Head and neck cancers, which include cancers of the mouth, throat, and other nearby areas, can make it very difficult to eat and get the nutrients you need.
Treatments like surgery, radiation, and chemotherapy can also add to these challenges. Making sure you get the right nutrition is key to feeling better, healing faster, and getting the best results from your treatment.
In support of World Head and Neck Cancer Day which took place on the 26th July, our in-house dietitian has put together this guide to explain how to manage your nutrition if you or your loved one have been affected.
How does head and neck cancer affect nutrition?
Cancers in the head and neck area can block parts of your mouth and throat, making it hard to chew and swallow food. Surgery to remove tumours can change the way your mouth and throat work, and treatments like radiation and chemotherapy can cause side effects like a sore mouth, dry mouth, trouble swallowing, changes in taste, and nausea. All these factors can make eating difficult.
How do you know if you are in need of nutrition support?
Your healthcare team will regularly check your nutritional status. This includes looking at your weight, your muscle mass and what you’re eating. Tools like the Malnutrition Universal Screening Tool (MUST)1 and measuring grip strength2 help doctors and dietitians assess your nutritional status and can check if you are at risk of malnutrition.
Regular check-ups, early on, can help catch any concerns about your nutrition so your healthcare professional can find solutions as soon as possible.
It’s also important to note that nutrition screening shouldn’t just be done at the start. The goal should be to repeat check ins at regular intervals throughout each stage of treatment.
Here are some ways you can improve your nutrition:
Fortifying your diet
You might need to make some changes to your diet to make eating easier and to get the right nutrients. For example:
- Including soft foods: Eating soft or pureed foods can help if you have trouble swallowing.
- High-calorie, high-protein foods: These can help you keep your weight up and maintain your strength.
- Adjust to flavour changes: If your taste changes, trying different flavors such as citrus and sour flavourings, or using different types of seasonings such as chilli or ginger can make food more enjoyable.
Add a nutritional supplement to your diet
An oral nutritional supplement (ONS) is a special type of drink, semi-solid or powder that provides extra nutrients and should be used alongside food and drink. ONS are prescribed if you are not meeting your nutritional requirements through meals or snacks and are therefore at risk of becoming malnourished. This could be due to someone having low appetite, side effects such as nausea or inability to eat due to swallowing difficulties
For example, icesupp is a nutritional supplement that provides 5g protein, 150 calories, 2.5g fibre and essential vitamins and minerals per serving, helping to top up the diet with extra nutrients..
A variety of flavours of ONS should be offered and consuming them cold can also boost palatability.4
Your dietitian may discuss alternative nutrition support options:
If you can’t eat enough by mouth, you may need a feeding tube. This is called enteral nutrition, and they can be classified into the following types of feeding methods:
- A short-term tube called a naso-gastric tube (NG): A tube that goes through your nose into your stomach or small intestine might be used for a short time.
- A longer term tube called a percutaneous endoscopic tube (PEG): If you need help with nutrition for a longer time, a tube might be placed directly into your stomach or small intestine through your skin. The type of food given through the tube will be chosen based on what your body needs and what you can tolerate.
- IV Nutrition called Total Parenteral Nutrition (TPN): If your digestive system can’t be used at all, you might get nutrients through an IV. It’s used only when necessary.
How can you manage side effects to help improve your nutrition?
Handling the side effects of cancer treatment is important for keeping your nutrition on track. Here are some different side effects and tips to help alleviate the impact they may have on your eating and drinking:
Sore mouth and dry mouth
Radiation therapy can cause your mouth to become sore and dry:
- Sore mouth: Using special mouthwashes, regularly cleaning your mouth, eating cold foods and drinks and using pain relief can all help.
- Dry mouth: Drinking plenty of water, using saliva substitutes and wet sponges and sucking on ice chips can help keep your mouth moist.
Trouble swallowing
If you have trouble swallowing (dysphagia), a speech and language therapist can help with exercises and techniques to make swallowing easier. Sometimes, you might need to change the texture of your food or use a feeding tube to make sure you get enough nutrition.
Changes in taste
Changes in taste can make food less appealing. You may wish to try different flavors, spices, and food temperatures to increase variety and interest.
How can your healthcare professional team support you?
Getting the right nutrition involves a team of healthcare professionals working together:
- Oncologists: These are your cancer doctors. They understand how important nutrition is and work with dietitians to include nutrition in your treatment plan.
- Dietitians: Dietitians are experts in nutrition. They assess your nutritional needs, create personalised nutrition plans, and provide ongoing support and education.
- Speech and language therapists: They help with swallowing problems and teach you techniques to make eating and drinking safer and easier.
- Nurses: Nurses monitor your overall health, including nutrition, and help manage any side effects. They also teach you how to use feeding tubes if needed.
- Social workers: Social workers can help with emotional support, financial concerns, and finding resources to help you get the nutrition you need.
In summary
Ensuring you get the right nutrition when you or your loved one has head and neck cancer is essential for your treatment and recovery. Regular nutritional check-ups, personalised diet plans, and managing treatment side effects can all help. A team of healthcare professionals will provide support every step of the way, making sure individual’s nutritional needs are met.
If you have any concerns about yours or your loved ones nutrition, we advise that you consult your healthcare professional. We also recommend checking out The Swallows Head & Neck Cancer Group for further support here.
In the meantime, you can check out our other blogs on our website here. Or, if you have a question about diet, nutrition and wellness leave a comment over on our Instagram.
References
- Talwar B, et al. Nutritional management in head and neck cancer: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol. 2016 May;130(S2):S32-S40.
- Flood A, et al. The use of hand grip strength as a predictor of nutrition status in hospital patients. Clin Nutr. 2014 Feb;33(1):106-14.
- Available at: https://www.bapen.org.uk/education/nutrition-support/nutrition-by-mouth/oral-nutritional-supplements-ons/ Accessed July 2024.
- Jin J et al. (2008). Factors affecting therapeutic compliance: A review from the patient's perspective. Ther Clin Risk Manag.; 4(1): 269-86.
This blog has been written by Corrine Toyn RD, Dietitian & Marketing Consultant.
