Suedharz Klinikum Nordhausen, Germany
Dr. Buentzel is working as a clinical oncologist since 20 years. His actual position is the director of Head Neck Oncology department as well as the Palliative Care Unit at the Academic Hospital Nordhausen, Germany. His clinical research topics are the multimodality of head and neck cancer and the supportive care for these patients. Dr. Buentzel was the principal investigator of some international studies in this field and is board member of different oncological journals. He is teaching ORL at Jena University since 2008 and member of the German ENT and Cancer Society.
The lecture will address different aspects of nutrition in the therapy of head neck cancer patients. The first part will be focused on questions of nutritional diagnostics. Screening and assessment tools will be presented in order to get a standardized anamnesis. Biophysical (bioimpedance analysis) and/or laboratory measurements (albumin, protein. C-reactive protein) should give us additional information before the anticancer therapy starts. Our data have shown a majority of patients suffering from malnutrition already at the time of first diagnosis. Our second part will demonstrate the influence of anticancer therapy on the nutritional situation of our patients. Surgery, radiotherapy and chemotherapy will produce side effects and complications as dysphagia, xerostomia, loss of taste and dental problems. Dysphagia remains a main problem of these patients during the rest of their life. The third part of the lecture will describe the nutritional therapy before, during and after the anticancer therapy. Early nutritional therapy improves the outcome of our patients from surgery as well as radiotherapy. A pilot study has shown decreased rates of radiotherapy breaks, surgery complications and longtime toxicities due to irradiation. The therapy should be adapted to the general and swallowing possibilities of the patient. Each clinical assisted nutrition (enteral or parenteral feeding) should be combined with swallowing training. The rehabilitation of oral nutrition has to be one of the most important aspect of supportive care in these patients.