Addressing symptoms that affect patients’ eating according to the Head and Neck Patient Symptom Checklist©

Abstract

Purpose The purpose of this prospective study was to assess which nutritional impact symptoms (NIS) interfere with oral intake in patients with head and neck cancer (HNC) and how the symptoms interfere with body weight loss, up to 1 year after treatment. Methods This was a prospective study of 197 patients with HNC planned for treatment with curative intention. Body weight was measured before the start of treatment, at 7 weeks after the start of treatment, and at 6 and 12 months after completion of treatment. NIS and NIS interfering with oral intake at each follow-up were examined with the Head and Neck Patient Symptom Checklist© (HNSC©). Results At 7 weeks of follow-up, patients experienced the greatest symptom and interference burden, and 12 months after treatment the NIS scorings had not returned to baseline. One year after treatment, the highest scored NIS to interfere with oral intake was swallowing problems, chewing difficulties, and loss of appetite. At all 3 follow-ups, the total cumulative NIS and NIS interfering with oral intake were associated with body weight loss. Factors increasing the risk for a body weight loss of ≥ 10% at 12 months after treatment were pain, loss of appetite, feeling full, sore mouth, difficulty swallowing, taste changes, and dry mouth. Women scored higher than men in NIS and NIS interfering with oral intake. Furthermore, during the study period about half of the population had a body weight loss > 5%. Conclusion Because both nutritional and clinical factors may affect body weight, this study highlights the importance of a holistic approach when addressing the patients’ nutritional issues. Trial registration ClinicalTrials.gov NCT03343236, date of registration: November 17, 2017.

Acute Taste Dysfunction in Oropharyngeal Cancer Patients after Transoral Robotic Surgery

“…Therefore, TDs should be discussed routinely during preoperative counseling. Taste changes may be acceptable in the early postoperative period when eating is also limited by pain and odynophagia, but long‐term TDs represent a social and emotional loss for HNC patients 63–65 . Postsurgical TDs from edema or inflammation are likely transient, as most TDs after benign tonsillectomy resolve within 1 month 21 .…”

“…Taste changes may be acceptable in the early postoperative period when eating is also limited by pain and odynophagia, but long-term TDs represent a social and emotional loss for HNC patients. [63][64][65] Postsurgical TDs from edema or inflammation are likely transient, as most TDs after benign tonsillectomy resolve within 1 month. 21 However, this study could not determine the prevalence of persistent TDs after TORS alone because most OPSCC patients underwent adjuvant radiation or chemoradiation within 6 weeks.…”

Texture properties of foods targeted for individuals with limited oral processing capabilities: the elderly, dysphagia, and head and neck cancer patients

“…A holistic approach is important to addressing the HNC nutritional issues of patients. 85 It is critical to explore how the reported symptoms interact with real food textures, and what the sensory perceptions of the patients are. Care foods must be soft and readily deformable under reduced tongue pressures.…”

Avaliação do impacto nutricional do tratamento antineoplásico de pacientes com câncer de cabeça e pescoço de interesse do cirurgião-dentista: revisão sistemática

“…A qualidade da evidência foi caracterizada entre as classificações "alta", "moderada", "baixa" ou "muito baixa" para cada um dos grupos de desfechos diferentes. Dentre as localizações mundiais, os estudos selecionados foram desenvolvidos em 3 continentes (América do Norte, Europa e Ásia) e 8 países diferentes: Holanda (Jager-Wittenaar et al, 2011;de Leeuw et al, 2012), Japão (Sadakane-Sakuramoto et al, 2021;Morioka et al, 2022), Suécia (Granström et al, 2021), Estados Unidos da América (Funk et al, 2012;Ganzer et al, 2015;Cardoso et al, 2020), Turquia (Arslan et al, 2015, Alemanha (Gellrich et al, 2015;Kramer et al, 2019), França (Bozec et al, 2020) e Inglaterra (Kalavrezos et al, 2013) (Figura 5.2).…”

“…Em relação ao desenho dos estudos, totalizaram 7 estudos observacionais transversais (Jager-Wittenaar et al, 2011;de Leeuw et al, 2012;Kalavrezos et al, 2013;Ganzer et al, 2015;Bozec et al, 2020;Cardoso et al, 2020;Morioka et al, 2022) e 6 estudos observacionais prospectivos (Funk et al, 2012;Arslan et al, 2015;Gellrich et al, 2015;Kramer et al, 2019;Granström et al, 2021;Sadakane-Sakuramoto et al, 2021).…”