Dietetic assessment of ambulatory cancer patients: with special attention to problems of patients suffering from head--neck cancers undergoing radiation therapy.
The prime objective of nutritional surveillance of cancer patients is to set up screening criteria for those who are likely to be at risk of nutrition problems and to further assess those so identified. Interventions to improve nutritional status or comfort are called for. The single most useful item with respect to screening is careful weight measurement at every visit. Subjective reports of appetite and food intake, 24-hour recalls of dietary intake, and therapy being undergone by the patient are also useful. Assessment involves obtaining the 24-hour recall data and in some cases keeping food records, and determining the patients' food likes and dislikes. Taken together, dietary, biochemical, clinical, anthropometry, and patient history data permit us to achieve greater certainty as to the problem. Usually energy intakes are problematic, but other nutrition difficulties may also be present. Intervention with respect to diet may involve therapeutic diets, special nutrition advice, or general advice. Food assistance, help with food management, and general health education may also be necessary. Constant surveillance consisting of short encounters and follow-up are mandatory. Examples of these principles as they apply to head--neck cancers will be presented.