A return to "normal eating" after curative treatment for oral cancer. What are the long-term prospects?

The ability to eat determines not only a patient's nutritional status, but also influences quality of life. A retrospective investigation of the incidence of side-effects affecting eating and their effect upon quality of life more than 1 year after treatment, was undertaken to evaluate long-term patient rehabilitation. 25 patients with oropharyngeal carcinoma were interviewed. Nutritional intake and effect on diet were assessed by analysis of patient diet diaries. Nutritional status was measured from weights recorded at time of treatment and anthropometric measurements at time of study. All patients completed a quality-of-life questionnaire and the importance of side-effects was measured by a ranking exercise. Seventy-two per cent of patients required modifications of dietary consistency. Energy and protein intakes decreased with increasing degrees of dietary modification. Side-effects affecting eating persisted in 23 out of 25 patients, with 80% still having a dry mouth at a mean of 3.5 years post-treatment. Forty per cent had not regained weight lost during treatment. The top ranked side-effects perceived to be of greatest importance to quality of life all related to the ability to eat. A return to "normal eating" is not possible in all patients.