Francesca Tabacchi, a specialist oncology dietitian at Oxford University Hospitals, is currently being funded by the NIHR Oxford Biomedical Research Centre to do a PhD on malnutrition and nutritional support in cancer patients undergoing chemotherapy.
“I was very excited to start my research because I saw where practice could be made better, and I am hopeful to improve the care we provide to patients through projects like mine.”
Francesca’s role is as a dietitian in the cancer service, supporting patients with a range of cancers who are undergoing chemotherapy.
“I’m interested in how we can we improve dietetic practice. In my job, one of the problems is that malnutrition can sometimes be hidden. For example, in overweight patients, even if they’ve lost weight, they may have more difficulties in being identified as malnourished. My research is focused on how we can identify patients that need more nutritional support and provide the right care as soon as possible,” she explains.
Cancer often gives symptoms that affect eating, such as lack of appetite or fatigue. Chemotherapy adds to those symptoms, with side-effects including nausea or loss of taste. This results in a high proportion of cancer patients losing strength and fitness, which can affect their quality of life.
The role of the cancer dietitian is crucial in the patients’ pathway to help them find a new eating routine that helps them manage their symptoms and ensure they get all the nutrients they need in order to tolerate their cancer treatment as well as possible.
Francesca has always been interested in research: “My bachelor’s degree thesis was a clinical trial; for my masters I did an experimental thesis as well; I then got a job as a research assistant. It’s always been there alongside my clinical training.”
In September 2021, with support from her manager Alison Howard, she started her PhD at Oxford Brookes University. She is doing this part-time because she wanted to continue to do her clinical work alongside her research.
“That’s why having this BRC award was really helpful. It allows me to continue doing both,” Francesca explains. “It’s super important. From a clinical point of view, you can see what evidence is missing and what questions you cannot answer; that’s what informs research. All our clinical work, all the advice we give to patients, it’s all based on scientific evidence. That’s why it’s always important to check that what you’re advising is still correct and up to date; are you delivering it in the best way possible. They go hand in hand.”
As part of her studies, she will interview around 40 patients from around the country about the kind of nutritional information they would want to receive, at what time, and how they would prefer it to be delivered.
She says: “Once we have that strong background, it should give us a robust base for making recommendations, or even trying new interventions or changing pathways or policies.”
“Allied health professionals should be more involved in research. I have been lucky my team and hospital have been very supportive of me doing a PhD and they are always interested in my progress.”
As Francesca’s career progresses, she is keen that she continues to do both clinical work and research. “The optimal thing would be to continue both, because I don’t want to become too detached from practice, but I also don’t just want to work clinically and never do research again. I would not want to lose that contact with patients; you need to know what it’s like to actually do the job.”
Francesca says she would advise other nurses, midwives and allied health professionals to get involved in research: “Start small – do your own audit, your own quality improvement project, your own service evaluation; collect the results, present them, talk about them and one thing will lead to another – other people might be interested; there might be funding or networking opportunities.
“All of us perfectly capable of doing it, it’s just a question of finding the right support.”