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Supportive
Clinical nutrition support
Feeding a patient properly is a treatment, and losing weight during treatment is not inevitable.
What it is
Weight loss and muscle loss during cancer treatment predict worse tolerance, more delays and worse outcomes. Where eating by mouth is not enough, head and neck radiation, oesophageal obstruction, severe mucositis, gut failure, nutrition can be delivered by feeding tube or intravenously.
The decision to place a feeding tube before head and neck radiation, rather than during a crisis in week four, is one of the highest-value calls in supportive oncology.
When it is used
- Before and during head and neck radiotherapy
- Oesophageal or gastric obstruction
- Severe mucositis
- Unintentional weight loss over 5%
- Prolonged inability to meet needs by mouth
How the decision is made
- Whether a tube should be placed prophylactically or reactively, and what the evidence says for your treatment.
- Route: nasogastric, gastrostomy, jejunostomy, or parenteral.
- Realistic protein and calorie targets, and who will review them.
Assessed, prescribed and monitored here; tube placement at a partner endoscopy unit.
Who does what
What we handle, and what happens elsewhere
KPCIRC handles
- Nutritional assessment and a written target
- A prophylactic-versus-reactive tube recommendation
- Feed prescription, teaching and home supply plan
- Weekly review during the treatment course
- Swallowing rehabilitation planning
Performed and billed elsewhere
- Tube placement
- Feed supply
- Refeeding syndrome is a real risk after prolonged poor intake. Feeding is started deliberately slowly and with blood monitoring.
Questions to ask your own doctor
Take these with you. They work whether or not you are treated here.
- Am I likely to need a feeding tube, and when should it go in?
- What weight loss would worry you?
- How much protein should I be getting?
- Will I be able to eat normally again afterwards?
Support that goes with it
Where this is used
Cancers this commonly forms part of
Not sure this is the right option for you?
That is exactly what a second opinion is for. Bring what you have, we will tell you what is missing and what the alternatives actually are, in writing.