Approximately one third of patients with advanced cancer of the head and neck are severely malnourished. Another one third of patients suffer from mild malnutrition. Adequate nutritional support given before cancer therapy will reduce therapy-related complications in severely malnourished patients. Patients who are less severely malnourished should receive definitive cancer therapy promptly with concurrent concern for nutritional support. Advantages of nutritional support are that patients feel better, have a higher tolerance to therapy with fewer complications, and achieve a higher response rate to therapy. The disadvantages to such a program are modest but real. This therapy is expensive and it is hard to prove its long-term benefit. Attempting treatment may be frustrating in poorly motivated patients. Appropriate delivery of nutritional support in selected patients has been determined as highly rewarding to the physician.
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