Eating Well during Head and Neck Cancer Treatment

Eating well during head and neck cancer is important. Good nutrition makes it easier to tolerate treatment and improves your quality of life. But if you have a cancer in the head and neck area—such as thyroid cancer, tongue cancer, throat cancer, oral cancer, or salivary gland cancer—treatments and side effects may affect how you eat.

People with head and neck cancers may have these problems:

• Difficulty chewing or swallowing
• Taste and smell changes
• Loss of appetite
• Thick saliva or mucus
• Sore mouth and throat
• Dry mouth and throat

Huntsman Cancer Institute patient Don Burbank got radiation treatment for tongue cancer and experienced many side effects. Throat cancer patient Carolyn Larrivee recognized her own difficulties with throat cancer and both wanted to share some advice.

Registered dietitians and speech therapists are part of your care team. They help with side effects that make it hard to eat. Speech therapists provide swallowing exercises or recommend food with a certain texture, such as soft or pureed, to make sure you can eat safely.

When you are not feeling well and have trouble swallowing, it can be hard to meet your body’s energy needs. If you start losing weight, it means your body is not getting enough energy. Registered dietitians can help you figure out how to consume enough protein and calories to maintain your weight and muscle mass. They consider your preferences and provide you with appropriate food and fluid options.

Don’s dietitian recommended a high-calorie, high-protein soft diet, including foods like pudding and gelatin. When those foods became too hard to swallow, Don went on a total liquid diet with drinks that gave him enough calories and nutrients. Carolyn also stayed on a liquid diet before progressing to soft foods. She loved yogurt before chemotherapy, but after treatment, she found she disliked the texture and stopped eating it.

Everyone has different nutrition needs and different issues, so it’s important to work with your dietitian and medical team to find what works for you. Here are some tips from Don, Carolyn, and HCI dietitians:

Eat small meals throughout the day.

• Try eating every 2–3 hours to give you energy all day long.
• Eat at the same time every day. You may want to set an alarm to remind you it’s time to eat.
• Introduce one food at a time to see what you can tolerate.

Choose high-calorie and high-protein foods.

• Anticipate weight loss. Eat foods with higher calories and protein to help maintain your weight without having to eat a large amount of food.
• Whole-fat dairy products, cream-based soups, and nutrition supplement beverages are good high-calorie and high-protein foods.
• Fruit smoothies are great, but avoid citrus fruits in case of mouth sores.
• Eat meat like tenderized chicken, pork, meatballs, and sausages with a soft food like spaghetti.

Add extra calories to your food.

• Add extra fat to your food to increase calories without having to eat a lot more.
• Cook vegetables in oil and butter to get the nutrients of vegetables along with extra calories.
• Avoid peanut butter because it is a choking hazard.

Focus on foods or drinks that are easy to chew and swallow.

• How you eat may change throughout treatment. You may start eating soft foods, but find that a liquid diet is best.
• Keep soft foods and nutrition supplement beverages on hand in case it becomes too hard to swallow.

If it does become difficult to swallow, try it in stages. Turning your head to the side to prevent aspiration can be extremely helpful when taking pills.