Radiotherapy to your head and neck area can make you lose weight because you might have:
- a sore or dry mouth
- a poor appetite
- taste changes due to treatment
- difficulty swallowing due to soreness or swelling in your throat
These effects might be temporary and gradually go back to normal after treatment ends. But for some people, the effects may be permanent. There are things you can do to help keep your weight up.
Voice over: When having radiotherapy to your head and neck, you can experience many different side effects. One of these might be weight loss.
Louise: Unfortunately, weight loss with head and neck radiotherapy is very common. Obviously we don't want you to lose too much weight, so we would work very closely with the dietitian to support you.
Charlie: The clinical team in advance warned me I would lose weight. They told me to prepare for it. They told me to eat lots of calories in advance and I thought they were kidding, but the reality is, the weight did drop very, very quickly.
Louise: Initially, if you start to notice any problems eating, we would recommend you start to move to a slightly softer diet. Foods that are soft, easy to swallow, but highly nutritious.
Charlie: Soups and gravies and maybe move on to scrambled eggs and rice puddings.
Louise: If you then find that that starts to become problematic, we do have some special little drinks that you can use as a meal replacement.
Tasha: I had a smoothie drink that was given to me by the doctors. It's like a smoothie with calories in and it's a small bottle so you're just topping up what you’re missing not eating and drinking fully.
Charlie: My swallow mechanism just stopped working, so everything I had to take was being taken through the stomach tube.
Louise: Occasionally the radiotherapy can have a real impact on how easily you can swallow and if it starts to become very problematic, they may suggest they use feeding tubes to help ensure you are getting the right nutrients.
Voice over: For information on other head and neck radiotherapy side effects, visit the Cancer Research UK website.
Why it's important to maintain your weight
Your radiotherapy team plan your treatment using scans of you that were taken before your treatment began. They plan it very precisely using your body measurements. This means if you lose or gain weight during radiotherapy it can change the amount of radiation that the cancer or nearby healthy cells receive.
Because of this, it is important that your weight stays around what it was when you had your planning scan. If you lose too much weight, your radiographers will work out the effect that this may have on your planned treatment and see if you need another planning scan.
Losing too much weight might also make you feel weaker.
Coping with weight loss
It's important to eat and drink as well as you can during your radiotherapy. Your side effects aren't likely to start for a week or so, which means for as long as you feel well try to eat your normal diet.
You might see a dietitian once a week during your treatment. They can help to advise you on foods that are easier to eat. They can also prescribe or get your doctor to prescribe nutritional supplements, such as high calorie drinks to help keep your weight up. Remember to drink plenty of other fluids too.
Your doctor might also prescribe strong painkillers if your throat is very sore and eating and drinking is painful.
Try not to drink alcohol (especially spirits) or smoke because this can make your mouth and throat very sore.
If eating becomes very difficult you might have:
- liquid feed through a drip into a vein or a tube down your nose to your stomach
- a feeding tube put into your stomach through the skin (called a percutaneous endoscopic gastrostomy or PEG tube)
Some hospitals might arrange for you to have a feeding tube before you start radiotherapy - this is to stop you from losing too much weight. This varies from hospital to hospital.