Nutrition Spotlight - Head and Neck Cancer, Virginia Cancer Specialists

In April, we focused on increasing knowledge of head and neck cancers for Head and Neck Cancer Awareness Month.  So, for May, we’d like to shine the spotlight on this cancer and its nutrition implications, as we see many patients at Virginia Cancer Specialists facing unique eating challenges throughout the various phases of their treatment pathway.

It is estimated that up to 50% of patients with head and neck cancer have already experienced weight loss at the time of their diagnosis. One of the possible reasons is due to an increase in metabolism and muscle wasting that is referred to as cancer cachexia. Also, patients often present with mouth and throat issues which contribute to poor food intake, and this can be further complicated with surgery, radiation, or chemotherapy. We encourage patients to be proactive and schedule a consult with a registered dietitian once any treatment modality begins, if not before—your physician and nurse navigator can help identify the right time.  The dietitian can help determine calorie and protein needs, address nutrition-related symptoms, and support you in stabilizing or reversing weight loss.  Good nutrition will improve how well you respond to treatment, help you stay on treatment course, and prevent hospitalizations.

Here are some simple strategies that can help patients overcome nutrition-related challenges:

Difficulty chewing or swallowing:

– Modify the texture of food to achieve the desired consistency to minimize the severity of this side effect:

• A soft diet consists of foods than can be easily mashed with a fork, for example ground meat with gravy and mashed potatoes, flaky fish, scrambled eggs, well-cooked pasta, stew or soup.
• A pureed diet is one where foods and liquids can go into a blender, ranging in consistency from smooth and pour-able to thick enough to hold its shape on a spoon.

 Dry mouth or thick saliva:

-Hydrate with at least 64 oz. of fluids per day

• Choose soft or pureed foods; add gravies and sauces to moisten foods
• Use citrus to increase production of saliva. Peach, pear, or apricot nectars may be better options if mouth sores are present

 Sore mouth or throat:

-Avoid tart, acidic, salty, tomato-based, or pickled foods

• Drink smoothies, liquid nutrition supplements, and other liquids through a straw to bypass sores
• Use a blender (such as an immersion blender) to make soups and stews smooth in consistency

No taste or “off” tastes:

-Try acidic flavors (lemon, lime, oranges), salt, herbs, spices, and olive oil to bring out the flavor in foods

• Use sweet flavors like maple syrup, jams, honey if foods taste salty or metallic
• Sometimes patients enjoy flavors they don’t expect to, so they should explore foods outside their normal repertoire

Patients who are unable to meet their nutrient needs by mouth would benefit from a feeding tube, for example a PEG tube. Keep in mind, this is usually temporary and, oftentimes, patients will utilize a feeding tube in addition to eating and drinking to ensure proper nutritional status.

VCS Nutrition Team