EFFECTIVENESS OF NUTRITIONAL COUNSELING IN IMPROVING THE NUTRITIONAL STATUS OF HEAD AND NECK CANCER PATIENTS UNDERGOING CONCURRENT CHEMOTHERAPY AND RADIOTHERAPY THROUGH CONTINUOUS GUIDANCE ON NUTRITION
Though nutrition plays a vital role during all phases of cancer treatment, in patients suffering from head and neck cancer, it is particularly important. Studies have reported the malnutrition prevalence rate of head-neck cancer patients as high as 74.2%. Studies have shown that early intervention and counselling by a dietician, with proper evaluation and guidance for nutritional management is of paramount importance is improving the nutritional status of patients in head and neck cancer.
Materials and Methodology
A retrospective data from 1st October 2018 to 31st March 2019 for 50 head and neck cancer patients on concurrent chemotherapy and radiotherapy before initiation of the dietary counseling initiative henceforth referred as Non Counseling Group (NCG) was compared with retrospective data from 1st May 2019 30th October 2019 of 50 head and neck cancer patients on concurrent chemotherapy and radiotherapy who received the diet counselling services henceforth referred as Regular Counseling Group (RCG).
On the first day of therapy Nutritional Status of Regular Counselled Group (RCG) and Non Counselled Group (NCG) subjects were Well Nourished 10 (20%) and 10 (20%) respectively; Moderately malnourished 27 (54%) and 23(46%) respectively; Severely malnourished 13 (26%) and 17 (34%) respectively. On the other hand on last day of therapy Nutritional Status of RCG and NCG subjects were Well nourished 20 (40%) and 4 (8%) respectively; Moderately malnourished 27 (54%) and 19 (38%) respectively; Severely malnourished 3 (6%) and 27(54%) respectively. Analytical data as per comparison revealed that nutritional status of RCG subjects are better than NCG subjects
The present study showed that the nutritional status of the patients gradually declined during the treatment with peak decline by 3rd week. As a result of dietary counseling, changes in mode of diet delivery, further deterioration was prevented leading to better nutritional intake.
Patient assessment and dietary counselling with as recommended continued in subsequent sessions.
On the third week 16(32%) patients consumed adequate calories and 26(52%) patients consumed optimum protein. Adequate calorie intake was recorded in 18(36%), 17(34%) patients and protein intake in 28(56%), 29(58%) patients in the 4th and 5th week.
The data revealed that the patients were motivated and benefited by the continuous counseling by the dietician as the complaint of fatigue did not further increase after 5th and 6th week which is very commonly seen in such patients on therapy.
Conclusion: This study demonstrated that Nutritional counseling, starting of tube feed at an appropriate time and oral nutritional supplements should be used to increase dietary intake and to prevent therapy-associated weight loss and interruption of therapy.
Key words: Head and Neck cancer, Diet counseling, Nutrition