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Many patients with cancer of the head and neck are malnourished

02 September 2010

Nearly twenty percent of patients with cancer of the head and neck were malnourished prior to treatment. During treatment the number of cases of malnutrition siginificantly increases. Head & neck cancer patients lose about five percent of their body weight during treatment, of which two thirds is loss of fat-free mass. This is the result of research conducted by dietician Harriët Jager-Wittenaar of the University Medical Center Groningen. She will be awarded a PhD by the University of Groningen on 8 September 2010.

Malnutrition is a common problem for head & neck cancer patients. It can be attributed to a number of factors: problems in the mouth or throat due to the tumour’s location or to treatment can complicate eating and drinking, resulting in insufficient energy and protein intake. Another cause of malnutrition can be inflammation, either due to the disease or its treatment. The goal of Jager’s research was to determine how often malnutrition occurs in patients with cancer of the head and neck during different phases of diagnosis and treatment. She also wanted to establish the important risk factors for malnutrition during these phases.

Loss of muscle mass

Apparently, difficulty swallowing is an important cause of malnutrition both before and after treatment. Loss of appetite and loss of taste, along with aversion to eating, are also causes of malnutrition in the period leading up to treatment. Jager’s research also showed that weight loss during treatment is mainly due to loss of fat-free mass (muscles), which in turn leads to decreased physical functioning. Jager also shows that head & neck cancer patients have difficulties in regaining lost fat-free mass after being treated. It proves impossible to do in the first four months after treatment.

Timely referral

Jager shows that weight loss and loss of fat-free mass cannot always be prevented, even with dietary treatment. Inflammation due to the disease or its treatment and decreased physical activity also probably contribute to loss of fat-free mass. Jager indicates the importance of preventing malnutrition for as far as possible. She makes the case for patients, those close to them and healthcare staff learning to recognize malnutrition risk factors and for having patients referred in time to a dietician.

Curriculum Vitae

Harriët Jager-Wittenaar (Hoogezand-Sappemeer, 1974) studied Nutrition and Dietetics. She conducted her research at the department of Oral Surgery at the University Medical Center Groningen.  Her thesis is entitled ‘Pre- and post-treatment malnutrition in head and neck cancer patients’. Her promotors are: prof. J.L.N. Roodenburg, prof. P.U. Dijkstra en prof. A. Vissink.

Note for the editor

Contact: via the Press Office of the University Medical Center Groningen, phone. +3150361 2200, e-mail: 

Last modified:15 September 2017 3.29 p.m.

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