Oral/Mouth Cancer - Diagnosis, Nutritional Assessment, and Dietary Treatment

January 24, 2022

Written by Maira Ahsan

Oral/Mouth Cancer - Diagnosis, Nutritional Assessment, and Dietary Treatment

January 24, 2022

Written by Maira Ahsan

Cancers of the mouth and pharynx make chewing and swallowing difficult, and many patients experience anorexia and lose weight. These tumors may be surgically removed and/or radiotherapy or chemotherapy used. Before treatment, a soft, semi-solid, or fluid diet should be given.

Here the question arises;

Does nutritional status before surgery matter?

Yes. A patient who is well nourished is more likely to withstand the stress of surgery and make a more rapid recovery afterward. Protein and energy supplements may be needed to prevent any further loss of weight and to maintain a patient's nutritional status. If a patient can't consume an adequate diet orally, nasogastric feeding by tube may be required.

So let's talk about Cancer of the mouth and its dietary treatment in detail;

Cancer of the mouth

Before treatment, patients who have cancer of the mouth often need encouragement to eat. In addition to a soft, semi-solid, or fluid diet the following suggestions may be helpful. In order to relieve the sore mouth, which is common in this condition, patients should be advised to avoid very hot, salty, and spicy foods. Food that is eaten lukewarm may be tolerated better. Acid fruits and fruit juices should also be avoided as they will sting. Dry meals are also likely to cause discomfort and plenty of gravy or sauce will make eating easier, Chilled drinks may be soothing. At the time of surgery, it is the usual procedure to insert a nasogastric tube.

Feeding with a commercially prepared enteral feed can then be started after the operation as soon as gastric emptying has been established.

How can adequate gastric emptying be checked?

Using a nasogastric tube 60-100 ml water can be infused. Aspiration should be carried out every four hours until there is only a minimal return of aspirate. This shows that gastric emptying is taking place.

Dietary Treatment

A soft, high-protein, high-energy, light diet should be introduced the patient can feed through the mouth, and the use of the nasogastric tube should then gradually be phased out.

Such surgery may be extremely disfiguring, and a patient may become very depressed. In view of this and the side effects of any other cancer therapy the patient may be receiving, it is particularly important to give encouragement and practical advice to ensure an adequate nutrient intake.

Radiation therapy

Radiation therapy may result in several side effects and problems that discourage eating. Radiation of the mouth results in tender, swollen tissues, which may make nasogastric feeding necessary. Radiotherapy may also damage the taste buds alter taste sensitivity, and consequently cause a loss of appetite.

A dry mouth and lack of saliva can also make eating difficult. This type of patient may be undernourished with high energy and protein needs but feel disinclined to eat. The patient should be given small frequent meals and every attempt made to make them look appetizing. Even when it is necessary to puree the foods, their appearance can be improved by pureeing the courses separately, rather than presenting a bowl of muddy soup. The patient will also need a supplement of vitamin C if fruit and fruit juices cannot be tolerated.