By Jeff Tucker

Food for Thought

UNM Cancer Center Researcher Studies Potential Connection Between Food Insecurity and Cancer Diagnoses

Every day in New Mexico, some people must make the difficult decision whether to put food on the table or spend money on other necessities, such as a utility bill or rent.

"Food insecurity is an early indicator of financial trouble," said Jean McDougall, PhD, an assistant professor in The University of New Mexico Department of Internal Medicine and a member of the Cancer Control and Population Science Program at the UNM Comprehensive Cancer Center.

Cancer-related financial hardship has been an interest of McDougall's for much of her career. Recently she published a paper surveying nearly 400 patients identified from the New Mexico Tumor Registry, in which her team assessed patients' level of food security before and after their cancer diagnosis.

McDougall and her team measured the food insecurity in 394 patients between the ages of 21 and 64 who had been diagnosed with cancer between 2008 and 2016.

The findings showed that 26 percent of the patients were food insecure both before and after their cancer diagnosis, while 10 percent of the patients were food secure prior to diagnosis and became newly food insecure after diagnosis.

Participants were asked to rate how true the following statements were:

Within the past 12 months, we worried whether our food would run out before we got money to buy more.

Within the past 12 months, the food we bought just didn't last and we didn't have money to get more.

Patients who responded that these statements were often true or sometimes true were categorized as food insecure.

"I was surprised to learn that 36 percent of cancer survivors surveyed were food insecure in the year after their cancer diagnosis," McDougall said.

McDougall said the study didn't look specifically at what caused the food insecurity, particularly among the 10 percent of patients who slipped from secure to insecure.

"I think people don't really realize how quickly food insecurity can happen," she said. "It doesn't take much for a person to become food insecure."

Factors can include a loss of income from having to take time off from work and travel expenses if the cancer treatment facility is far away.

"One of the biggest challenges for people in the study was the loss of income, either for the patient or their partner," she said.

That timing, accompanied by new medical expenses, can be financially challenging. The cost of treatment itself is tougher to pin down because of complexities in insurance coverages and reimbursements, McDougall said.

Food insecurity was more common among younger patients. A number of factors could account for that, McDougall said, including the tendency for younger patients to have less savings, more debt and children in the home.

Food insecurity can lead to difficult decisions for recovering patients. Food usually is something that people buy week by week. Not being able to pay for food can lead to harder choices down the line, including forgoing utility bills or refilling prescriptions and delaying other medical care.

The study is just the first step for McDougall.

"Now that we're talking about it and it's such a big problem, the question is: how do you identify and empower the people who are food insecure?" she said.

That will take more study and more research.

She said she wants to look deeper into how a system of screening questions could be implemented at clinics that would check for patients experiencing food security and then match them with appropriate resources, be they grocery vouchers, food banks or the Supplemental Nutrition Assistance Program (SNAP).

"Because I'm a researcher, I want to know how best to implement screening and food resource referral into the clinic," McDougall said. "We need to figure out how to get patients and providers talking about food security and how to address it in our health care system."

UNM Comprehensive Cancer Center

The University of New Mexico Comprehensive Cancer Center is the Official Cancer Center of New Mexico and the only National Cancer Institute-designated Cancer Center in a 500-mile radius.

Its more than 120 board-certified oncology specialty physicians include cancer surgeons in every specialty (abdominal, thoracic, bone and soft tissue, neurosurgery, genitourinary, gynecology, and head and neck cancers), adult and pediatric hematologists/medical oncologists, gynecologic oncologists, and radiation oncologists. They, along with more than 600 other cancer healthcare professionals (nurses, pharmacists, nutritionists, navigators, psychologists and social workers), provide treatment to 65% of New Mexico's cancer patients from all across the state and partner with community health systems statewide to provide cancer care closer to home. They treated approximately 14,000 patients in about 100,000 ambulatory clinic visits in addition to in-patient hospitalizations at UNM Hospital.

A total of nearly 400 patients participated in cancer clinical trials testing new cancer treatments that include tests of novel cancer prevention strategies and cancer genome sequencing.

The more than 100 cancer research scientists affiliated with the UNMCCC were awarded $35.7 million in federal and private grants and contracts for cancer research projects. Since 2015, they have published nearly 1000 manuscripts, and promoting economic development, they filed 136 new patents and launched 10 new biotechnology start-up companies.

Finally, the physicians, scientists and staff have provided education and training experiences to more than 500 high school, undergraduate, graduate, and postdoctoral fellowship students in cancer research and cancer health care delivery.

Categories: Comprehensive Cancer Center