Navigating Nutrition as a Childhood Cancer Survivor: Understanding Patient and Family Needs for Nutrition Support

Abstract Purpose: Nutrition challenges are common during childhood cancer treatment and can persist into survivorship, increasing the risk of non-communicable chronic diseases. Evidence based practice and implementation of nutrition support for childhood cancer survivors (CCS) has been poorly investigated and may influence the future health of survivors. This study aimed to explore the nutrition support needs of CCS and the barriers and facilitators to delivering follow-up services in New Zealand (NZ).Methods: Qualitative thematic analysis of semi-structured interviews were performed at a specialist paediatric oncology centre in NZ with CCS and their family (N = 20 individuals) and health professionals (N = 9). Results: Three key themes emerged from the analysis: 1) the current survivorship care pathway does not provide adequate nutrition support, 2) weight and dietary changes are common challenges, and 3) requirements for nutrition support in survivorship are varied. Common nutrition-related concerns included fussy eating, poor diet quality, difficulties tube weaning, and challenges with weight gain. Participants expressed a desire for education on healthy eating alongside information about cancer-related nutrition issues, such as learned food aversions. A preference for clear referral pathways and multifaceted interventions tailored to individual patient needs were identified by CCS and health professionals. Conclusion: The trifecta of treatment side effects, negative feeding practices, and poor messaging from health professionals creates a challenging environment to optimise nutrition. A stepped care model matching the intervention intensity with the CCS is required. Education for healthcare professionals will improve the delivery of timely nutrition support and monitoring practices.