Nutritional Management of Patients with Head and Neck Cancer—A Comprehensive Review

Abstract

While surgical therapy for head and neck cancer (HNC) is showing improvement with the advancement of reconstruction techniques, the focus in these patients should also be shifting to supportive pre and aftercare. Due to the highly sensitive and anatomically complex region, these patients tend to exhibit malnutrition, which has a substantial impact on their recovery and quality of life. The complications and symptoms of both the disease and the therapy usually make these patients unable to orally intake food, hence, a strategy should be prepared for their nutritional management. Even though there are several possible nutritional modalities that can be administrated, these patients commonly have a functional gastrointestinal tract, and enteral nutrition is indicated over the parenteral option. However, after extensive research of the available literature, it seems that there is a limited number of studies that focus on this important issue. Furthermore, there are no recommendations or guidelines regarding the nutritional management of HNC patients, pre- or post-operatively. Henceforth, this narrative review summarizes the nutritional challenges and management modalities in this particular group of patients. Nonetheless, this issue should be addressed in future studies and an algorithm should be established for better nutritional care of these patients.

A Narrative Review Comparing Nutritional Screening Tools in Outpatient Management of Cancer Patients

“…The NUPAC study revealed that tumours of the oesophagus, stomach, and head and neck are associated with the highest prevalence of weight loss, registering 57%, 50%, and 47%, respectively [ 35 ]. Furthermore, the review by Martinovic et al [ 40 ] specifies that patients with head and neck cancer show a prevalence of weight loss that ranges between 25 and 65%, which can increase up to 80% due to various causes such as the interruption of intake due to surgical procedures, as well as the adverse effects of radiotherapy and chemotherapy treatments, such as mucositis, dysphagia, and xerostomia [ 36 , 40 ]. In other studies, the type of malignant disease was not significant for assessing undernutrition using a standardised questionnaire, such as the MNA, because the patients predominantly had diseases such as breast cancer or lymphoma ( n = 50), compared with small sample sizes for lung cancer ( n = 6) and head and neck cancer ( n = 2) [ 41 ].…”

Role of Prehabilitation and Rehabilitation on Functional Recovery and Quality of Life in Thyroid Cancer Patients: A Comprehensive Review

“…In addition to swallowing exercises and dietary modifications, the use of adaptive techniques and positioning can assist in managing dysphagia [ 92 ]. These techniques may include postural adjustments, such as chin tucks or head tilts, to optimize swallowing function and reduce the risk of aspiration [ 92 ]. Figure 5 summarizes dysphagia management strategies for thyroid cancer survivors.…”