Crowder et al. interviewed head and neck cancer survivors who had all undergone radiation treatment, exploring any chronic nutritional impacts. At the time of the interviews, no one had any current evidence of disease. They were all eating/drinking by mouth, and were between six months and ten years post radiation and/or chemo.
 

Researchers noted a higher than anticipated response rate to their request for participants, suggesting that these individuals were eager to share their experience.
 

All participants reported being impacted nutritionally by their radiation treatment. Dysphagia, xerostomia (dry mouth), taste alterations, and bothered chewing were the most cited problems. Nearly all avoided certain foods and required lots of liquids to clear solids. Long term side effects of treatment meant that they had longer mealtimes, ate less food, and were at a lower weight than before treatment.
 

Nearly 40% of participants didn’t know about the lasting side effects of radiation treatment on their nutrition and swallowing, with nearly 20% reporting they wouldn't have pursued treatment if they had known. What a big decision to feel ill-prepared for! 

The authors suggest that early and multimodal education about the nutritional implications of radiation treatment for HNC is important to help individuals cope with the ongoing challenges they’ll have. If you think this experience might be common in your area, consider how you can support patients suffering the long term effects of radiation treatment as well as providing context to patients early in the decision making process.

Crowder, S. L., Najam, N., Sarma, K. P., Fiese, B. H., & Arthur, A. E. (2020). Head and neck cancer survivors’ experiences with chronic nutrition impact symptom burden after radiation: A qualitative study. Journal of the Academy of Nutrition and Dietetics. https://doi.org/10.1016/j.jand.2020.04.016