Dietary Management and Cancers of the Larynx and Pharynx

February 1, 2022

Written by Maira Ahsan

Dietary Management and Cancers of the Larynx and Pharynx

February 1, 2022

Written by Maira Ahsan

Cancers of the pharynx and larynx

Cancer at both these sites makes it difficult for sufferers to eat and swallow food and this leads to loss of appetite. In addition, cancer of the larynx makes it difficult for a person to speak, causing a hoarse voice.

Dietary Management

Cancer of the larynx is the most usual reason for a laryngectomy (the removal of the larynx). Many patients undergoing this surgery will be at nutritional risk before it, of course, because they find eating and swallowing difficult: hence a soft, semi-solid, or liquid diet with supplements may be advised before treatment. A nasogastric tube is usually inserted when the pharynx or larynx is removed and feeding by it should be continued for at least ten days. Once healing has taken place a soft, light diet with energy and protein supplements can be introduced as the nasogastric feeding is phased out. Some patients may still find it hard to swallow and may need dilation to help them.

There is a danger that patients with either condition will restrict themselves to a very narrow range of soft foods and drinks, so it is important to encourage them to eat as wide a variety of foods as can be tolerated, and to check at every stage what they are eating.

Patients who have also had their parathyroid glands removed will also need calcium and vitamin D therapy.

Why does the removal of the parathyroid gland affect a patient's needs for calcium and vitamin D?

The parathyroid glands produce PTH (parathormone), which has a vital role in regulating calcium metabolism, partly through its effects on the production of the active form of vitamin D. When the level of calcium in a patient's blood falls, PTH is released. This stimulates the kidneys to reabsorb more calcium and stimulates the production of 1.25 dihydroxy vitamin D, which promotes the absorption and mobilization of calcium. In the bones, PTH stimulates osteocytes to resorb calcium, which can then be released into the circulation. When the parathyroid gland has been removed PTH cannot be produced, and this regulatory mechanism cannot function.