Addressing and advancing best-practice nutrition care for patients with human papillomavirus-positive disease
Patients with head and neck cancer are at high risk of malnutrition despite intensive nutrition intervention, with the causes being multifactorial. Extensive literature supports the link between malnutrition and/or sarcopenia with adverse outcomes, including reduced quality-of-life and survival. Human papillomavirus (HPV) is now the primary cause of oropharyngeal squamous cell carcinomas (OPSCC) worldwide. HPV positive (HPV+) OPSCC displays unique histopathological, biological and clinical characteristics, including an improved prognosis, compared to HPV negative (HPV-) disease. Patients with HPV+ OPSCC at diagnosis are younger, asymptomatic, non-smokers, and are more overweight/obese compared to patients with HPV- OPSCC; yet research demonstrates they suffer higher rates of critical weight-loss and treatment toxicities. Despite this, limited research has investigated the incidence, prevalence and impact of malnutrition and/or sarcopenia in HPV+ OPSCC. No guidelines exist to guide practice, and as a result nutrition care for patients is not being optimally addressed, risking suboptimal health outcomes into survivorship.