Medical Nutrition Therapy Services
Proper nutrition is vital for people with cancer and directly supports their treatment and recovery. It can play a key role in cancer prevention as well as help prevent a cancer or disease from returning after treatment.
At Fred Hutchinson Cancer Center Medical Nutrition Therapy Services, our registered dietitians are extensively trained in cancer care, and work with patients who are facing a full range of cancer types, stages and needs. We not only help manage treatment-related symptoms but proactively help patients maintain strength and healthy body tissue, both during treatment and afterward. Our services are free and available exclusively to Fred Hutch patients.
How we can help
Every patient is different, every cancer or disease is different, and a patient’s needs can change over time when it comes to nutrition. Our team will work closely with your physician to discuss how your specific diagnosis or treatments are affecting you. Using that information, we work with you to create a nutrition plan.
Here are some of the reasons patients come to us:
- To help maintain strength and weight
- To manage side effects, such as taste changes, nausea or low appetite
- To manage nutrition support recommendations, such as tube feeding or intravenous nutrition
- To help manage diagnosis-specific nutrition issues, such as difficulty swallowing during radiation treatment
- To discuss disease-specific diet and nutrition recommendations, including the long-term impacts of treatment
- To review appropriate diet guidelines to help prevent recurrence or a secondary cancer
- To develop a plan for weight management
Frequently Asked Questions (FAQs)
Registered dietitians (RDs) are nutritionists who have received extra training and certification. At Fred Hutch, all our staff are registered dietitians.
Registered dietitians are credentialed food and nutrition experts. To earn this designation, they must go through extensive training and formal education, including completing an internship and passing a national registration exam. Our registered dietitians provide medical nutrition therapy, which means they use an evidence-based approach (based on substantial scientific research ) to treat and help patients manage medical conditions through diet and nutrition.
The Commission on Cancer (CoC) is an organization that sets professional standards for cancer care, and Fred Hutch is an accredited CoC hospital. One of CoC’s rules is that cancer patients can be referred only to registered dietitians (not nutritionists) for medical nutrition therapy.
Medical nutrition therapy focuses on managing a disease or condition using nutrition. It is an evidence-based approach, which means it is based on substantial scientific research about the right foods and/or nutrients to treat medical conditions.
To do this work, a registered dietitian must carefully assess patients using their special expertise, then develop an individual nutrition plan to help them. They also need to regularly monitor and evaluate the patient, since needs can change and the nutrition plan may need to be adjusted. At Fred Hutch, education and counseling are also important parts of medical nutrition therapy, helping patients maintain proper nutrition and stay as healthy as possible before, during and after treatment.
A CSO is a registered dietitian who is also a board-certified specialist in oncology (cancer) nutrition. To become a CSO, a registered dietitian must complete a minimum of two years of clinical practice with 2,000 hours of documented experience in cancer care, in addition to passing a national board certification exam.
All registered dietitians at Fred Hutch are either CSOs or are actively working toward this certification. This professional credential is earned through the Commission on Dietetic Registration (CDR), the credentialing agency for the Academy of Nutrition and Dietetics.
Yes. Our team respects the dietary needs and choices of all patients. Because Fred Hutch is a nationally recognized cancer center, people of different cultures and ethnicities come to us from all over the world for treatment. As registered dietitians, we have experience developing nutrition plans that honor diverse beliefs and needs as well as specific diet preferences.
We are here to help, and our registered dietitians will partner with you to build a nutrition plan that will support your health while keeping your budget in mind. As part of our team-based approach to patient care, we work closely with Fred Hutch’s patient navigation and social work teams. These teams help to connect patients and families who are going through financial difficulties with resources that can help them.
Our registered dietitians provide science-based recommendations. We partner with Fred Hutch’s Integrative Medicine Program and pharmacy team to make sure supplements and dietary products are safe before recommending them to our patients. We also give evidence-based (based on substantial scientific research) recommendations on questions about diet changes/regimens while you are undergoing your personalized treatment plan.
Sometimes having cancer or a cancer treatment can affect your ability to swallow and digest food. This means you might need temporary physical nutrition support, such as tube feeding or intravenous (IV) nutrition, to make sure your calorie and protein needs are being met. We work closely with your physician to decide if this is the best option for you.
What happens at your first appointment
Before your first visit to Medical Nutrition Therapy Services, one of our registered dietitians will go over your medical records in detail. After they review your records and meet with you, they will suggest options for your personalized nutrition plan. We encourage you to bring your caregiver with you to your appointment, so you can both ask questions and better understand the nutrition recommendations and plan. We also suggest you write your questions down in a notebook before your first appointment. This will help make sure your questions get answered, and you’ll have a place to take notes.
If you are coming to us before or during cancer treatment
At your visit, we’ll discuss any issues or concerns you may have. You might need help managing a side effect. Or you might be wondering how you can stay as strong as possible and maintain your weight. Maybe you’re concerned you’ll have to eat certain foods or won’t be able to eat others. Whatever your questions or concerns, we are here to listen and to help develop a plan that works for you.
Once we have a better understanding of your needs, we’ll ask you questions to better understand where you are right now — such as what you’re currently eating, any issues that have come up since your diagnosis and your weight history. We’ll also ask you about how active you are or are able to be.
Our goal is to set nutrition goals with you by the end of this first appointment. Together, we’ll discuss in detail how we’ll change your diet to help you. When you leave your appointment, you should have a clear understanding of your nutrition goals, such as your calorie, protein and fluid needs; how to meet these needs if you have to change your diet due to treatment-related symptoms; and specific dietary strategies to help manage treatment-related symptoms like a sore mouth and throat, diarrhea or constipation. For example, many patients struggle with low appetite or feeling full quickly. Using a whole-foods approach, we will discuss eating smaller, more frequent meals, including calorie-dense foods such as nut butters or avocado, and the benefits of drinking calorie-protein-containing fluids like smoothies or soups.
Before you leave, we’ll figure out when you need to schedule your next appointment so we can follow up and see how the nutrition plan is working as well as address any new concerns or symptoms. If you are in active treatment and having difficulty meeting your nutrition goals, we’ll set a follow-up plan with you. Often, these appointments are every one to two weeks. If you develop new issues as you go through treatment, your physician will refer you to us for another appointment.
If you are coming to us for cancer prevention
Some Fred Hutch patients do not have cancer, but they’ve been identified as someone who is at high risk of developing a cancer. This might be due to their genetics, family history or other reasons. They often receive care from one of our prevention teams, such as our High Risk Surveillance Clinic, Gastrointestinal Cancer Prevention Program or the Breast and Ovarian Cancer Prevention Program. We work closely with these teams and help people who are referred to us from them.
During your appointment, we’ll ask you about your current diet, find out about any food sensitivities or preferences and more. Once we have the answers and a better picture of your current diet and activity level, we’ll be able to offer nutrition recommendations. You’ll leave the appointment with an understanding of the foods that may increase your risk of developing cancer and how you can decrease that risk through the foods you choose to eat.
If you need support after your cancer treatment (survivorship)
Once you have completed active treatment, you may return to Fred Hutch for survivorship or surveillance (monitoring) appointments. In addition, if you have any nutrition-related issues or questions, your physician will schedule an appointment for you with our team. At this appointment, a registered dietitian will ask you about your diet and develop an eating plan to manage any issues, including ongoing digestion, weight and/or metabolic issues such as high glucose or cholesterol levels. We’ll also review established guidelines from a diet perspective to reduce the risk of your cancer returning.
Currently, there is no evidence to suggest that COVID-19 can be transmitted through food or water systems. However, you can take extra steps to help protect your health while preparing, cooking and shopping for food.
For more information, download our "Food, nutrition and COVID-19" PDF in the Resources section below.
Below is a list of online resources provided by both Fred Hutch and trusted organizations that you may find helpful for learning about food safety and nutrition.
This document answers common questions and explains extra steps you can take when preparing, cooking and shopping for food.
Fred Hutch dietitians provide a medical nutrition therapy demonstration on New Day Northwest.
A free bilingual cooking resource teaching healthy eating to people affected by cancer, founded by a three-time cancer survivor in partnership with Fred Hutch.
The American Institute for Cancer Research (AICR) has an online resource library full of videos, infographics and other nutrition resources related to cancer prevention and survival.
Find care team profiles
Meet the caring, dedicated dietitians who take care of you and your family at Fred Hutch.
Laura Buono is a registered dietitian with 20 years of experience. She works with hematopoietic cell transplant patients at the South Lake Union clinic and provides care to general oncology patients at Fred Hutch at UW Medical Center – Northwest. She has taught graduate-level medical nutrition therapy for 10 years. Laura is a board-certified specialist in oncology nutrition and a certified nutrition support clinician.
Linda Kasser has more than 40 years of experience as a registered dietitian. She works primarily with patients who have gastrointestinal cancers and sees patients receiving care at our South Lake Union clinic, Fred Hutch at Overlake and our Issaquah clinic. Linda is a board-certified specialist in oncology nutrition.
Paula is a registered dietitian with more than 30 years of experience in cancer care. Paula works primarily with hematopoietic cell transplant patients at our South Lake Union clinic and at the Fred Hutch Survivorship Clinic. She has a special interest in working with children and families. Paula is a fellow of the Academy of Nutrition and Dietetics and is a board-certified specialist in oncology nutrition.
Patty McDonnell is a registered dietitian with more than 20 years of experience in cancer care. Patty primarily works with patients who have blood cancers, sarcoma and genitourinary cancers and sees patients at our South Lake Union and Issaquah clinics. She is a fellow of the Academy of Nutrition and Dietetics and is a board-certified specialist in oncology nutrition.
Kerry McMillen is a registered dietitian who has worked with cancer patients for more than 20 years. She is the manager of Fred Hutch Medical Nutrition Therapy Services, works with patients at all Fred Hutch clinic locations and has a special interest in working with hematopoietic cell transplant patients. Kerry is a fellow of the Academy of Nutrition and Dietetics and is a board-certified specialist in oncology nutrition.
Tal Ozery is a registered dietitian who works with patients at risk of developing a gastrointestinal cancer. She also sees patients with head and neck cancers. Tal has a special interest in counseling patients with eating disorders. She cares for patients at our South Lake Union, Peninsula and Issaquah clinics.
Raymond Palko is a registered dietitian who works with patients who are at high risk of developing breast or ovarian cancer. He also works with patients with breast, renal and endocrine cancers and melanoma, as well as supporting them after treatment. Raymond sees patients at our South Lake Union and Issaquah clinics. Raymond is a board-certified specialist in oncology nutrition.
Mary Rasmussen is a registered dietitian who works with autologous transplant and cellular immunotherapy patients at our South Lake Union clinic. She is a board-certified specialist in oncology nutrition and has more than 10 years of experience in cancer care.
Erin Schmidt is a registered dietitian who has worked extensively with allogeneic hematopoietic cell transplant patients at our South Lake Union clinic for more than 10 years. She is a board-certified specialist in oncology nutrition.
Hailey Wilson is a registered dietitian who works with gastrointestinal, thoracic, head and neck cancer patients at our South Lake Union and Issaquah clinics. She has eight years of experience and is a board-certified nutrition support clinician.