Gary Lafoy
Gary Lafoy is a recovering tongue cancer patient at UHN. With the help of the Head and Neck team at Princess Margaret Cancer Centre, he was able to return to a healthy weight after his cancer treatment. (Photo: UHN)

Gary Lafoy has been courageously fighting tongue cancer for the past three months.

When Gary began outpatient radiation treatment for his tongue cancer in June at the Princess Margaret Cancer Centre (PM), he was eating well and was at a stable body weight.

Common side effects of radiation treatment to the head and neck area, however, include taste changes, pain when swallowing and thick oral secretions, which can make it challenging to eat by mouth. Patients receiving head and neck cancer treatment may often have a prophylactic feeding tube inserted to prevent weight loss, reduce dehydration and hospitalizations and avoid treatment breaks.

Sept. 23 to 27 is Canadian Malnutrition Week. This year's theme is "Malnutrition in the Community," aiming to lessen the burden of malnutrition in the greater community.

A study completed by the Canadian Malnutrition Task Force (CMTF) found that nearly 45 per cent of adults were malnourished upon admission to hospital. Acute illness or trauma, infections, and diseases that cause inflammation all contribute to increased nutritional needs.

This combined with a decreased appetite and other factors affecting oral intake, can make malnutrition difficult to correct.

In Gary's case, his physician recommended a feeding tube be inserted into his stomach at the start of his second week of radiation to help him when eating and drinking by mouth became too difficult.

As treatment progressed, Gary started having more difficulty eating and began losing weight. With support from the Head and Neck team at PM on how to use his feeding tube, he was able to stabilize his weight and improve his nutrition status.

He says Joanne Pun, Registered Dietitian, provided excellent advice on how to choose the right kind of foods and nutritional supplements when he started to lose weight and have more difficulty swallowing.

"Joanne was easy to connect with and reach if I had questions," Gary says. "She provided comfort and ensured I was on the right track during and after treatment."

How malnutrition can affect patients during treatment

Maintaining a stable body weight and a good nutrition status is one of the many common hurdles patients face during treatment.

Malnutrition is a deficiency in energy, protein and other nutrients, which affects functional ability, body tissues and overall health.

"Malnutrition can be preventable and treatable, and we need to start treating food as medicine," says Dr. Johane Allard, Director of the Nutrition Support Program at UHN and co-chair of the CMTF.

The UHN Malnutrition Task Force, a multidisciplinary committee, is leading the way at UHN by recommending that nutrition care processes should involve a team of physicians, nurses, registered dietitians, diet technicians, and other members of allied health.

An interdisciplinary approach

Gary says other key members of the Head and Neck team, including nurse practitioner Jennifer Deering and Veronica Rodriguez, Clinical Research Coordinator of the Swallow Study, were instrumental in encouraging and guiding him throughout his seven-week treatment.

He recalls that Jennifer provided him with a helpful care schedule which guided him on how to fit tube feedings and medications into his daily routine.

"Veronica pushed me to continue swallowing to exercise my swallowing muscles," Gary said. "So I did, even though it was difficult."

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