When a patient has head and/or neck cancer, eating can often become a difficult activity. Usual side effects include nausea and vomiting, mouth sores, dry mouth, smell sensitivity, weight loss, and difficulty chewing and swallowing. Following initiation of radiation and chemotherapy, these side effects are often amplified, and the patient may not be able to eat at all. The good news is there are tools available to help reduce the severity of these side effects.
Having a dietitian within your health care team is important to make sure that you are receiving adequate nutrients and calories during and after your cancer treatments. Each treatment plan is customized to each individual based on the person’s needs.
Before the start of your treatment, it’s important to eat healthy meals as much as possible. Healthy meals include fruits and vegetables, lean proteins, whole grains, and low-fat dairy. Once treatment has started, one’s focus should shift to weight maintenance. During treatment healthy soups, premade protein shakes, or homemade smoothies with protein, fruits and vegetables, can all assist in staying hydrated. If you are having issues with specific textures and consistencies of soups or beverages, address them with your healthcare team, in particular your dietitian. Your dietitian can provide guidance for texture modifications in the setting of swallowing and/or chewing difficulty. The goal is to not lose any more weight than may have already been lost.
If you experience mouth sores, make soups, or have beverages that are cold or at room temperature. Stay away from alcohol, carbonated beverages, spices or acidic foods, all of which can make the mouth sores worse and irritate the mouth resulting in poor intake. Drinking through straws and/or sucking on ice chips may help ease pain. If you experience dry mouth, try chewing gum between meals and staying hydrated with fluids with added electrolytes. Also limit “hard” foods such as crunchy peanut butter, tough meat, and other foods that cause pain.
If food starts to have a metal taste, limit your contact with metal such as switching to plastic silverware or glass/plastic bottles. You can also try different sources of foods that start to taste different or bland, and season the food very well. For example, if red meats start to taste different, try chicken or lean turkey. If the food cooking starts to make you feel nauseated, try making cold foods or asking someone else to do the cooking, allowing you to be away from the kitchen as the food is cooking. Stay away from greasy and fried foods during this time as these types of foods will irritate your mouth pain as well as upset your stomach.
Also, make sure that proper oral hygiene is being practiced as discussed between you and your healthcare team, especially your dentist. Lacking proper oral hygiene can add to bacterial infections in the mouth and once again, not being able to eat during and after treatment. Stay away from mouthwashes that have alcohol in them to prevent more mouth pain and dry mouth.
When a patient has a head/neck cancer, eating can become a full-time job. Fatigue experienced from the radiation and chemotherapy and multiple side effects results with the patient not wanting to eat. The primary goal for the patient is to be able to consume their necessary calories and nutrients to prevent further weight loss and minimize experienced side effects. Whether your meals have to be pureed, blenderized, or marinated to make the foods softer, there will always be an option for you to eat food when you have a head/neck cancer.