Nutritional Implications in Head and Neck Cancer - A Review

Cancer is a complex disease wherein mutations in protein-encoding genes lead to numerous tempo-spatial changes in cell physiology, ultimately leading to malignant tumors. Indian Population Based Cancer Registries documents incidences of cancers across the country and it was reported that highest Age Adjusted Rates was found in cancers of the tongue, hypopharynx and oesophagus which are head and neck cancers. They are amongst the commonest malignancies, accounting for approximately 20% of the cancer burden in India, tobacco and alcohol are the two major risk factors. Common acute reactions experienced during radiotherapy are dysgeusia and fatigue, which may cause cancer cachexia. These patients have one of the highest malnutrition prevalence rates, which affects physical function and quality of life with 25-50% of these patients classified as nutritionally compromised prior to commencement of treatment. Minimizing weight loss for patients at nutritional risk is a major goal of nutritional management. It is important to replenish the protein and energy intakes along with the micronutrients. Common nutrition goals for surgical patients include symptoms management, weight maintenance, preservation of functional status and body composition which can be attained by modulation of dietary components, addition of oral nutritional supplements, or provision of enteral or parenteral nutrition. Recent studies have shown that Enteral nutrition support via percutaneous endoscopic gastrostomy administered to the patients help in preventing weight loss, dehydration, nutrient deficiencies, treatment interruptions, hospitalizations and improving quality of life. Successful management of these patients requires orderly care and follow-up by a multidisciplinary nutrition team.