Weight loss in head and neck cancer patients little noticed in general practice.
2010
InTRODUCTIOn: in head and neck cancer patients, weight loss increases morbidity and mortality, and decreases treatment tolerance and quality of life. Early nutritional intervention has beneficial effects on these factors. AIM: We observed patients’ weight courses after specialists’ care and surveyed nutrition-related docu mentation by general practitioners (GPs). METHODs: From a Head and n eck Oncology Centre (H nOC) study, 68 patients were asked to partici pate in an extended general practice cohort. Twenty-six patients participated in the prospective threemonthly weight measurements during the year after H nOC care. We extracted nutritional information contained in referral letters (n=24) and medical records from the year before referral (n=45) and after HnOC care (n=26). An impaired nutritional status was assigned to weight loss ≥10% within six months or Body Mass i ndex (BM i) <18.5 kg/m 2 and ‘at risk’ to weight loss ≥5% but <10% within six months. REsULTs: Three (12%) participants were nutritionally impaired and two (8%) were deemed ‘at risk’. Although GPs suspected a (pre-) malignancy in 11 cases (46%), only two (8%) documented weight loss or BMi and four (17%) nutrition-related complaints in their referral letters. Medical records more often contained information on nutrition-related complaints and tube feeding later in the disease course, as opposed to concern over weight loss or BM i. DIsCUssIOn: Therefore, we call for nutritional management in general practice, by urging practitioners to assess patients’ nutritional status throughout the disease course and intervene if necessary. The pass
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