Chapter 14 Consequences of Cancer

BOX 14.7 cont. Nutrition and Supportive Care Intervention Strategies for Cancer-Related Side Effects or Symptoms

Sore Throat (Esophagitis, Dysphagia, or Odynophagia)

Identify the cause(s) of the sore throat (eg, chemotherapy agents, radiation therapy, medications, infection), and treat appropriately. Counsel the patient to do the following: ●

Eat soft, moist foods with extra sauces, dressings, or gravies. ● Avoid dry, coarse, or rough foods.

● Avoid alcohol, citrus, caffeine, tomatoes, vinegar, and hot peppers.

● Experiment with food temperatures (eg, warm, cool, icy) to find the most soothing temperature(s). ●

Thickened Saliva

Identify the cause(s) of the thickened saliva (eg, radiation therapy to the head and neck, medications, infection), and treat appropriately. Counsel the patient to do the following: ●

Maintain good oral hygiene: rinse the mouth frequently with a bland rinse. ● Sip on liquids throughout the day to keep the oral cavity moist. ● Thin thick oral secretions with club soda, seltzer water, or papaya nectar. ● Try guaifenesin or Alkalol products to help thin oral secretions. ● Try using a cool-mist humidifier while resting and sleeping. ● Use a home portable suction machine to remove thick oral secretions.

● Consult with a physician for consideration of pharmacological interventions to manage thick secretions.

Unintended Weight Loss Identify the cause of weight loss and cancer and cancer-treatment adverse effects that negatively affect nutri- tional status, and treat appropriately.

Counsel the patient to do the following: ●

Eat small, more frequent, nutrient-dense meals and snacks. ● Add protein and kilocalories to favorite foods.

● Try protein- and energy-containing supplements (eg, whey or soy powder, oral medical foods). ● Keep nutrient-dense foods close at hand, and snack frequently.

●

Consult with a physician for consideration of pharmacological interventions to stimulate appetite and improve food and beverage intake.

Xerostomia

Identify the cause(s) of xerostomia (eg, chemotherapy, radiation therapy to the head and neck, medications), and treat appropriately. Counsel the patient to do the following: ●

Sip liquids throughout the day to keep the oral cavity moist. ● Try tart foods to stimulate saliva, if open sores are not present. ● Try sugar-free lozenges, mints, candy, or gum.

● Eat soft, moist foods with extra sauces, dressings, or gravies.

● Try mouth moisturizers or saliva substitutes to keep the oral cavity moist. ● Maintain good oral hygiene: rinse the mouth frequently with a bland rinse.

● Consult with a physician for consideration of pharmacological interventions to manage xerostomia.

Source: Adapted with permission from Grant BL. Appendix A: Nutritional and supportive care intervention strategies for cancer-related side effects. In: Pocket Guide to the Nutrition Care Process and Cancer. Chicago, IL: Academy of Nutrition and Dietetics; 2015:135-144.

Consult with a physician for consideration of pharmacological interventions to manage esophagitis, dysphagia, and odynophagia or obtain a referral for swallowing evaluation.

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