A Powerful Practice: In-House Pantries Combat Food Insecurity for Patients With Cancer

Some of the things many of us take for granted—eating a banana or handful of blueberries as part of a hurried breakfast, snacking on carrots or an apple, or having a refrigerator full of produce from which to build a healthful dinner—aren’t as accessible to many patients undergoing treatment for cancer. That was an eye-opening revelation Laura Kerns, MPH, RD, senior clinical dietitian and Integrative Oncology Program manager at the Ochsner Health, Gayle and Tom Benson Cancer Center in New Orleans, described experiencing in a recent ACCC webinar, Supplying Security: How Food Pantries Empower Patients With Cancer, when she was confronted with data showing that only 20 patients out of 151 (who were surveyed by a separate Louisiana cancer center in 2016) indicated that they always had at least 1 daily serving of fruit or vegetables.  

A Shift in Perspective 

“This was a very humbling moment for me, as a dietitian,” Kerns said in the webinar. “This wasn’t meeting your 5-a-day, or now, as we talk more about, 7 to 10 servings a day of fruit and vegetables—this was just eating a fruit or vegetable in a given day.” But nutritional guidelines take a backseat when it’s a struggle to simply put food on the table. “I realized I had been telling patients [eat] fruits and vegetables [eat] more fiber, talking to them about their diets during their cancer treatment,” Kerns said. “And that might have been something that was not helpful, because it was unattainable or inaccessible to these patients.” 

Approximately 10% of households in the US report food insecurity, according to 2020 numbers reported by the US Department of Agriculture. For patients diagnosed with cancer, it’s estimated that between 17% and 55% are affected. Many cancer institutions and programs have taken it upon themselves to decrease the burden of patient food insecurity by initiating their own food pantries, with setups ranging from compact, utility-closet–based versions that include personal care products to larger-footprint, open-plan spaces designed to approximate a shopping experience. Whatever their square footage, these in-house resources aim to combat the deleterious outcomes to which malnutrition can contribute—according to Kerns, these include compromised treatment efficacy as well as declines in mental health and increased annual health care costs—and to treat patients experiencing food insecurity with dignity. 

Destigmatizing Pantry Patronage 

“Our space is bright and beautiful,” said Michelle Snell, hospital outpatient department associate at St. Elizabeth Healthcare in northern Kentucky. “It was very important to our leadership team to destigmatize the need to receive food. We wanted to provide an open shopping experience for our patients, so that they had the opportunity to choose the foods [that are] best for them and their families.” Housed in a former art studio, the 750-square-foot pantry is in a high-traffic, easily accessible area where patients and their family members can come and go as they please, with no referral needed. Since the pantry opened, it has provided more than 42,000 pounds of food—including bags of pesticide-free greens courtesy of local business 80 Acres Farms—to approximately 5,600 individuals.  

Smaller, more controlled operations can be equally effective at connecting patients with the sustenance they need. “I like to say we are small but mighty,” said Aimee Hoch, MSW, LSW, OSW-C, FACCC, who moderated the webinar and is an oncology financial navigator at Grand View Health in Sellersville, Pennsylvania, about the pantry she helped build with no external funding. The pantry is stocked primarily through donations by cancer program staff and other department staff and operates with thoughtful discretion. Patients who screen positive for food insecurity select on a tablet the items they’d like to receive, then staff fill a bag with the requested items from the pantry and present it to the patient. “Our goal was to try to keep it as discreet as possible when going from the food pantry to the patient and as they move throughout our cancer program,” Hoch said. Plans are in the works to streamline the intake process by partnering with community food pantries to link patients to those pantries without requiring an additional appointment. 

Logistics and Other Considerations 

The webinar delved into special concerns that can vary by program site, as well as universal considerations. At Ochsner Cancer Institute on the Louisiana Gulf Coast, where hurricanes are a threat, generator backup for pantry refrigerator-freezers is key to prevent food spoilage and waste due to power outages. For open-plan pantries, accessibility for patients who use walkers and wheelchairs is another thing to be mindful of, as well as minimizing disruptions to a clinic’s flow of traffic if a non-patient care space is available. Staffing is yet another practical dimension of implementation—will the pantry’s upkeep and tracking be handled by a volunteer, as at Grand View, or by staff or a combined team?  

None of these considerations should stop a cancer program from starting up a pantry, though. As Hoch said, and illustrated with a photo of Grand View’s well-stocked space, “I promise that if you can find a closet, you can start a food pantry.” 

Jessica Ridge is a content coordinator at the Association of Cancer Care Centers (ACCC).