Nursing Strategies to Combat Food Insecurity in Metastatic Breast Cancer

The environment in which a patient lives can be just as influential as their genetic code. At the 2026 American Society of Clinical Oncology (ASCO) Annual Meeting, research led by Emily L. Podany, MD, of Washington University School of Medicine, demonstrated that patients with metastatic breast cancer (MBC) living in food deserts face more aggressive tumor biology and significantly shorter survival.

Specifically, these patients are twice as likely to harbor RTK/RAS pathway mutations and nearly three times as likely to have CCNE1 copy number variants, both of which drive tumor growth and contribute to a poor prognosis.

For oncology nurses, these findings are a call to action, shifting the focus from clinical monitoring to comprehensive, solution-oriented advocacy. Podany’s research shows that living in a food desert, defined as residing more than a mile from a food store in urban areas, correlates with a median overall survival of just 24 months, compared to 31 months for those with high food access.

This disparity is even more stark for Black patients with HR+/HER2- disease, whose survival can drop to a median of just 11 months in low-access areas.

Screening with compassion

A central takeaway from Podany’s work is the pivotal role of the oncology team in identifying social determinants of health (SDOH). Nurses are often the primary point of contact for patients, making them ideally suited to conduct these sensitive screenings.

In an interview conducted at the meeting, Podany emphasized that “patients respond well to being asked in a kind patient-centered way whether they're experiencing any social determinants of health, transportation difficulties, food security, [or] financial issues.”

To facilitate these conversations and reduce patient anxiety, some institutions, including Washington University, are utilizing digital screeners on iPads. This method allows patients to disclose sensitive information without the immediate pressure of a face-to-face interaction, which can then be followed up by a nursing or social work consultation. As Podany noted, “Patients do want help... they want us to care and we do care.”

The ethical imperative: Solutions over questions

While screening is a critical first step, Podany cautioned that it must be part of a broader support strategy. “Honestly, I think the most important thing though is making sure the patient knows that we have answers,” she stated. “It’s unethical to ask the question without a solution. Asking somebody, ‘Can you feed your family?’ and then not doing anything about it if the answer is no is probably not the best option.”

For nursing staff, this means being well-versed in the specific resources available both within the hospital and the surrounding community. Implementing evidence-based practices is essential to move from data collection to meaningful intervention.

Practical interventions for the oncology team

Nurses can help bridge the gap by connecting patients with established food security programs. Podany highlighted several successful models:

• Hospital gardens: Some facilities maintain gardens where patients can access fresh fruits and vegetables.
• Mobile support: Food security vans deliver groceries directly to patients who lack transportation.
• On-site resources: Ensuring easy access to food pantries within the clinical setting can alleviate immediate hunger.

Beyond material support, Podany’s clinical focus also includes shared decision making and ensuring that “all patients understand their disease and care plan.” By integrating genomic data with social realities, nurses can tailor patient education and supportive care to the unique challenges of underserved populations, ultimately working to close the survival gaps highlighted at ASCO.

References

1. Podany EL, Foffano L, Katakam N, et al. Impact of food access and poverty on somatic genomic profiles and clinical outcomes in metastatic breast cancer. J Clin Oncol. 2026;44(suppl 16; abstr 1015)