Being proactive with your nutrition when receiving cancer treatment to the head and neck area
Dear OncoLink "Ask The Experts,"
I have recently undergone surgery for removal of an encapsulated squamous cell tumor on the right side of my neck (and a small piece from the back of my tongue). The oral surgeons removed all of my remaining teeth as a precondition for the seven weeks of radiation and chemotherapy that I will begin next week. I am attempting to gain any information that I can about what I can do with my diet to assist my well-being and recovery through all of this. Basically, I'm just looking for diet information so that I can be as proactive as possible with this very important step in my recovery!
Ellen Sweeney Cordes, RD, Registered Dietitian at the Abramson Cancer Center of the University of Pennsylvania, responds:
Being proactive with your nutrition when receiving cancer treatment to the head and neck area is very important. The main goal through out your treatment, nutritionally, will be to maintain your weight. When receiving chemo and radiation together, placement of a stomach feeding tube is often recommended at the start of treatment. This is because as the treatment progresses, the mouth and/or throat area will become sore, and often a patient finds it very difficult to eat or drink during the last few weeks of treatment. The feeding tube is placed in the stomach in order to have an alternative way to get nutrition into the body when the oral route becomes too uncomfortable. Deciding on whether to place a stomach tube should be discussed with your doctor.
When treatment begins, eat as normally as possible. As soreness in the mouth and/or throat occurs (often beginning in week 3 or 4), begin to transition your diet to soft, moist, high calorie foods (like oatmeal, yogurt, pasta, ice cream, casseroles, canned fruits) that will be better tolerated. It is also recommended to begin drinking liquid supplements like Boost Plus® or Ensure Plus® 2 to 3 times per day to supply more calories and nutrients when you are eating less. If a feeding tube were placed, you would likely begin using it to supplement your oral intake at week 4 or 5. Boost Plus®, Ensure Plus® or Nutren® 1.5 formulas are most often used in the feeding tube for nutrition. Your nurse or dietitian would instruct you on its use. You can get more tips on eating during treatment by reading the American Cancer Society booklet, Nutrition for the Person with Cancer. You can get the booklet free through your cancer center. I would also encourage you to ask to see a dietitian at the beginning of your treatment to help with your nutrition goals through out the treatment process.