Good nutrition crucial before head and neck cancer therapy

February 26, 2016 Namou Kim, MD, FACS

Good nutrition is crucial for any patient undergoing cancer therapy, but many head and neck cancer patients struggle to get the nutrients they need as they prepare for treatment.

A large proportion of patients with head and neck cancers present to their doctors with significant weight loss. Sometimes, the weight loss is unexplained. But more often, there is a clear reason for it.

Tumors can make it hard to eat

Head and neck cancers include malignant tumors originating from the oral cavity, tongue, throat and larynx (voice box).  The upper aerodigestive tract is a very sensitive part of the body, and malignant tumors often can cause great pain, especially when chewing and swallowing. This causes patients to avoid food, which leads to weight loss. Tumors also can cause mechanical difficulty in the swallowing process. For example, tumors can obstruct the throat and impair movement of the tongue.

To further exacerbate the problem, many patients with head and neck cancers already are prone to malnutrition. A significant number of patients with oral cavity and laryngeal cancers tend to be chronic smokers and alcohol drinkers, and those two substances tend to deprive patients of a normal appetite—many times long before they develop head and neck cancer.

Problems after surgery

For a patient with low nutritional and protein reserves, any cancer treatment becomes more challenging. These patients do not do as well after surgery, with slower or poor healing. This in turn can delay the necessary post-operative chemotherapy and radiation, which can raise the risk of a tumor recurrence.  If a patient with low nutritional reserves receives chemotherapy and radiation before surgery, there could be an increased risk of complications that require hospitalization or a detrimental break in treatment to stabilize the patient.

During an initial consultation with a patient, I discuss the importance of optimizing nutrition. Often, a swallow therapist will work with patients to help them eat more. When necessary, we refer patients to an oncology dietician to maximize their caloric and protein intake. And on occasion, when the situation is dire, we will recommend a feeding tube, typically placed directly into the stomach, to improve nutritional reserves before treatment.

A team approach to treatment

At the Swedish Cancer Institute (SCI), a comprehensive team that includes physicians and a cancer nurse, swallow therapist, social worker, case manager and dietician works to minimize the impact of low nutritional reserves on patients during head and neck cancer treatment. This team also works with patients after treatment to assure they are receiving the nutrition they need and are safe on their own.

Learn more about SCI’s head and neck cancer treatment program here. To talk with someone or make an appointment, call 1-855-XCANCER.

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