Head & Neck Cancer and Nutrition

Head & Neck Cancer and Nutrition

Head and neck cancers develop in the mouth, nose, cheek / buccal cavity, throat, larynx or thyroid glands. Carcinoma in any of this path, causes food intake to be compromised, difficulty in swallowing or chewing resulting in inadequate food, causing risk of malnutrition. This can, manifest into nutritional deficiencies, lower muscle mass, weight loss and poor quality of life.

The prime nutritional challenge is the inadequate oral intake. Other challenges include:

• Poor response to radiation and chemotherapy, as nutritional reserve is deteriorate
• Occurrence of taste alterations, nausea, mucositis, dysphagia and xerostomia.
• Nutritional requirements and the therapies recommended are symptomatic.
• Aim to provide 25-30 kcal/kg ideal body weight. This will increase based on the grade of malnutrition and stage of treatment. Whole grains, high quality proteins and essential fats or medium chain triglycerides are preferred.
• Dietary inputs maybe protein heavy (1.5g-2.0 g protein/kg IBW) along with multi-vitamins as required to cater the increased nutritional requirement.
• Carbohydrate increase is recommended for those to undergo surgery in the head / neck.
• Nutritional therapy to commence at least 10 to 14 days prior to surgery.
• For oral cancer it is advisable to opt for high calorie-high protein semi solid or soft texture modified foods. Soups, high protein smoothies, pureed vegetables, grain porridges are usually well accepted. Ensure 5-6 well-spaced meals. Oral nutritional supplement can be advised if oral intake is less than 50% of the recommended
• Post-surgery, enteral nutrition / tube feeds is recommended in transient phase. This can be through naso-gastric, naso-jenjunal or through percutaneous endoscopic gastrostomy (PEG)in case of severe long term management. Frequent monitoring of the nutritional state is critical so as ensure timely nutritional intervention in this type of cancer along with counselling with patient and family.