Preparing for Treatment of Oral, Head and Neck Cancers

Quite simply, for a majority of people diagnosed with head and neck cancer—it hurts to chew and swallow, and it can be very difficult to eat—before, during and even after cancer treatment. Earlier this week, we reviewed some of the common side effects to expect during and after oral, head and neck cancer treatment. This week we will discuss some important ways to be proactive.  Being proactive can help to prevent and manage these side effects. It is important to see your dentist and ask to be referred to the registered dietitian at your Cancer Center.  Here are some useful tips:

1. See the Registered Dietitian Before Treatment:

Ideally, everyone preparing for cancer treatment should be thoroughly assessed and evaluated for nutritional risk.  Ask your oncologist for a referral to see the registered dietitian (RD) in your Cancer Center, hospital, or local community.  Some Cancer Centers even have RDs with specialized training, knowledge, and experience in working with people with cancer—these RDs are called Certified Specialists in Oncology Nutrition (CSOs).

Work with the RD to develop an eating plan that is right for you during treatment.  No two people are alike!  The RD will recommend how many calories and much protein you need to help you maintain your body weight.  From treatment through recovery you should strive to maintain your weight—even if you are overweight. Cancer treatment is not the time for losing weight!  Losing muscle—your body protein stores—rather than body fat during this time adds to loss of strength and energy, and often leads to a more lengthy recovery once treatment is over.

Sometimes your oncologist and your RD may recommend a feeding tube for two very important reasons:

  • to help you undergo treatment without treatment breaks, interruptions, or dose reductions;
  • and to help you maintain your weight and body nutrition stores.

Regardless whether you have a tube feeding placed or not, you need to continue to continue to swallow liquids throughout your treatment—or for as long as your doctor says it is safe to do so.  Swallowing through treatment helps to preserve swallowing function.

preparing for cancer treatment to the head and neck2. See the Dentist Before Treatment:

A referral to the dentist prior to the beginning your radiation therapy is critical for oral health.  Mouth problems need to be taken care before treatment begins!

Your dental team will check and clean your teeth, remove damaged teeth, and perform needed dental work.  You will be counseled regarding the importance of doing daily oral hygiene such as:

  • brushing your teeth with a soft toothbrush;
  • using a fluoride-containing toothpaste or gel for life;
  • and rinsing the mouth frequently throughout the day with a homemade saline, baking soda solution.
Homemade Saline, Baking Soda Rinse

  • Mix fresh daily.
  • Sip, swish and then spit out rinse.

Ingredients:

4 cups of water

1 teaspoon of salt

1 teaspoon of baking soda

Serious consequences of not removing damaged teeth before treatment can result in cavities, gum disease and possible damage to the jaw bone. You will also be given daily exercises for maintaining chewing and jaw function.

If you do not have teeth, mouth care is still important!  Ill-fitting dentures or dental plates should not be worn and frequent rinsing of the mouth and good oral hygiene is still required.  Be sure to clean your dentures or dental plates as directed by your dentist.  If you have an oral prosthetic check with your radiation oncologist and/or the doctor that made the device for instructions about using it during treatment.

If you do not have a dentist ask for your oncologist for suggestions of dentists in your area that have experience in seeing people going through cancer treatment.  If you do not have dental insurance or unable to afford a dentist, ask your oncologist or your Cancer Center social worker for suggestions about free dental clinics or reduced-cost dental services in your area.

3. See the Speech Pathologist:

If you have any concerns about your swallowing, ask your oncologist about being referred to a speech pathologist before your treatment begins.  This is especially important if you have any of the experienced any of the following procedures or conditions:

  • Have you undergone surgery to your mouth or throat prior to starting your therapy?
  • Do you have a history of swallowing problems?
  • Do you have a cancer that makes it difficult to chew or swallow?

Being assessed for swallowing function is important for swallowing safety and for the prevention of aspiration and possibly pneumonia!  Some people may even benefit by continuing swallowing therapy through treatment to support and preserve swallowing muscles that can become affected by treatment.

In closing, being prepared for your treatment and knowing about what to expect can help you to stay nutritionally strong, as well as help you to heal and recover as quickly as possible, once your treatment has been completed.  Stay tuned for the next blog—nutrition and physical activity recommendations for life after treatment—cancer survivorship.

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