact on how long we live, and certainly on how well we live."

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