Nutrition Counseling Program Turns 20!

This January, the UCSF Cancer Center’s Outpatient Nutrition Counseling program celebrated its 20th anniversary.

This landmark anniversary is a great opportunity to look back at the origins of the Nutrition Counseling Program which presently consists of Greta Macaire, RD, MA; Anna Hom, RD, MS; Neha Shah, MPH, RD, CNSC; Ayana Davis, RD, MS; and program founder, Natalie Lagomarcino Ledesma, MS, RD (pictured from left to right, below).

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We must first travel back to 2001 to an initiative Peter Carroll, MD, put forward in urologic oncology. Dr. Carroll has long been a champion of the use of nutrition and healthy eating habits as a means to influence management of symptoms, and reduction of recurrence in prostate cancer. In doing this work with patients, he saw an opportunity for nutritional intervention to take on a larger and more robust role in treatment. By working with a dietitian, greater attention could be placed on the patient’s needs, by harnessing the power of a healthy eating routine.

To accomplish this, Dr. Carroll was able to secure philanthropic funding, and collaborated with Keren Stronach, then manager of the Patient Family Cancer Support Center (PFCSC) and current Cancer Center Patient Experience Specialist, and Pat Booth, then director of Clinical Nutrition Services, to create and recruit for an oncology-specific dietitian role dedicated to the Cancer Center.

At the time, viable educational resources on nutrition during and after cancer treatment were not widely available, and very few cancer centers were staffed with an oncology-specific dietitian. UCSF was on the leading edge of patient care in starting the program and offering this level of support.

The hire of Natalie Ledesma in 2002 marked the official start of the Nutrition Counseling Program. Natalie started her career focusing on sports nutrition and worked with athletes to maximize their physical performance. As a graduate student, she began working with early-stage breast cancer patients as part of the Women's Healthy Eating & Living (WHEL) trial. It was her work helping these women reach their goals of reducing risk of recurrence and improving treatment outcomes through healthier eating habits that influenced a change her career’s trajectory.

When the position in the Cancer Center opened, Natalie was the perfect fit. 

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A screenshot of the Cancer Center website promoting the Nutrition Counseling Program in 2002.

Natalie, in partnership with Dr. Carroll and other providers in the Cancer Center, built the program from the ground up. From a single office in the Mount Zion PFCSC, Natalie’s support found its way to patients throughout the Cancer Center and generated positive change in their lives. Natalie developed cutting-edge patient education material and led regular educational seminars to bring critical oncologic nutrition information to patients and the public.

The program was founded with a few guiding patient service principles that remain true today: helping mitigate side effects, better facilitation of treatment, improving patient outcomes, and lowering risk of cancer recurrence.

From the first day of the program’s operation, dietitians in the Cancer Center have worked directly with patients to incorporate nutrition changes into their day-to-day life in a realistic and seamless way. They connect the patient to the science of nutrition with compassion and ensure that patients feel valued.

The health benefits patient experienced was only part of what the program provided. The team quickly noted a great sense of empowerment among patients now able to actively participate daily in their treatment through adjusting their diet. This ability to have influence over their experience and outcome has been extremely gratifying for those patients. 

The program grew and warranted expansion beyond its one-person footprint. In 2007, Greta Macaire joined the team and serves as a senior dietitian for the program. The program has continued to grow, and with it, UCSF’s ability to offer cancer patients cutting-edge nutrition counseling and care.

Congratulations to the Cancer Center's Nutrition Counseling Program on 20 years of incredible service!! Our heartfelt thanks and appreciation to Bernadette Festa (former dietician), Natalie Lagomarcino Ledesma, Greta Macaire, Sarah O'Brien (former dietitian), Lisa Ploss (retired), Neha Shah, Ayana Davis, and Anna Hom for your service to Cancer Center patients and the cancer community.