Reilly J J
Department of Surgery, Mercy Hospital, Pittsburgh, PA 15219.
Oncology (Williston Park). 1990 Jun;4(6):105-15; discussion 115-6.
Malnutrition in the head and neck cancer patient arises both from the pathophysiology and treatment of the malignancy. Even when treatment of the cancer is successful, the patient may die of malnutrition. However, it is now possible to precisely diagnose malnutrition and treat it more effectively. Begin with a careful assessment of the patient, including weight, anthropomorphic measurements, serum protein levels, immune response, and an evaluation of the risk of therapy and prognosis. Both the enteral and parenteral routes can be effective--the choice is often determined by the presence of a functional gastrointestinal tract, the ease with which one may gain access to the gut, the risks of the different techniques, and the costs incurred.