Why have I been referred to the dietitian?

The oncology dietitian is part of the head and neck team. They will support you throughout your treatment and will be able to advise you how best to meet your nutritional needs.

Radiotherapy will have significant side-effects which will affect your ability to swallow. It is important that you maintain your weight throughout treatment. Even a small amount of weight loss can be significant as it can affect how well your mask fits and the accuracy of the target area for treatment.

If you do lose weight, your mask may not fit properly which may lead to a delay in your treatment whilst a new mask is made and the treatment re-planned. Treatment may be postponed if you become de-hydrated and need to be admitted to hospital.

It is also important for you to stay well-nourished and hydrated as this will help you to:

• maintain your strength and energy levels
• cope with your treatment
• maintain your quality of life
• avoid infections
• heal quickly after treatment.

How will radiotherapy affect my ability to eat and drink?

The side-effects of treatment will vary between individuals. Generally, you will experience increased dryness, pain, a sensation of having to swallow past something, thickened secretions, poor appetite and tiredness. These side-effects will gradually build up as the treatment progresses and will continue after the treatment has finished. Any of these side-effects can affect your intake causing you to lose weight.

What else can I expect?

The oncology dietitian has pre-assessed you, given you advice and answered any questions you may have had about your treatment. Your weight and height will have been recorded and you should aim to maintain your weight from now on.

You should contact the oncology dietitian if you are losing weight before you start your treatment.

During treatment they will assess you at least weekly to check your weight, intake and symptoms and if necessary will suggest changes to your diet. As treatment progresses the type of food and the amount you can eat will change. Some people are only able to manage fluids at the end of treatment. You will be offered supplement drinks if you need them.

Is there anything else I need to do?

• Be wary of hot foods and fluids. Your mouth will be able to cope but your throat may find them too painful.
• Cool drinks and foods help to soothe your throat.
• It is best to avoid alcohol as it may make the pain and dryness worse.
• If you smoke, it is advisable to stop as it will make your symptoms worse.
• If you are taking medications, talk to your doctor about having them changed to soluble forms.
• If your throat is getting dry, you will need to drink plenty of fluids. Milk may be easier to drink than water.
• Take small mouthfuls of food and chew very thoroughly before swallowing. Choosing soft foods with plenty of sauce or gravy and having a drink to wash the food down will help.
• You may want to blend or puree your food but don’t feel that you have to.
• If your pain is under control, it is more likely that you will be able to keep eating and drinking.
• Don’t wait for your weekly review, ask to see us if you have a problem.

What happens when I finish treatment?

Once you have finished treatment the side effects can continue for up to a fortnight. You should then start to feel as if your throat is recovering. We would expect you to be eating a normal diet within four to six weeks of the treatment finishing.

You will continue to be reviewed by the oncology dietitian in the joint head and neck clinic. If you are having difficulties you will be offered a longer individual appointment with the oncology dietitian in the support and rehabilitation clinic. If you prefer, we can refer you to a community dietitian who can see you closer to home.