Evaluation of Malnutrition and Quality of Life in Patients Treated for Oral and Oropharyngeal Cancer

Abstract

Background. Oral and oropharyngeal cancer is a debilitating disease with high morbidity and mortality. Depending on the site and extent of the involvement of the cancer and the type of treatment modality, these patients can develop pain, trismus, xerostomia, dysphagia, and taste disturbances, compromising them socially and nutritionally. The aim of the study was to evaluate malnutrition and quality of life in patients treated for oral and oropharyngeal cancer. Methodology. A cross-sectional study was conducted which included 97 patients treated for oral and oropharyngeal cancer. The quality of life of the selected patients was assessed by using a validated European Organization for the Research and Treatment of Cancer’s Quality of Life Questionnaire, Head and Neck and Mandibular Function Impairment Questionnaire. Pre- and posttreatment weight of the patients were assessed, and weight loss of ≥10% of pretreatment weight was considered as malnutrition. The chi-square test was used to correlate the symptoms with the quality of life. A paired t test was used to assess the differences in weight before and after treatment, and a p value of <0.005 was considered as significant. Results. The most commonly reported symptoms were xerostomia (93.81%), pain (81.44%), and dysphagia (76.3%). A total of 40.2% of the individuals in the study had malnutrition. Malnutrition was comparatively lower in the group who had nutritional supplements. Conclusion. The quality of life in patients treated for oral and oropharyngeal cancer deteriorates immediately after the treatment; however, it significantly improves over time.

Treatment-Related Dysgeusia in Oral and Oropharyngeal Cancer: A Comprehensive Review

“…Finally, Pingili et al significantly correlated the sensory difficulty for a taste sensation with malnutrition in patients affected by OSCC and OPSCC treated by surgery and/or radiation therapy and/or chemotherapy. No significant differences regarding both the follow-up time (3 months vs. 6 months) and the treatment type (surgery alone, surgery and radiation therapy, surgery, radiation therapy and chemotherapy) emerged [22].…”

“…Moreover, there are several H&N disease-specific QOL questionnaires, such as the University of Washington QOL Questionnaire (UW-QOL), Functional Assessment of Cancer Therapy-H&N (FACT-H&N), the European Organization for Research and Treatment of Cancer QOL Questionnaire-H&N module (EORTC-H&N35) and 14-item Oral Health Impact Profile (OHIP-14). Their number reflects the absence of a 'gold standard' module; however, many researchers used the UW-QOL and/or EORTC-H&N35 questionnaires [7,8,17,19,21,22,24,[27][28][29]31,33,34,36] since they are extensively validated in the OSCC patients. According to Tomita et al, a partial glossectomy critically lowers taste sensation in the remaining tongue.…”

Clinical and economic value of oral nutrition supplements in cancer patients: a position paper from the Survivorship Care and Nutritional Support Working Group of Alliance Against Cancer.

“…A cross-sectional study including 97 patients treated for oral and oropharyngeal cancer with a combination of surgery and CRT reported an immediate decrease of the QoL after the treatment and a 40.2% prevalence of malnutrition. However, malnutrition was prevented in a signi cant number of patients (72.5%) who were provided with ONS (54). Also for lung cancer patients some studies have shown some improvements in weight maintenance, muscle function, and quality of life (22).…”

Strategies to Mitigate Chemotherapy and Radiation Toxicities That Affect Eating

“…Medical professionals and cancer patients alike believe toxicities are inevitable and general amelioration techniques are often overlooked. Difficulty eating and malnutrition during cancer therapy are common problems that can be assessed with many tools [35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51]. The challenge is to have an acceptable quality and quantity of nutrient intake with minimal toxicity without compromising effective cancer treatment.…”

“…Malnutrition in cancer patients is a common problem. There are many indices and tools to define malnutrition, cachexia, and sarcopenia [35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51]62,[69][70][71][72][73][74][75][76][77]. Although weight loss from the time of diagnosis is one measure, the quantity and quality of food in the diet and information from the patient generated subjective global assessment (PG-SGA) tool can provide more specific information [35,36,45,51,62,66,[69][70][71][72][73][78][79][80].…”