Obiective: The use of complementary and alternative methods is common in oncology, but nothing is known about the role of CAM in the last days of a patient's life. Material and tnethods: Between 1-2007 and 10-2008 the palliative care teatn treated 85 patients (50 male, 35 female, median age 62 years) on out-door basis. All fatnilies were asked to complete a structured questionnaire regarding the use of CAM during the last period of the patient's life. Patients suffered from cancer in 83/85 patients (98%), 2 patients had neurologic disorders. Results: Only 20 fatnilies (31%) have not used any CAM. Spiritual support (praying, hospice services) was asked for by 60/85 families (71 %). 25/85 families (29%) reported drug use. Favorite tnethods were vitamins (n = 11, 13%), trace eletnents (n = 9, 11%), and mistletoe (n = 8, 9%). 30 patients (35%) were treated by physiotherapy (28 oncology patients, 2 neurology patients). Logopedy and ergotherapy were used in 10 patients (12%). 12 fatnilies (14%) reported use of aroma-therapy in patient's eare. The tnain infonnation source was the GP (house physician) (45/85, 53%)), followed by the palliative care team (30/85, 35%) and pharmacies (27/85,32%). Internet, journals or self-service information were only used by 25/85 families (29%). The effectivity of the categorized methods was estitnated between 1 and 5 (very good -worthy) by the patients or their families. The following ranking was registered: spiritual support 2.4; physical therapy 2.7, logopedy/ergotherapy 3.1, drugs 3.3. 65/85 families (76%) were satisfied with the infonnation received from the health care practitioners. Conclusion: Complementary tnethods are often practieed during the last days of a patients life. Families and friends are looking for valid infonnation and need help from the professionals. The different methods have been evaluated regarding effectivity as well as acceptance by the pattents.

Objective: Is there a relation between nutritional status and the prognosis of head and neck cancer patients? Which diagnostic procedures gives us sufficient information about the malnutrition of the individual? Material and methods: A first retrospective study analyzes the outeome of 110 patients in relation to initial weight loss and weight loss at the end of radiotherapy. A second study investigated the changing bioimpedance (BIA) data of 27 survivors and 39 patients who died between their first and last measurement during nutritional therapy (at least 4 weeks). Results: A critical initial weight loss is 10 kg or more at the point of diagnosis. At the end of radiotherapy the body mass reduction should be lower than 15 kg. Raw data of BIA reflects the changing nutritional status at the end of life. We observed a stabilized phase angle in survivors (4.7° to 5.2°) whereas dying patients have shown a significant decreased phase angle (4.6° to 3.7°, p < 0.05). Conclusion: The prognosis of head and neck cancer patients is tightly related to their nutritional status. Specific nutritional anamnesis (initial weight loss, total weight loss, BMI) and additional biophysical measurements are recommended to observe the individual status during the follow up.

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