By Ms. Shumshum Chowdhury, Dept of Nutrition and Dietetics, HCG EKO Cancer Centre, Kolkata

A healthy diet is an essential part of a head and neck cancer patient’s journey before, during, and after the treatment. Following a healthy diet can help prevent weight loss, lack of appetite, and other side effects of head and neck cancer treatment.

Cancer dietitians work with patients and families to personalize nutrition therapies that help in responding better to the treatment. A patient is prescribed a specific diet plan after nutritional screening and assessment. It is always important to get enough nutrition during the treatment. A dietitian must always explore new diet challenges on a day-to-day basis.

This will help in keeping the weight stable and maintaining muscles strength. Here is a focus on the diet of head and neck cancer patients.

Diet before treatment

Post diagnosis of cancer, the patient is advised to go on high calorie and high protein diet before surgery. At least 30Kcal-35Kcal per kg per day and 1.2g to 1.5g per kg per day intake is required. If a patient is malnourished, then ideal body weight to be considered, and, if the oral intake does not meet the total calorie intake, then nutritional supplements are advised.

Nutrition dense breakfast: Serving 2. Total calorie 190Kcal and total protein 12.2g Ingredients: 1/4 cup oats, 2 egg white, oil -2ml, mixed herbs, garlic, turmeric powder, pink salt. Method: Heat the kadai put 2 ml oil, add 2 cloves of garlic then add two egg white and sauté for 1 min. Then add oats and dry roast for 2 min, add water 1/2cup, turmeric powder, salt and mixed herbs and cook for 2 minutes. Ready to serve. (Egg white can be replaced by homemade cheese curd.

Diet during treatment

The diet followed by the patient during the treatment is to be monitored closely since two barriers of treatment are crossed by the patient during this phase. The first phase is during the surgery and then the post-surgery part. A liquid diet comprising of 35Kcal per kg per day and 1.5g per kg per day to be consumed.

Post recovery from surgery patients can follow a semi-solid or soft diet. Diet pattern varies from patient to patient. Some patients observe their intake patterns and customize the diet as per their requirements or else dietitians must be consulted for a proper diet plan based on the treatment plans. After 3 to 5 cycles of radiation therapy nasal gastric tube is recommended with the same post-surgery calorie requirement.

Patients must maintain a food diary from 1st day of radiation so the calorie intake can be monitored. If a patient is taking radiation therapy orally, then blending high calorie and high protein is recommended.

Calorie dense Soup: Serving 2. Total calorie 235 Kcal and total protein 6 g Ingredients: 1 Carrot, 1 Beet, 1Sweet Potato, 100g Pumpkin, Olive Oil -5ml/ Butter-5gm, turmeric powder, pink salt, and cream. Method: Boil all the vegetables and mash it to make a smooth paste. Then add turmeric powder, butter, cream, and salt. Boil it for 5 min and serve at room temperature.

Diet after treatment

This is the phase where patients are allowed to consume a bland to low spicy diet according to their acceptance. Now patients are encouraged to increase their food intake. They are prescribed a well-balanced diet consisting of energy 25Kcal-30Kcal per kg per day and protein 1.0g-1.3g per kg per day. Fruits, vegetables, lean protein, high fiber grains, and whole pulses to be included in the diet.

After the initial recovery, they must improve long-term health so that their years ahead can be satisfactory as a survivor.

Antioxidant Smoothie: Serving 1. Total calorie 113 Kcal and total protein 2 g Ingredients: 1 Apple, 1 Banana, 1tsp chia seed, 1 tsp roasted crushed flaxseed, 2-4pcs roasted crushed almond,1 cup coconut milk. Mix all the ingredients.

After the treatment is completed, if the patient suffers from any sort of co-morbidities, they require special intervention and monitoring. During this journey, their diet changes as per their biochemical and hematological report. A six to eight meal diet plan is advised for patients who suffer from anorexia and nausea. This pattern is followed to regain and maintain the body weight and BMI back to normal and to strengthen the body’s immunity. A well-balanced and high protein diet is required to regain a normal BMI.

It is always important to prioritize the patient’s preference before tailoring a diet plan. Only then the nutritional intervention can give the best result. It should always be ensured that a nutritional assessment is part of all comprehensive treatment plans for patients with head and neck cancer.