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Mucositis throughout gastrointestinal tract

Docetaxol

Diarrhea

with chemotherapy to enhance the effects of both treatments.

Biological therapies are based on the use of cyto-kines derived from cells in the immune system. Cytokines are administered to stimulate the body's immune response to reduce or prevent tumour growth and often cause anorexia.

Endocrine therapies are primarily used to control the growth of hormone-dependent cancers, such as cancer of the breast or prostate. Drugs may be used to block production of hormones or to block hormone receptors.

Head and Neck Cancer

Surgical resection is often used for cancers of the oropharynx. Removal of the tumor and reconstruction may lead to periods when the patient is not allowed to eat or drink in order to allow healing to take place. Resection of the mandible, tongue, maxilla, or pharynx may lead to difficulties with chewing or swallowing. There may be an increased risk of aspiration because of a poor ability to control food or fluids in the mouth or because of an alteration in the anatomy or cranial nerves required for swallowing.

Radiotherapy to the head and neck can have a significant impact on nutritional status with both early side effects, during or immediately after treatment, and late side effects, which may occur years after treatment (Table 4). Reduced food intake and weight loss due to soreness and dysphagia are particularly common and occur in up to approximately 90% of patients. A dry mouth (xerostomia) occurs when the salivary glands are irradiated and leave the teeth increasingly prone to tooth decay.

Table 4 Side effects of radiotherapy to the head and neck

Early

Late

Mucositis (inflammation of

Mucosal ulceration

the mucosa)

Xerostomia

Stomatitis (inflammation of

Increased viscosity of saliva

the mouth)

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