Project case study 3: oncology dietetics

Oncology dieticians play a vital role in the management of malnutrition and maintenance of nutritional status throughout a patient’s cancer journey.  Enteral feeding tubes are a lifeline in being able to provide an alternative route for nutrition in this patient group and their popularity has grown over the years and has had a huge impact on the clinical outcome from HNC treatment.

Appropriate placement of enteral feeding tubes requires proactive decision-making within the multidisciplinary team, but there have been no specific clinical guidelines on the use, placement and management of feeding tubes in HNC. National Institute for Health and Clinical Excellence guidelines simply state that gastrostomy feeding should be considered in people likely to need long term (four weeks or more) enteral tube feeding and that there should be specific guidelines on the use, placement and management of gastrostomy tubes in HNC patients.

Over the last four years Oncology Dietitians, Alison Howard and Rupali Shah have been working on a clinical audit of enteral tube feeding practices in HNC patients in Oxford.  The aim of their audit was to establish length of tube feeding following HNC treatment (surgery, radiotherapy and chemoradiotherapy) to be able to develop evidence-based guidelines on appropriate enteral feeding routes according to treatment modality.

The audit’s outcome has supported improved selection of enteral feeding routes, and Alison and Rupali’s recommendations have now been implemented by the JR’s head and neck team.

Helping HNC patients throughout Europe

All this work has paid off through improvements to clinical practice and patient care. It has also resulted in invitations to present the findings at national and international level, with two posters on Alison and Rupali’s research accepted for presentation at the 5th European Head and Neck Oncology Conference hosted in Poland in April 2012.

Heads Up awarded the dieticians a £500 educational grant to support attendance at the conference.  Alison and Rupali had also been awarded £500 for best clinical practice by BAPEN Nutricia (British Artificial Parenteral and Enteral Nutrition) in 2011 and they used this prize money to help fund the trip to Poland so that they could both attend the conference.


Alison and Rupali would like to thank Heads Up supporters for helping fund their attendance at this conference to communicate their work to the wider head and neck community.

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