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Head and neck cancers include cancers of the oral cavity (including lip cancer and tongue cancer), larynx (laryngeal cancer), pharynx (pharyngeal cancer), hypopharynx (hypopharyngeal cancer), nasal cavity (including nasopharyngeal cancer), salivary glands, and sinuses (paranasal sinus cancer). Since the head and neck area is so closely involved with eating and drinking, nutritional intake can be more easily affected.

A Healthy Diet is Important

A healthy diet is an important part of a head and neck cancer patient’s journey before, during, and after treatment. Eating healthy can help prevent weight loss, lack of appetite, and other side effects of head and neck cancer treatment. It can also help you feel better and respond better to your cancer treatment.

See Recipe Gallery 

Before Treatment: Head and neck cancers can cause eating problems before treatment even begins. Side effects like trouble swallowing and mouth sores can make eating difficult.

  • Eating well before treatment can help you with these issues.
  • Eating well can help you succeed during treatment.

During Treatment: Eating problems are common during head and neck cancer treatment. Side effects like nausea or decreased appetite can make it hard to feel well and eat healthy.

  • Eating healthy can help with these side effects and help give you more energy.
  • Addressing eating problems can help prevent delays in treatment, hospital stays, and improve how well you respond to treatment. 

After Treatment: A healthy diet is also important after treatment. A healthy diet can help:

  • Ongoing side effects after treatment
  • Maintaining a healthy weight
  • Managing other chronic conditions

Listen to our Radio Show on Nutrition with Head and Neck Cancer

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.

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

Other Members of Your Health Care Team

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)

Percentage of weight loss that is significant within a specific time frame*

>5% in 1 month

>7.5% in 3 months

>10% in 6 months

>20% in 1 year

If you weighed 150 lbs., significant weight loss is:

7.5 lbs. for a 150 lb. person

11.25 lbs. for a 150 lb. person

15 lbs. for a 150 lb. person

30 lbs. for a 150 lb. person

If you weighed 200 lbs., significant weight loss is:

10 lbs. for a 200 lb. person

15 lbs. for a 200 lb. person

20 lbs. for a 200 lb. person

40 lbs. for a 200 lb. person

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

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.Food and Symptom Journal

Getting 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

Managing a Feeding Tube

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

Fatigue (Feeling Tired)

Fatigue (Feeling Tired)

  • Ask family and friends to help make meals and with other daily tasks
  • Take it one day at a time and look at each day as a new day. Don’t get discouraged
  • Take breaks throughout the day
  • On days that you have more energy, cook soup or stews in bulk to have meals on hand
  • Try not to overdo it on higher energy days, so you can conserve your energy
  • Increase your physical activity as best you can in order to help fight fatigue

Lack of Appetite (Not Feeling Hungry)

Lack of Appetite (Not Feeling Hungry)

  • Eat 5-6 small meals throughout the day, instead of 3 big meals
  • Keep an eating and drinking schedule and set an alarm to remind you to eat
  • Drink fluids in between meals instead of with meals so that you do not fill up on fluids
  • Keep snacks next to you during chemotherapy or while in bed
  • Eat with friends or family or watch television while eating to take your mind off of your lack of appetite
  • Make mealtime as pleasant as possible. Set the table, use nice plates, and have flowers as a centerpiece
  • Have easy-to-eat, easy-to-prepare foods in the house such as:
    • Yogurt, pudding, or applesauce
    • Cottage cheese with canned fruit
    • Whole grain cereals
    • Low sodium canned soups
    • Oatmeal packets
    • Pre-made smoothies
    • Peanut butter crackers
    • Trail mix or nuts (if you can chew and swallow well)
    • Mashed or baked potatoes
    • Pre-made nutritional drinks
    • Hard boiled eggs
    • Hummus dip
    • Pasta salads, tuna salad, egg salads

Mouth Sores and Mouth Pain

Mouth Sores and Mouth Pain

Mouth sores and mouth pain can occur before, during and after head and neck cancer treatment.

  • Choose foods that help soothe the mouth, including:
    • Cold foods, such as popsicles, frozen fruit, and ice cream
    • Soft, mild foods, such as cottage cheese, smoothies, and yogurt
    • Well-cooked, soft meals such as potatoes, macaroni and cheese, casseroles, stews, and ground meats
  • Avoid foods that could irritate the mouth, including:
    • Acidic or spicy foods, such as citrus fruits, tomatoes, peppers, and vinegar
    • Crunchy or hard foods, such as crusty bread, pretzels, and chips
    • Hot foods. Choose room temperature or cold instead
    • Alcohol and carbonated drinks
  • Suck on ice chips when you have mouth pain
  • Drink through a straw to avoid sore spots
  • Rinse your mouth out before and after meals with a homemade baking soda rinse. Swish and spit, DO NOT SWALLOW. Prepare a new batch each day
    • ½ tsp salt, 1 tsp baking soda, 1 quart of water

Try these recipes if you experience mouth pain: Almond Banana Wheatberry Cereal RecipeAvocado Macaroni and Cheese RecipeBanana Melon Smoothie RecipeChicken, Broccoli, and Noodle Casserole Recipe & Roasted Cauliflower Soup Recipe

Problems Chewing or Swallowing

Problems Chewing or Swallowing

Chewing and swallowing can become more difficult after surgery and chemotherapy for head and neck cancer treatment.

  • Choose foods that are easier to chew and swallow:
    • Soft foods - scrambled eggs, oatmeal, soft pasta, potatoes, soups, and stews
    • Softer protein sources such as fish, ground meats, eggs, beans, and creamy nut butters
    • High calorie drinks, such as smoothies, milkshakes, or nutritional supplements. (Be sure to discuss all nutritional supplements with your health care team first.)
  • Stay away from foods that could cause chewing or swallowing pain:
    • Hard foods, such as crackers, crusty breads, raw vegetables, and crunchy cereals
    • Tough meats, such as steak, pork chops, turkey, or chicken breast
  • Make foods easier to chew and swallow by:
    • Pureeing foods in the blender
    • Adding dressing, sauces, or gravy to meats and other dishes
    • Thickening foods as needed with cornstarch, baby cereal, potato flakes, gelatin, or commercial thickeners
  • Swallowing a spoonful of honey right before radiation treatment may help protect your throat5

Address Concerns with Your Health Care Team

If you regularly cough or bring food back up after eating, be sure to tell your health care team. You may need to meet with your speech-language pathologist to assess how well you swallow.

If you have trouble opening and closing your mouth to chew foods, talk to your health care team. You may need to meet with your physical therapist for exercises to help you.

Try these recipes if you have problems chewing or swallowing: Banana Melon Smoothie RecipeChicken, Broccoli, and Noodle Casserole RecipeCranberry Coconut Popsicle RecipeCreamy Beet Hummus RecipePolenta with Fruit Compote RecipeRoasted Cauliflower Soup Recipe & Sweet Potato Chili Recipe

Diarrhea

Diarrhea

Diarrhea is when you have loose, watery bowel movements. It can also come along with stomach pain or cramping.

Foods to AVOID when you have diarrhea:

  • High fiber and bulky foods, such as raw vegetables, nuts, and whole grains 
  • Dairy foods
  • Foods that are high in sugar, such as juices or sweets
  • Greasy and fried foods
  • Alcohol and caffeinated drinks

Foods to eat when you have diarrhea:

  • Easy-to-tolerate foods:
    • Apples or applesauce
    • Bananas
    • White rice or pasta
    • Oatmeal, barley, or cream of rice cereal
    • Plain potatoes without skin
    • Baked chicken, turkey, or fish
    • Canned fruit (in juice), such as canned peaches or pears
  • Hydrating fluids with electrolytes, such as coconut water, broth, electrolyte drinks and diluted fruit juices. Carry a water bottle to stay hydrated.
  • Probiotics from food such as yogurt, kefir and fermented foods. Talk to your health care team before taking any probiotic supplements

Try these recipes if you experience diarrhea: Ginger Turkey and Wild Rice Soup Recipe & Savory Stuffed Spaghetti Squash Recipe

Constipation

Constipation

Constipation is when you have trouble having a regular bowel movement and are not able to have a movement every day.

  • Increase foods that can help promote a bowel movement:
    • Choose high fiber foods, such as whole grains, fruits, vegetables, nuts, and beans
    • Try prunes and other dried fruits and juices, such as prune or apple juice
    • Drink hot beverages, such as herbal tea and decaffeinated coffee
  • Make sure you drink enough water
  • If you are having gas and bloating, stay away from “gassy” vegetables like cabbage, broccoli, cauliflower, peas, corn, and beans
  • Move more if you are able - walk, stretch, or do yoga
  • Talk to your health care team about drugs or other tips that can help with constipation

Try this recipe if you experience constipation: Savory Stuffed Spaghetti Squash Recipe

Dry Mouth

Dry Mouth

Dry mouth can be caused by certain medications, radiation treatment for head and neck cancer, or not drinking enough.

  • Staying hydrated can help prevent dry mouth and taste changes. Aim for at least 64 oz of hydrating fluids daily unless told otherwise by your doctor. Carry a water bottle with you to stay hydrated.
  • Increase your saliva by:
    • Adding lemon or lime to water (if you don’t have mouth or throat sores)
    • Sucking on sugar free tart candies prior to eating
    • Chewing on sugar free gum in between meals
    • Using citrus fruits or juices in marinades or dressings
    • Moistening foods with sauces and gravies
  • Limit dry or hard-to-swallow foods, such as baked potatoes, peanut butter, tough meat, and “doughy” bread
  • Avoid alcohol and limit caffeinated drinks

Other non-food tips for dry mouth:

  • Use alcohol-free mouthwash daily
  • Apply lip balm or petroleum jelly to protect your lips
  • Sleep with a humidifier in your room to help moisten your mouth at night. Be sure to clean the humidifier regularly.

Try these recipes if you experience dry mouth: Cranberry Coconut Popsicle Recipe & Herbed Lemon Salmon Recipe

Changes in Taste and Smell

Changes in Taste and Smell

Foods may taste or smell different every day. You may find it helpful to keep trying different foods to find what appeals to you.

If everything tastes bland or has no taste:

  • Add stronger flavors onto foods. If you don’t have mouth or throat sores, pickles, condiments, sauces, dressings, vinegar, or citrus juices may help
  • Add spices and seasonings to enhance the flavor of your food
  • Marinate meats for a stronger flavor
  • Suck on sugar free tart candies before or after a meal
  • Rinse your mouth out before and after meals with a homemade baking soda rinse. Swish and spit, DO NOT SWALLOW. Prepare a new batch each day
    • ½ tsp salt, 1 tsp baking soda, 1 quart of water

If everything tastes metallic or bitter:

  • Choose other protein sources (such as fish, chicken, or beans) if red meat tastes metallic
  • Use plastic utensils instead of silverware
  • Add sweeteners such as honey or pure maple syrup onto foods to offset the bitter taste

If the smell of food makes you not want to eat:

  • Avoid being in the kitchen when food is being made
  • Open a window or turn on a fan to minimize the smells
  • Choose cold or room-temperature foods instead of hot foods, which can smell stronger
  • Light a pleasant scented candle or essential oil diffuser to remove offensive odor

Try these recipes if you experience changes in taste: Creamy Beet Hummus RecipePolenta with Fruit Compote Recipe & Savory Stuffed Spaghetti Squash Recipe

Nausea and Vomiting

Nausea and Vomiting

Nausea and vomiting can be caused by certain treatments for head and neck cancer. There are many things that you can do to help manage it.

  • Even though you do not feel like eating, an empty stomach can make nausea worse. Aim to eat a small amount of food every 1-2 hours to prevent nausea
  • Choose room temperature or cold foods, instead of hot entrees
  • Drink ginger tea or chew ginger candies when you feel nauseous
  • Choose dry and bland foods, such as crackers, pretzels, and plain pasta or rice
  • Limit your intake of fried, greasy, or “heavy” foods, as these can make nausea worse
  • Drink hydrating fluids (such as water, 100% juice, coconut water, or chamomile or ginger tea) throughout the day to prevent dehydration

Other non-food tips for nausea and/or vomiting:

  • Talk to your health care team about anti-nausea drugs. For the most benefit, take anti-nausea drugs 30-45 minutes prior to a meal. You may also need to take them around the clock, instead of as needed.
  • Try deep breathing, meditation, or guided imagery to help settle your stomach and mind
  • If drugs or supplements make you nauseous, talk to your health care team about taking them with food, instead of on an empty stomach

Try these recipes if you need help with nausea: Ginger Turkey and Wild Rice Soup Recipe & Almond Banana Wheatberry Cereal Recipe

​Weight Loss

Weight Loss

It is important to prevent weight loss during head and neck cancer treatment. To prevent weight loss and add calories to your diet:

  • Aim to eat 5-6 small meals daily, instead of 3 big meals
  • Add high-calorie additives to the foods you eat regularly such as:
  • Avocado
    • Olive oil or butter
    • Nuts and seeds
    • Cheese
    • Sauces and gravies
    • Peanut butter, almond butter, or other nut butters
    • Dried fruit
  • Add high-calorie smoothies or nutritional drinks to your daily routine
  • Include high-protein foods to help your body heal and prevent further muscle mass loss:
    • Nuts and nut butters
    • Beans and seeds
    • Meat
    • Fish
    • Poultry
    • Eggs
    • Dairy products
  • Talk to your health care team about physical therapy if you feel weak or unable to maintain your daily routine

Try these recipes if you need to add calories to your diet: Avocado Macaroni and Cheese Recipe & Baked Apple Yogurt Parfait Recipe