Why have I been referred to the dietitian?

The oncology dietitian is part of the Head and Neck Team. It is important that you follow the advice in this leaflet in addition to information given to you by other healthcare professionals.  They will support you throughout your treatment and will be able to advise you how best to meet your nutritional needs. It is important that we optimise your nutrition, weight and hydration during treatment. The reasons for this are highlighted below.

• Maintain your strength and energy levels to help you cope with your treatment
• Maintain your quality of life
• Avoid infections (poor dietary intake lowers immunity making you more susceptible to infections)
• Heal and recover after treatment.

How will radiotherapy affect my ability to eat and drink?

Radiotherapy will have significant side-effects which will affect your ability to eat, drink and swallow. The side effects will vary between individuals depending on which part of the mouth and neck is being treated. Generally you may experience increased dryness, taste changes, pain, thickened secretions, poor appetite and tiredness. These side effects will gradually build up as treatment progresses and will worsen for up to two weeks after treatment has finished. As any of these side effects can affect your intake, causing you to lose weight, a feeding tube may be placed before you start treatment to enable you to maintain your nutrition and hydration.

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 dehydrated and need to be admitted to hospital.

How will chemotherapy affect my ability to eat and drink?

Chemotherapy may cause side effects which vary between individuals. It may cause nausea and vomiting, loss of appetite, taste changes and diarrhoea or constipation. You will be given medication to control these side effects. Our advice would be to take these medicines regularly, as prescribed and if your side effects are not controlled you should contact your local chemotherapy unit.

What else can I expect?

The oncology dietitian will review you before, during and after treatment. This may be face-to-face or by phone or video. If you have any nutritional questions or concerns, you can contact your dietitian between reviews.

During treatment the dietitian will assess you regularly 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. Most people are only able to manage fluids at the end of treatment. You will be offered nutritional supplement drinks as you need them.

Things to consider on treatment

• Please let us know if you have any food allergies
• Cool drinks and foods help to soothe your throat
• 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 Please let us know if you would like support to stop smoking
• You will need to drink plenty of fluids, your dietitian will give you further guidance on this
• Choose soft foods with plenty of sauce or gravy and have a drink to wash the food down
• Tell your treatment team if you are in pain
• 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 will get worse for at least two weeks. After this they will start to improve slowly. It may take several months before you are eating a more normal diet; this varies from person to person. The dietitian will support you through this period. If you have a feeding tube, we will aim to gradually reduce tube feeding as you eat and drink more and work towards removing the feeding tube.

You will continue to be reviewed by the oncology dietitian until you are established back to a nutritionally complete diet to promote long term health and wellbeing.