Nurses: The Lifeline for Dietitian Referrals in Cancer Care

In oncology, patient care requires a cohesive, interdisciplinary approach where nursing staff frequently serve as the frontline defense against treatment-related complications. According to Jeanna Brouwer, RDN, an outpatient oncology dietitian at the OSF HealthCare Cancer Institute, oncology nurses are the absolute "lifeline" to their patients.

Indeed, nurse-led education and professional advocacy are paramount to ensuring cancer patients receive timely, highly effective nutritional interventions.

Dismantling Nutritional Misconceptions

A major obstacle in oncology nutrition is the patient’s own perception of what a registered dietitian nutritionist (RDN) does. Brouwer noted in an interview with Oncology Nursing News that when nurses recommend a dietitian to address severe treatment side effects like mucositis or diarrhea, patients often react with apprehension. "The patient often thinks, ‘Oh, they're going to tell me what I can and cannot eat or just want me to eat healthier or lose weight,’" Brouwer explained.

To overcome this barrier, nurses must educate patients on the therapeutic reality of clinical nutrition. Frontline nurses are uniquely positioned to reassure patients that oncology dietitians do not focus on restrictive dieting or weight management. Instead, their primary objective is to manage side effects, optimize nourishment, and help patients feel stronger.

"They're going to really help you fight and survive throughout this cancer treatment and make these side effects as diminished as possible," Brouwer says.

A Clinical Case in Point: Vitamin D Optimization

The critical nature of early dietary intervention is clearly illustrated in supportive care therapies, such as vitamin D optimization. Vitamin D, a fat-soluble pre-hormone, regulated immune function, skeletal bone health, and overall post-treatment recovery. Yet, vitamin D deficiency is widespread among Americans, compromising the robust immune system patients require during treatment. Studies have shown a strong association between adequate vitamin D status and better clinical outcomes in certain cancers.

To support optimal clinical outcomes, Brouwer strongly recommends establishing a baseline vitamin D level through blood testing before initiating any form of supplementation.

Clinical scenarios dictate highly tailored approaches:

• Prostate Cancer: Patients undergoing androgen deprivation therapy (ADT)—which blocks testosterone and alters bone metabolism—often require concurrent supplementation with vitamin D3 and calcium to mitigate the risks of osteopenia and osteoporosis.
• Pancreatic Cancer: Pancreatic insufficiency can cause severe malabsorption of fat-soluble nutrients. Traditional oral supplements may fail in these patients, necessitating specialized formulations like sublingual liposomal drops that bypass gut absorption entirely.

Nurses can actively monitor these distinct risk factors and help patients navigate complex supplement selection, advising them that standard dietary intake is often insufficient—requiring up to 10 glasses of milk daily to meet the recommended 1,000 to 2,000 IU. They should also instruct patients to look for third-party certifications like USP or NSF to ensure quality in an unregulated market.

Advocating for Sooner Referrals

Because nutritional decline can occur rapidly, Brouwer urges nurses to act swiftly when patients struggle with side effects. "Reaching out and saying, 'Hey, they're really struggling. Can we get them in soon?' and advocating for sooner appointments is always something that I love when my nurses reach out to me for," Brouwer stresses.

By bridging the gap between side-effect identification and clinical nutrition, oncology nurses remain a vital lifeline for patient survival and overall quality of life.

References

1. OSF HealthCare. Why vitamin D matters during cancer treatment. OSF HealthCare Newsroom. Published July 29, 2026. Accessed August 19, 2026. https://newsroom.osfhealthcare.org/why-vitamin-d-matters-during-cancer-treatment/