Addressing Food Insecurity to Support Quality Cancer Care

Shenandoah Oncology, part of the US Oncology Network, demonstrates that truly exceptional cancer care extends beyond therapy inside the clinic walls. The clinic took deliberate steps to confront the challenges its patients faced, beginning with one of the most basic yet urgent needs: reliable access to food.   
The commitment grew from a clear intention to understand the full emotional and practical burdens carried by patients navigating cancer treatment.

Listening to Patients & The Data-Driven Discovery of Disparity 

As part of the Enhancing Oncology Model (EOM), Shenandoah Oncology implemented the National Comprehensive Cancer Network (NCCN) distress thermometer, a survey that asks patients to rate their stress to identify concerns ranging from pain and fatigue to housing, transportation and food. In 2023, a review of these surveys revealed a striking truth: food insecurity was the most common concern among patients. 

Recognizing the profound impact of nutrition on cancer treatment outcomes, the clinic’s leadership knew they could not ignore what they were hearing. 

“We really tried hard to focus on food insecurity, so patients aren’t afraid to talk to our navigators and say, ‘I need this’”, said Misty Chicchirichi, who oversees quality programs at Shenandoah Oncology. “We did a lot of research because we didn’t want to offend anybody or make them feel insecure. We want to take the best care of them.” 

Turning Insight Into Action 

The clinic’s response was swift and multifaceted and emphasized both access and dignity. Misty and her team established an on-site food pantry in a private, discreet location that is stocked with high-protein dry goods, canned meats, beans, vegetables and fruits. Staff members generously contribute regularly, often through creative efforts like “jeans day,” where employees bring pantry items instead of making cash donations. 

“The private setup allows our patients to shop for items they might need and help themselves privately, removing the stigma often associated with seeking assistance,” said Chicchirichi. 

To further support patients, Shenandoah Oncology partnered with Highland Food Pantry, a local organization that provides eight bags of groceries each month for patients who may not have access to other food resources. These bags include essentials like powdered milk and shelf-stable proteins, ensuring that even the most vulnerable patients have nutritious options at home.  

The initiative went deeper than providing food and also included an elevated focus on nutrition education. The clinic implemented a cancer center-vetted nutrition screening tool for chemotherapy patients, to identify those at risk of malnutrition and weight loss. The data underscored the need for expert support, leading Shenandoah Oncology to successfully advocate for the local hospital to hire a second dietitian. These professionals now offer quarterly cooking demonstrations, such as high-protein soups in the winter and smoothies in the spring, using nutritional supplements provided by partners. Patients receive samples, coupons and access to free or low-cost supplements, making it easier to maintain their strength during treatment.  

“Right now is not the time for our patients to lose weight. Now is when you need the protein to help fight the cancer and tolerate chemotherapy,” Chicchirichi said. “We hate to see patients losing weight and having their protein levels drop. It’s really important to keep those stored up so they can stay strong and get treatments on time.”  

The initiative’s success is rooted in the dedicated of the entire Shenandoah Oncology team, with the clinic’s nonprofit, Hopes Angels, providing grocery gift cards for patients experiencing sudden financial strain, easing short-term crises that might otherwise delay care.   

A Community Effort with Measurable Impact  

Nearly two years after launching the food pantry, follow-up distress surveys show a dramatic shift: food insecurity is no longer the top concern among patients. Instead, issues like pain management and fatigue now top the list.  

The clinic’s work has been recognized nationally, with invitations to share its approach at national health equity conferences, inspiring other practices to address social needs among their own patients. 

By listening deeply and responding with compassion, Shenandoah Oncology has allowed its patients to focus their energy on treatment and recovery. This proactive, data-driven approach has set a new standard for holistic cancer care, one where no patient must choose between treatment and a healthy meal.