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February 2, 2011

UVA Health System Team Gives Away 21 Million … Calories

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A team of people who treat cancer patients at the UVA Cancer Center has just passed a landmark. They have given away 21 million calories in the form of free nutritional supplements over the past three years. This story is one of ingenuity and perseverance that has led to a population of healthier and stronger patients.

The initial goal of the program was to provide free nutritional supplement drinks to a few patients undergoing radiation treatments for cancer. Many of the patients were unable to afford the cost of nutritional supplements as sold in stores. While all patients in radiation oncology were eligible to get the supplements, at first the program didn’t have enough to give away to everyone. With increases in grant funding and even contributions from staff members, UVA students, grateful patients, and support from the UVA Cancer Center the program grew to the point that it has now given away an estimated 2500 cases of Ensure Plus®, each case containing 8,400 calories, since 2004.

Not only has the program saved patients dollars, the program has made a measurable difference in the health of patients, too. Data recently published in an international cancer journal showed that all patients who received supplements benefited from the program. On average, patients showed almost a 40% decrease in weight loss. They also had significantly lower rates of feeding tube placement. The feeding tube is a device that is placed into the stomach though the abdominal wall while a patient is under sedation, for patients who are unable to take in enough calories by mouth.

“Seeing the immediate, positive results in our patients makes our work worthwhile,” says Dr. Paul Read, UVA associate professor of radiation oncology. “The program will continue as we look for funding and philanthropic sources, but it is our annual challenge. Weight loss in cancer patients is a serious problem.”

For example, head and neck cancer patients can have complex nutritional problems because of tumor-related problems. They may have substantial weight loss both before and during radiation therapy. They may have trouble swallowing due to tumor pain, or an obstruction that prevents swallowing, or anorexia and fatigue because of products secreted by the tumors. Patients with lung, esophageal, gastrointestinal and gynecologic tumors as well as those with cancers that have spread all have nutritional difficulties.

“This program is beneficial not only because it provides the much needed nourishment for our patients, but it takes the worry out of trying to figure out how they will afford the supplements that are so critical for their health,” says Diane Cole, a UVa Cancer Center manager.

The story of how the program grew is inspiring. In 2003, the UVA Head and Neck Cancer Support Group was raising approximately $1,000 per year and paying approximately $35 per Ensure Ò case retail (30 cases per year) to provide nutritional supplementation for head and neck cancer patients. This was a good start, but could not meet the nutritional needs for a population of about 100 head and neck cancer patients each year, who needed up to 8-10 cases during their radiation treatment.

The team applied for and received a UVA Hospital Auxiliary Grant in 2004 for $2,000 for Ensure Plus Ò nutritional supplementation, after learning they could purchase this at significantly reduced cost through hospital contracts with Ross Pharmaceuticals. The program, which was well received by both patients and the staff, provided approximately 400 cases of Ensure Plus, but this fairly rapidly depleted the program in under one year.

Drs. Janelle Molloy and Gulkin Isin, two medical physicists in the UVA Department of Radiation Oncology, and Dr. Read donated an additional $1,300 to continue the program while alternative funding sources were secured.

In 2005, Dr. Read convinced a committee that this program would make a good Patient Quality Initiative Program at UVA Cancer Center, and they received several thousand dollars more. Philanthropic funds have also arrived, with added support from grateful patients.  In 2006, the team received a donation of $2,000 from the UVA student organization called FORCE, Fighting, Overcoming, and Responding to Cancer Everywhere.

The program has steadily grown to include all radiation therapy patients with nutritional needs, and in 2007 alone, UVA provided more than 1200 cases of supplements to patients. The program is a joint effort of the UVA Department of Radiation Oncology, the UVA Department of Otolaryngology Head and Neck Surgery, The UVA Division of Hematology-Oncology, and the University of Virginia Cancer Center.

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