Towards optimising nutritional intake in the spectrum of childhood cancer treatment and survival

Childhood cancer is the second leading cause of death in Australian children, aged 1-14y. As medical advances improve, outcomes for childhood cancer patients also improve. For children with cancer, treatment occurs at an important period of growth and development, and this can affect their health as adults. In fact chronic disease such as obesity and cardiovascular disease are recognised long term problems for adult survivors of childhood cancer. With the changing landscape in paediatric oncology, the focus of nutritional therapy for paediatric oncology patients may need to shift. Decisions on nutritional management during therapy have the potential to influence nutritional management in the long term. The broad aim of this thesis was to explore the implications for Nutrition and Dietetics care in managing the needs of child cancer patients during therapy and following survival. The research was grounded in clinical practice, using an in depth case study of a specialist paediatric oncology clinic in Sydney, Australia. A number of separate but related investigations took place to address specific questions and highlight the way forward for improved practice.