Eating Well with Head & Neck Cancer

A healthy diet is an important part of a head and neck cancer patient’s journey before, during, and after treatment. Proper nutrition can help prevent weight loss, boost appetite, and reduce treatment-related side effects. Eating a balanced, nutrient-rich diet not only supports your immune system and overall well-being but also helps your body respond more effectively to cancer treatment. 

Oncology Registered Dietitians

Registered Dietitians (RDs) are experts on diet and nutrition. To help prevent or manage eating problems, it is important that you see a Registered Dietitian (RD) regularly during cancer treatment. Patients who get help from an RD are able to limit weight loss better than patients who don’t get help from an RD.

An RD who has the letters “CSO” after his or her name is a “Board Certified Specialist in Oncology Nutrition.” They have demonstrated experience and skills in developing healthy eating plans for cancer patients. To find an oncology dietitian, you can search online or ask your health care team to recommend one.

Other Members of Your Healthcare Team

The oncology dietitian can help a head and neck cancer patient with:

• Plans for weight loss or weight gain
• Side effect or symptom management
• Meal planning and menu planning
• Feeding tube formula help
• Help with dietary supplements, special diets, food allergies, and intolerances
• Plans for healthy eating after treatment
• Support for caregivers

Your doctor may recommend that before and during treatment you see:

• Speech language pathologist (SLP)
• SLPs can help with swallowing problems by providing ongoing treatment and exercises. Your SLP will also work with your RD to ensure that you get enough calories by using easy-to-swallow food.
• Dentist (DDS)
• Dentists can help if you have tooth pain, mouth sores, or dry mouth.

Other important members of your health care team may include:

• Physical therapist (PT) or Occupational therapist (OT)
• A PT or an OT can help if you have weakness or problems doing normal activities. If treatment makes it hard to open your mouth, a PT or OT can give you exercises to help.
• Oncology nurse (RN, OCN)
• An oncology RN can help support you through any medical issues during and after treatment.
• Social worker (LCSW), Psychologist (PhD), or Psychiatrist (MD)
• These professionals can help with emotional support during treatment. Social workers may also help you find financial support.

Head and neck cancer can be overwhelming. It is important to talk to your health care team about your questions and concerns. Make sure you write them down before your visits and include things such as:

• Side effects, like nausea, mouth sores, or problems swallowing or chewing
• If you cannot eat or drink regularly or have consistent pain when doing so
• Inability to complete normal tasks
• Ongoing weight loss (see chart for weight loss)

Significant Weight Loss Within a Specific Time Frame

It is important to let your doctor and dietitian know about any weight loss, even if yours is not this large.

Drastic and unintended weight loss may be due to a condition that is caused by the cancer itself. Doctors refer to this condition as cancer cachexia.

Food and Symptom Journal

Another way to be an active partner with your health care team is to keep a food and symptom journal. It will help you to track what you eat and your side effects. Sharing the journal with your health care team will help them to manage your treatment and recommend the healthiest diet for you. Here is an example of a Food and Symptom Journal.

Managing a Feeding Tube

If you have problems swallowing or have lost a lot of weight, your health care team may recommend a feeding tube (otherwise known as enteral nutrition support or a PEG tube). Many head and neck cancer patients get a feeding tube at some point.

• A feeding tube is a short-term solution for making sure that you get the right amount of calories and nutrients and prevent weight loss
• You are still able to eat by mouth while using a feeding tube
• Once you can eat enough by mouth, the feeding tube can be easily removed. Then you can get back to eating normally

If you have a feeding tube, make sure you talk to your health care team if you have any problems, including the following:

• Digestive problems (nausea, vomiting, bringing food back up, diarrhea, cramping, or bloating)
• Continued weight loss
• Mechanical problems with the tube, like formula leaking or pain at the site
• Problems paying for your formula