The role of dietary counseling and nutrition support in head and neck cancer patients.
Head and neck cancer patients frequently present with malnutrition. Treatment options put the patient at further nutritional risk. Inadequate nutritional status is associated with poor prognosis. Dietary counseling and nutrition support can positively impact prognosis; however, the evidence is sparse and of poor quality. The aim of this review is to summarize the current evidence concerning the role of dietary counseling and nutrition support in head and neck cancer patients undergoing curative treatment. There remains a lack of evidence both in quantity and quality. Current findings support a role for dietary counseling and nutrition support from diagnosis through rehabilitation. Prognostic indicators for nutrition support include tumor location, tumor stage, and multimodal treatment. Results of an innovative nutrition-based care delivery model were positive. Dietary counseling is appropriate for all head and neck cancer patients to enable adequate oral intake from diagnosis through rehabilitation; however, some patients require nutrition support. Prognostic indicators and predictive models have been developed to identify patients who require early nutrition support. Next steps include development of evidence-based nutrition care paths that are tested at multiple sites using well designed longitudinal studies and randomized clinical trials.