The problem
Malnutrition and sarcopenia incidence can be high following curative intent treatment in head and neck cancer, which are known to be associated with an unfavourable prognosis, higher mortality, and reduced quality of life. Tube feeding is also commonly required for adequate nutrition support pre, during and post treatment and proactively identifying patients can help to minimise nutritional decline.
Summary of the research
- Development of national evidence-based guidelines for the nutritional management of adult patients with head and neck cancer which covers all aspects of treatment trajectory.
- Development of guidelines for the insertion of prophylactic gastrostomy tubes in high-risk patients and the implementation of proactive nutrition support to optimise nutrition outcome for patients undergoing chemoradiotherapy.
- Currently developing guidelines for the insertion of prophylactic gastrostomy tubes in high-risk patients undergoing surgery and optimising perioperative nutrition care pathways.
The impact
| Clinical impact: | The RBWH Nutrition & Swallowing Guidelines have been implemented into practice since 2007 and impact on >500 patients referred through the RBWH Head and Neck MDT every year, resulting in improved nutrition outcomes. |
| Economic impact: | The RBWH Nutrition & Swallowing Guideline implementation resulted in reduced unplanned hospital admissions, saving approx. 478 bed days/year ($550k/year). |
| Policy & practice influence: | The body of research has contributed to national Evidence-based guidelines for the nutritional management of adult patients with head and neck cancer, endorsed through Clinical Oncology of Australia (COSA), Dietitians Australia, Dietitians New Zealand, ANZ Head and Neck Cancer Society and the British Dietetic Association. |
| International reach: | For the last 10 years our research and publications have been used to influence international policy and practice in the UK and Canada with Clinical Guidance Policy documents and Guidelines published on PubMed Centralciting our work as shown below (Source: Overton 2023)
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| Academic contribution: | Our research program over last 20 years or so (2003-2023) has produced 53 peer-reviewed publications, with 705 citations. |
Our researchers
Dr Teresa Brown, Prof Judy Bauer, Dr Merrilyn Banks, Claire Blake, Elise Treleaven, Dr Joanne Hiatt, Belinda Camilleri, Rebecca Fichera