Assessing Malnutrition in Patients With Head/Neck Cancer
Posted: Thursday, February 21, 2019
Malnutrition is a well-known problem for patients with head and neck cancer, affecting as many as half of the patient population. However, “much of the nutritional assessment in this patient population is left to the discretion of the treating physicians, who may or may not be familiar with management of malnutrition,” according to a recent review of practice guidelines.
With the goal of highlighting practical information as a source for physician reference, Amarbir Gill, MD, of the University of California at Davis, and colleagues reviewed the current recommendations on the assessment and management of malnutrition as well as the relevant literature on the subject. Published in Head & Neck, the article is part of a series by the Education Committee of the American Head and Neck Society.
The authors noted that it is recommended that all patients with head and neck cancer receive nutrition and swallowing evaluation by a registered dietitian and speech language/swallowing therapist. The degree of malnutrition, as well as the need for subsequent therapy, can be evaluated by several metrics. Patients with observed weight loss (> 10% in the past 6 months or > 5% in the past 1 month) and perceived dysphagia or odynophagia may benefit from close nutritional monitoring. “Individuals undergoing surgical and/or nonsurgical cancer treatment with significant preexisting or acquired dysphagia should be assessed for candidacy for prophylactic or reactive feeding tube placement, Dr. Gill and colleagues indicated.
“Further study is needed to allow for a more refined algorithm to guide clinicians in their assessment and management of malnutrition in patients with head and neck cancer,” concluded the authors.
Disclosure: The study authors’ disclosure information may be found at wiley.com.