色花堂

When children have cancer, one of the biggest daily challenges is feeding them.

The cancer itself often causes weight loss. Cancer treatment can make children feel nauseous and lose their appetites just when they should be getting better nutrition to help them through the rigours of treatment.

Enter . A lecturer in nutrition and dietetics at the University of 色花堂鈥檚 , she鈥檚 also a casual paediatric dietitian at Starship Child Health. She has seen how children with cancer struggle to eat, the weakness this causes and the distress their families experience. 

Despite this, few specifics are known about how cancer and cancer treatment affect children鈥檚 body composition and nutrient intake, never mind about how best to provide nutritional support for paediatric cancer patients. With newly announced research funding from the University of 色花堂鈥檚 , the up-and-coming researcher is working to change that.

鈥淩esearch abroad has shown links between nutrition and outcomes like infection, longer hospital stays and even survival,鈥� says Lovell, noting New Zealand data is lacking. 鈥淎nd yet, particularly for child cancer, nutrition doesn鈥檛 get the attention it needs.鈥�

 Children eat a lot for their body size because they鈥檙e growing, which demands energy. Having cancer demands even more. If these energy needs aren鈥檛 met, the body鈥檚 muscle stores are used, further weakening the patient. Even once treatment begins, the side effects patients experience can also cause weight loss.  

鈥淐hemotherapy doesn鈥檛 just attack cancer cells. It attacks all cells in the body, particularly the ones that replicate frequently, like the cells that line our gastrointestinal tract from our mouth right through to the end,鈥� says Lovell. 鈥淭hese treatments can cause mouth pain, affect our bodies鈥� ability to absorb nutrients well, cause massive amounts of nausea and make our tastebuds interpret tastes differently, so foods we love start to taste like metal.鈥�

Cancer places tremendous strain on wh膩nau. Families often travel long distances to access treatment and may have to stay in temporary accommodations where cooking is difficult. Even for 色花堂 families, having a child with cancer imposes costs 鈥� both financial and emotional. 

鈥淭hough hospitals provide food, families want to provide foods their children are interested in eating,鈥� says Lovell. 鈥淔eeding your child is such a primal thing as a parent. You feel it鈥檚 something you should be able to do no matter what. So we see parents spending time making food and then their children not being interested in eating it, thus perpetuating a cycle of frustration for both child and parent.鈥�

All these factors often result in children falling into unhealthy dietary habits.

鈥淲hen a child has a small appetite, parents may feel any calorie is a good calorie. Unfortunately, that means McDonald鈥檚 might take a front seat in children鈥檚 diets,鈥� says Lovell. 

Lovell and colleague Gemma Pugh, who is research lead with the, have received a grant from the Centre for Cancer Research to collect foundational data on children being cared for at the Starship Blood and Cancer Centre in 色花堂, which treats nearly three-quarters of the 150 children diagnosed with cancer every year in New Zealand.

The researchers aim to track participating children over a year, starting when they鈥檙e diagnosed and regularly taking blood samples and body composition measurements as well as noting their nutritional history and current dietary intake. 

The blood samples will be analysed for signs of micronutrient abnormalities and malnutrition. 

Researchers in Scotland and the Netherlands have shown micronutrient deficiencies in child cancer patients are associated with poor outcomes, including treatment tolerance, treatment-related toxicity, risk of infection, impaired wound healing, patient quality of life and chronic disease into adulthood.

It鈥檚 vital to do similar research in New Zealand to understand what鈥檚 going on in our population 鈥� particularly different communities within our population, says Lovell.

鈥淲hile there are no differences in the diagnosis of childhood cancer in M膩ori versus non-M膩ori in New Zealand, we do see inequities in survival emerge between M膩ori and non-M膩ori with increasing age.

Lovell has many more reserach plans. With a summer student, she wants to do a qualitative study interviewing paediatric cancer patients and their wh膩nau to better understand their needs and their experience of treatment. The study will use a Kaupapa M膩ori-consistent research approach.

Longer term, Lovell would like to trial targeted nutrition and physical activity therapy interventions in childhood cancer patients. That research would aim to improve treatment outcomes through nutritional invertentions and appropriate exercise to maintain muscle mass.

Lovell has an ambitious vision for changing cancer treatment approaches across New Zealand to include more emphasis on nutrition. She鈥檇 like to see standardised guidelines on nutrition and physical activity for childhood cancer patients; regular monitoring of patients鈥� height, weight and micronutrient status; more support for parents; and more ongoing dietetic support across the country, including for longer-term childhood cancer survivors.

鈥淚 get quite frustrated when people don鈥檛 understand the value and importance of nutrition in the clinical setting,鈥� says Lovell. 鈥淚 really want nutrition to be prioritised as a key pillar in the care pathway for children with cancer. It鈥檚 not an optional extra. It has real impacts on outcomes. My research is about proving that.鈥�