Head & Neck

Nutrition

Nutrition may be the last thing on your mind. Although receiving a cancer diagnosis can make you feel like your life is out of your hands, nutrition is one area where you can have some control. Making a plan about how to address the unique challenges that accompany a head and neck cancer diagnosis will better position you to manage the cancer and treatment-related side effects as well as put some much-needed control back in your life.

In general, a person has to eat enough of the foods that contain key nutrients and drink plenty of fluids. Your treatment plan may make that difficult to achieve.

Surgery can cause physical changes that affect your ability to eat. Chemotherapy and radiation therapy target cancer cells along with healthy cells, which often results in side effects such as mouth sores, appetite loss, fatigue, nausea, diarrhea and more. These side effects can make it difficult for you to get the nutrients your body needs.

Make a plan by connecting with a registered dietitian, an important and valuable person on your health care team. Ideally, you will meet with one very soon after diagnosis. If your health care team doesn’t have a dietitian on staff, ask for a referral or request a nutrition consultation.

Your dietitian will work with you and your caregiver to develop a personalized nutrition plan based on your needs and your preferences with these goals in mind.

  • Prevent your treatment from being interrupted due to malnutrition by maximizing nutrient intake.
  • Ease the side effects of treatment.
  • Improve overall quality of life.

In addition, you will discuss common concerns, such as poor appetite, not being able to drink enough (staying hydrated is key) or how to handle taste changes. Your dietitian may also function as a liaison between you and your health care team, helping to relay or explain information, and serve as an advocate for you.

During active treatment, your body will require more nutrients to help the body heal and help you maintain your daily activities. As your nutrition needs change, it is important to communicate frequently with your dietitian to ensure you are meeting your physical needs. When you feel stronger, you feel more equipped to manage the challenges of treatment and, in turn, enjoy a better quality of life.

In addition to the information provided by your dietitian, these suggestions may help you manage common side effects.

Mouth Sores and Dry Mouth

  • Eat soft foods.
  • Avoid spicy, acidic or salty foods.
  • Avoid rough or coarse foods.
  • Consume foods at room temperature.
  • Stay hydrated. Carry a water bottle and drink frequently to keep your mouth moist.
  • Use a straw to avoid painful areas.

Swallowing Problems (Dysphagia)

  • Eat soft foods, such as soups, eggs and smoothies, or blend/pureé foods.
  • Avoid crunchy, coarse foods.
  • Add gravies and sauces.

Taste Changes

  • Rinse your mouth before and after eating with a baking soda solution (1 quart warm water, ¾ teaspoon salt and 1 teaspoon baking soda). Do not swallow.
  • Use a non-alcohol based mouthwash.
  • Use plastic utensils instead of metal ones.
  • Add extra flavor to foods with spices.
  • Use sugar-free lemon drops, gum or mints.

Appetite Loss

  • Eat small frequent meals instead of three large meals. Add extra calories by using extra butter, oil, mayonnaise, sauces, dressing, gravy, honey, jam, cheese and nut butters.
  • Add extra protein by including poultry, meat, fish, eggs, yogurt, cheese and beans to meals.
  • Drink high calorie liquids such as juice, protein shakes and milkshakes made with whole milk.
  • Exercise to help stimulate appetite.

Nausea

  • Eat small snacks frequently, such as dry toast or crackers, as an empty stomach may make nausea worse.
  • Keep ginger tea and ginger chews on hand. Ginger can help reduce nausea.

 

Explaining Enteral Nutrition (Tube Feeding)

Sometimes you may need additional help giving your body the nutrition it needs. Known as enteral (EN-teh-rul) nutrition, tube feeding may be your single source of nutrients, or it may be used to add them until you can eat enough by mouth. It may be a temporary or permanent solution.

A tube may be placed directly into your abdomen and into the stomach or intestine. What goes into the feeding tube is a liquid mixture to maintain strength and fuel the healing process. That formula is delivered through the tube directly into your gut. It can be given in several “meals” throughout the day (also called bolus feeding), or a specific amount can be delivered over a certain amount of time through the use of a special pump. Ask your doctor or pharmacist about whether some or all of your medications can be given through the feeding tube.

In the hospital, your health care team will manage this for you. If you need to continue (or begin) this type of feeding at home, you will be trained on the process. Contact your health care team immediately if you have any of these problems: leaking from the tube, discomfort at the tube site, digestive problems or continued weight loss despite taking in the appropriate amount of formula.

Keep in mind that although you may feel hesitant about having enteral nutrition, it can actually relieve the stress involved with getting the nutrition you require before your body is ready.

Lastly, don’t forget dental care. Even though you won’t be using your mouth to eat, brushing your teeth, flossing and caring for gums remains a priority.

 

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