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Breast Cancer Awareness UPMC dietitian gives patients power to help themselves

Tribune-Democrat - 10/23/2023

Oct. 23—SOMERSET, Pa. — Registered dietitian Franie Lechak has seen it time and time again in cancer patients getting chemotherapy or radiation.

"A lot of women look at it and say, 'I'll get thinner now,' " Lechak said.

"No, don't go there. I want you to maintain the weight where you are at."

Lechak, of Johnstown, is one of two full-time nutritionists for UPMC Somerset. She also works part-time at UPMC Hillman Cancer Center in Johnstown. She provides outpatient counseling and handles inpatient nutritional needs.

"A lot of times, people feel like, 'Oh, I have cancer; I will lose weight,' " she said of the apparent silver lining that comes from the combination of body-image pressures and cancer treatment.

However, Lechak said, depriving the body of nutrition during cancer treatment will result in muscle loss, not fat loss.

She said the first step she takes with patients is asking them to recall their typical eating habits.

" 'What did you eat yesterday?' And if there's no dairy, no vegetables, maybe a little protein and some diet sodas, that's not going to sustain your body," she said.

"And when you are under treatment, that radiation is working in your body not just when you are on that treatment table, but the whole time. It's working to get rid of bad cells. It can damage the good cells in the meantime."

Lechak's passion for food and nutrition stems from her parents, Frank and Mary Lechak, she said.

"I always had a deep interest in food because I grew up in a household where my dad was a diabetic," she said.

"Mom and Dad taught us to eat well. We weighed and measured everything on a gram scale for my father. He was a perfect diabetic. The doctor would tell him, 'I can't believe you are doing so well.' He really took good care of himself, and we, in turn, were taught to take good care of him."

For cancer patients whose bodies are burning a lot of calories, she emphasizes incorporating the five food groups into each meal.

"You need to maintain a good nutritional life, and that means choosing the five food groups," she said.

She follows the plate method, which helps people visualize the proper proportion of each food group for meals. It means filling half a plate with non-starchy vegetables, one quarter of the plate with protein foods, and the last quarter of the plate with carbohydrate foods.

Unless patients are vegetarian or vegan, she doesn't expect them to eat vegetables at breakfast, but she asks them to make up for it at lunch and dinner.

"People have a false notion that eating all five food groups will make you gain weight," she said, "but really when you look at it, there may only be 500 calories or fewer per meal, so with three meals a day, that's 1,500 calories, and that's only a base calorie level for women."

Budgetary constraints may also be perceived as obstacles to getting all five food groups.

"Especially now, people will say, 'Vegetables are expensive,' but if we plan a meal plan for a week using a bag of carrots, a stalk of celery, onions, with chicken, that's better than going through the drive-thru and spending $10 for one meal," she said.

UPMC Somerset Director of Food and Nutrition Jill Thomas said that Lechak goes above and beyond for patients and for community groups that consult the hospital for nutritional guidance.

"She is a friendly inspiration," Thomas said, "and she is dedicated to community interaction."

Lechak has been working in the medical field since 2002.

"The most rewarding part of my job is probably having somebody say, 'Thank you for helping me with my cancer; thank you for helping me with my appetite; thank you for teaching me what is proper eating,' " she said.

"You just want to make sure they were able to absorb what you told them and were able to put it into practice to help themselves because, when you look at nutrition in the hospital setting, there's something wrong with the body that needs healed.

"We can give medicines; we can do surgeries; but the body needs nutrition to keep the muscles and everything working properly, so when you get a patient on a path with good nutrition, it's rewarding, and then you see them again and they look better and they feel better. It's really great."

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