Good nutrition, the supply of optimal nutrients and fluid to meet requirements, is an essential component of health, with poor nutrition contributing to ill health and prolonged recovery from illness or disease. It is therefore crucial that the nutritional status of all patients is assessed and considered during the whole of the person's care. Treatment for cancer can contribute to long‐term consequences which may ultimately impact on nutritional status. Examples of this include dysphagia, reduced appetite, early satiety or altered bowel function leading to poor digestion and absorption of nutrients. As a result, people may experience weight loss and deficiencies of specific nutrients such as iron and vitamins D and B₁₂. The risk of these nutritional inadequacies can be predicted in some people, for example those who have undergone surgery to the gastrointestinal tract or who have received pelvic radiotherapy. However, in others they may be less predictable and arise due to late effects of cancer treatment or other co‐morbid conditions.

Gastrointestinal symptoms can arise because of cancer treatment. These can be both upper and lower gastrointestinal symptoms and may arise because of surgery to the gastrointestinal tract, chemotherapy or, more commonly, radiotherapy, particularly when given to the head, neck or pelvis. Persistent symptoms are likely to impact on quality of life with those affected potentially having problems swallowing or altered bowel habits. The latter can result in them being less confident to leave the house, travel or return to work. Symptoms may also impact on nutritional status as people make dietary changes in an attempt to control symptoms or experience malabsorption of macro‐ or micronutrients (Abayomi et al. [1], b).

Treatment of hormone‐dependent cancers such as breast and prostate cancer can result in changes in body composition with weight gain, additional fat deposition and a decrease in bone density. These changes arise due to a combination of treatment (hormonal) and nutritional factors and can influence body image, ability to exercise, morbidity and mortality outcomes with respect to both cancer and other diseases.

There is now also strong emerging evidence that patients with head and neck cancer treated by radical or adjuvant (chemo‐) radiation may present with late dysphagia (Hutcheson et al. [126], Szczesniak et al. [264]). These patients are disease free and can present up to 9 years post treatment. The most common presenting symptoms include dysarthria, dysphonia, cranial nerve neuropathy (especially X and XII), trismus and mandibular osteoradionecrosis.

The following signs may help identify those at risk of dysphagia and necessitate a referral to the speech and language therapist. Please note that these are red flags for recurrence and patients should be referred to their oncologist/surgeon.

Presenting at such a late stage may mean that therapy exercises will not be of benefit (Hutcheson et al. [126], Langmore et al. [142]) but the speech and language therapist can advise regarding postures and techniques to make the swallow safer. All head and neck cancer patients are given prophylactic swallowing exercises prior to commencing their chemo/radiotherapy and are advised to continue these forever.

While the focus of survivorship is often on patients, the impact on carers of supporting an individual with oropharyngeal dysphagia cannot be underestimated (Nund et al. [211], Patterson et al. [222]).

It is essential that issues with eating, drinking and ultimately nutritional status are identified both during and after cancer treatment. This enables people to be signposted to appropriate advice, support services or specialist services as appropriate.