Assessment of malnutrition in patients with head and neck cancer: a multidimensional approach

Abstract

Patients with head and neck cancer often have problems with food intake that can result in a disturbed nutritional balance and malnutrition. The disease itself, the localization of the tumor, and the side effects of the treatment, that is often aggressive, may result in not fulfilling nutritional needs. Malnutrition in its turn can delay recovery and negatively influence treatment tolerance. In this thesis the general aim was threefold. Firstly, to describe diagnostic value of malnutrition assessment methods. Secondly, to adapt an instrument to assess nutritional status for Dutch practice. Finally, to explore psychological mechanisms that may influence physical activity behavior in patients with head and neck cancer. This study has led to the conclusion that it is still a challenge to find the most suitable and effective method to treat malnutrition in patients with head and neck cancer. However, the Patient-Generated Subjective Global Assessment is now available and appears to be a suitable and available instrument for screening and assessment of malnutrition (risk) and provides information for tailored interventions. Patients with head and neck cancer may not always be interested in increasing their level of physical activity, because they may overestimate their actual level of physical activity. Since malnutrition is a highly complicated problem, a multidimensional approach is needed, with attention for nutritional balance, body composition and function, possible influence of inflammatory factors, and a sufficient level of physical activity