Editor's note (2024): the ever-changing and complicated approach to nutrition assessment and subsequent management has directed our approach to consult the nutrition/dietary service - both for assessment and direction in feedings (including tube feedings) HH

Note: below last updated before 2013

PURPOSE

1. To assess all newly diagnosed head and neck oncology patients' current nutritional status, identify and provide intervention to patients in need of pretreatment nutritional enhancement, and to assess and provide intervention to head and neck oncology patients during treatment and posttreatment

PROCEDURE - Newly diagnosed head and neck cancer patients

1. Assess nutritional status of new head and neck cancer patients on first clinic visit. Sample questions:
   1. How would you describe your diet/nutritional status? poor, probably inadequate, adequate, or excellent Have you experienced a weight loss over the past 2 to 3 months? If yes, was the weight loss intentional?
   2. Do you have difficulty or pain when chewing and/or swallowing your food?
   3. If yes, has this caused you to change the types or consistency of the food you eat?
   4. What do you eat in a normal day?
2. Provide patient with the appropriate educational materials if nutritional status warrants:
   1. "Healthy Eating Plan"
   2. "High Protein High Calorie Diet"
   3. "Soft Ground and Blended Diet Guidelines"
   4. "Mechanically Altered Diet"
   5. "Pureed Diet"
   6. "Food Tips"
3. Provide patient with information regarding available nutritional supplements. Instruct patient to eat or drink supplemental snacks between meals, 2 to 4 times per day.
4. Instruct patient to monitor weight every other day.
5. Consult dietician for more detailed assessment and intervention as needed.
6. Patients undergoing treatment or posttreatment:
   1. Monitor weight on every clinic visit.
   2. If weight loss has occurred, assess compliance with diet noting any difficulty eating or swallowing or complications with enteral feedings.
   3. Provide intervention as needed (eg, consult dietician, utilize written nutritional materials, assess need for supplements)