A leading head and neck dietician has told how those living with throat cancer are faced with a string of hurdles during the festive period, such as social isolation and depression following treatment.
Rebekah Smith, a senior dietician at University Hospitals Birmingham, specialises in the surgical side of head and neck cancer treatments but also see patients post radiotherapy.
The dietician is proactive in research in this area and is constantly in search of ideas to develop the service to improve patients care and quality of life during and after treatment.
She said: “An important part of my job is to support patients who have developed late side effects of radiotherapy treatment, for example increased difficulty swallowing and osteoradionecrosis.
“I think the main issue during the festive season is social isolation. This is a time that is full of socialising with friends, family and work colleagues and normally involves eating and drinking.
“A number of patients find it uncomfortable eating and drinking around other people following treatment or have certain dietary requirements that can make the patient feel apprehensive about eating at restaurants/parties/ friend houses.
“The patients may be limited to certain foods/ drinks that do not lend themselves to party foods/Christmas dinner.”
“Some feel angry, frustrated and fed up.”
Rebekah told how some patients also are left feeling ‘nagged’ by family members regarding eating and drinking.
This can cause tension with friends and family who are trying to show the patient that they love and care for them but can often be too much for the patient who physically cannot eat/ do anything more than they already are.
Rebekah said: “Eating and drinking is no longer pleasurable for some patients – it’s a means to an end.
“Patients may avoid social situations because they are embarrassed to eat and drink in front of other people. They can feel envious that they can’t eat and drink the way that they used to.”
Some of the issues Rebekah warned about include:
– Patient is tube dependant and it is not safe for them to eat or drink by mouth they may not have Christmas dinner at the same time as their family
– They need to have soft, moist foods or a pureed/liquid diet
– Meat is difficult to eat and Christmas dinners are usually beef/turkey
– Patients may be unable to control food/drink in their mouth and this may fall out when
– Patients who have undergone surgery can find that food get ‘lost’ in their mouth due
to lack of sensation and may need to rinse their mouth out after eating- this can be
difficult to do when out and about
– The patients mouth may still be sensitive to certain types of food such as spicy foods
or foods that have a shape taste
– What is the emotional impact of this on them?
There are a variety of emotions:
– Frustration and anger about not being able to take part in the festivities due to long term side
effects of treatment.
– Guilt and the feeling of holding family back because they can’t socialise the same
Here are the dietician’s top tips on how loved ones can help those with throat cancer cope during the festive season.
– Ringing restaurants ahead to see if they can provide smaller portions or altered
textured diet e.g. pureeing food
– Seeing what foods are available that are a consistency that they patient can manage
e.g. trifle can be made with just jelly, custard and creams, offering mashed potato as
well as roast, ensuring vegetables are well cooked and can be easily mashed
– Ensuring there is plenty of sauce to go with food e.g. gravy, custard, brandy butter,
bread sauce (made need thinned out with extra milk/cream) ect
– Let the patient choose what they want from a variety of different of different foods at
a Christmas rather than surviving everything up on a plate to them
– Encourage the patient to go out and socialise and don’t add any pressure to eat and
drink- remind the patients it’s about being with friends and family and not the eating
and drinking. They want to spend time with the patient and are not worried if they eat
or drink while they are with them. The patient may want to eat before they go out.