Oral Health's Impact on Weight Loss in Cancer Patients

Objectives: To investigate the impact of oral health on weight loss in newly diagnosed head and neck cancer (HNC) patients. Methods: This was a longitudinal, multi-site study where oral health and weight loss, in addition to other demographic, health behavior, and clinical variables, were assessed in 181 HNC patients at baseline and one year later. Weight loss was assessed as the one-year change in weight (pounds), and Body Mass Index (BMI). Oral health was assessed using the Head and Neck Quality of Life instrument (HNQoL). Results: The mean age was 59 years, 75% were males, 46% smoked, 24% were problem drinkers, 46% had pharyngeal cancer and 75% were stage III and IV cancers. Eight multiple regression analyses were conducted using the four HNQoL scales (eating, emotion, pain, and communication) as independent variables, one-year change in weight and BMI as dependent variables, controlling for age, gender, smoking, alcohol problem, cancer site, and cancer stage (p<0.001 for all eight models). There was a significant association between the eating, emotion and pain domains with both weight loss and decreased BMI (p<0.001 for these six models). The association between the communication domain and weight loss and decreased BMI was marginal (p<.10 for these two models). Conclusions: Oral health, as measured by the HNQoL instrument, predicts weight loss among HNC patients independently of other demographic, health behavior, and clinical variables. The Oral health of HNC patients should be routinely and periodically assessed to ensure more extensive follow-up and intervention for those most at risk for poor outcomes. This translates into improvements in the quality of life of HNC patients and better evidence-based decision-making in the treatment of HNC for both patients and providers. * This study was supported by the NIH through the University of Michigan's Head and Neck SPORE (Grant 1 P50 CA97248).