Determination of malnourishment in the head and neck cancer patient: assessment tools and nutrition education of radiation oncologists

The purpose of this study is to evaluate current assessment practices of malnourishment by radiation oncologists among the head and neck cancer patient population. A cross-sectional descriptive study was conducted. A 14-question survey was mailed to 333 radiation oncologists self-identified as "interested in the treatment of head and neck cancer." About 87% of radiation oncologists indicated that they used bodyweight as the sole determinant of malnourishment in head and neck cancer patients at initial consultation. Radiation oncologists with 0 to 10 years experience were found to have a higher level of formal nutrition education than those with 11 to 20 years (p = 0.0052). A significant difference was found between radiation oncologists with formal nutrition education vs. those without, in answering whether nutrition interventions play a significant role in the prognosis of such cancer patients (p = 0.0013). In addition, a significant difference was noted in methods used to determine proper caloric intake when the oncologists were stratified by their beliefs about nutrition being a significant variable affecting the prognosis of head and neck cancer patients (p = 0.0024). Assessment or screening for malnourishment in the head and neck cancer patient should be a routine part of the initial consultation. Radiation oncologists and their medical team, including nutritionists, should use an appropriate nutrition screening and assessment tool in addition to the body weight as an indicator of malnourishment. Nutrition education provided to radiation oncologists should be improved to better communicate the positive effects of nutrition interventions on prognosis.