Chewing and swallowing problems

Cancer treatment can cause difficulties with chewing and swallowing. These are usually temporary, but can sometimes be permanent.

Problems chewing – People with dentures who lose weight may find their teeth become loose, making it hard to chew. Treatment for head and neck cancer sometimes involves removing teeth.

Sore mouth – Chemotherapy and radiation therapy can damage the cells lining the mouth and digestive tract, leading to ulcers and infections. This is known as mucositis and it can make it painful to eat and swallow. Mucositis usually gets better a few weeks or months after treatment ends, but you may need softer food until then.

Problems swallowing – If you’re having difficulty swallowing (dysphagia), you may need to change the consistency of your food by chopping, mincing or pureeing. Signs that the texture of food is causing problems include taking longer to chew and swallow; coughing or choking while eating or drinking; food sticking in your mouth or throat like a ball; or throat clearing after meals. A speech pathologist can monitor your ability to swallow, and a dietitian can suggest foods and make sure you are getting enough nutrition.

A person with severe difficulty swallowing will need a feeding tube to ensure adequate nutrition. This is rare for most people with cancer, but is more of a possibility with cancers affecting the head and neck, stomach or oesophagus. If a feeding tube is required, your treatment team will discuss this with you.


Suggestions for a texture-modified diet

If you need to adjust the texture of your food, this sample menu provides some ideas. Your speech pathologist and dietitian will be able to suggest many other options, and you can also try some of these recipes.

Check with your dietitian if you have another health condition, such as diabetes, or if you have been told you need thickened fluid – you may not be able to have all of the foods suggested here, or you may need to modify them.

Learn more about these food textures:


Soft

Food can be chewed but not necessarily bitten. It should be easily broken up with a fork and need little cutting. Sauce or gravy can be added to make it softer.

Breakfast

  • scrambled or poached eggs
  • soft chopped fruit and yoghurt

Lunch

  • egg and commercial mayonnaise sandwich with crusts cut off
  • baked beans

Dinner

  • casserole with small pieces of tender meat and well-cooked vegetables 
  • well-cooked rice or wheat noodles (not fried) with boiled vegetables and crumbled soft tofu or tender meat

Snacks, dessert and drinks

  • mango 
  • stewed fruit pieces 
  • yoghurt with soft fruit pieces 
  • soft cake with lots of custard 
  • fruit smoothie

Avoid

  • nuts 
  • dried fruit 
  • dry or gristly meat 
  • raw vegetables 
  • muesli
  • hard cheeses (unless melted)

Minced and moist

Food should be soft and moist and easily form into a ball in the mouth. Small lumps can be broken up with the tongue rather than by biting or chewing.

Breakfast

  • oatmeal porridge or wheat biscuits with lots of milk and little texture
  • well-cooked rice pudding
  • congee (rice porridge)

Lunch

  • soup with vegetable or meat pieces (no bigger than 5 mm)
  • well-cooked lentil dhal with very soft rice

Dinner

  • moist macaroni cheese 
  • mashed or scrambled tofu with small, soft vegetable pieces (no bigger than 5 mm) 
  • moist risotto

Snacks, dessert and drinks

  • mashed banana 
  • steamed egg pudding 
  • soft cheesecake without the crust 
  • semolina pudding 
  • creamed rice 
  • milkshake 
  • milk or soy milk

Avoid

  • nuts 
  • hard vegetables 
  • all bread and crackers 
  • dried food 
  • lollies (jubes, marshmallows)

Smooth pureed

The texture of smooth pureed food means it can be moulded, layered or piped to make it look more appealing. You can add sauce or extra liquid if you prefer.

Breakfast

  • strained or pureed porridge (made with milk)
  • strained or pureed congee

Lunch

  • well-cooked pasta that has been pureed in a blender with added sauce
  • pureed canned tuna with commercial mayonnaise, pureed mashed potato
  • pureed soup strained to remove lumps

Dinner

  • pureed chicken blended with extra gravy or sauce and pureed noodles 
  • pureed lentil dhal or curry and pureed rice

Snacks, dessert and drinks

  • pureed pear or apple pushed through a sieve 
  • yoghurt with no fruit pieces/lumps 
  • ice-cream 
  • mousse
  • milk or soy milk

Avoid

  • meat 
  • eggs 
  • cereals or vegetables that have not been pureed in a blender
  • peanut butter

Click on the icon below to download a PDF booklet on taste and smell changes.


    Taste and smell changes

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Instructions for downloading and reading EPUB files

Apple devices

The iBooks application must be installed on your Apple device before you can read the EPUB.
Different ways to download an EPUB file to your Apple device:

  • email EPUB files to yourself and transfer the attachment to iBooks.
  • copy EPUB files into DropBox (or a similar service) and use the DropBox app to send them to iBooks.
  • open EPUB files directly from Mobile Safari and open them in iBooks, where they are saved automatically by downloading the EPUB from the website.

Need more help? Visit: http://support.apple.com/kb/HT4059

Kobo

To download an EPUB file to your Kobo from a Windows computer:

  • download and save the EPUB directly onto your desktop.
  • connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
  • select “Open folder to view files” to view the contents of your Kobo.
  • navigate to where you have stored your EPUB file in “Finder”, in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.

To download an EPUB to your Kobo from a Mac:

  • download and save the EPUB directly onto your desktop.
  • connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
  • open your “Finder” application.
  • select “Kobo eReader” from the listed devices to view the contents of your Kobo.
  • navigate to where you have stored your EPUB file in “Finder”, probably in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.

Turn on your Kobo and your EPUB will be located in “eBooks”, while a PDF will be located in “Documents”.
Need more information? Visit: http://www.kobo.com/help/koboaura/response/?id=3784&type=3

Sony Reader

To download an EPUB file on your Sony Reader™:

  • ensure you have already installed the Reader™ Library for PC/Mac software
  • select the eBook you want from our website and click the link to download it.
  • connect the Reader™ to your computer.
  • open the Reader™ Library software and click “Library” in the left-hand pane and select the eBook to view it.

Need more help? Visit: https://au.readerstore.sony.com/apps_and_devices/

Amazon Kindle 2nd Generation devices

EPUB files can’t be read on the Amazon Kindle™. However, like most eReaders, Kindle™ 2nd Generation devices are able to display PDFs. We recommend that you download the PDF version of this booklet if you would like to read it on a Kindle™.
To transfer a PDF to your Kindle™ via USB cable from your computer or Mac:

  • download the PDF directly onto your computer.
  • connect the USB cable to your computer’s USB port, and the micro USB end of the cable to your Kindle™. Note: the Kindle™ won’t be available as a reading device while it is connected to your computer until it has been disconnected.
  • open the Kindle™ drive and several folders will appear inside. The “Documents” folder is where you will need to copy or drag the PDF to.
  • safely eject your Kindle™ from your computer and unplug the USB cable. Your content will appear on the Home Screen.

Kindle also provides a Kindle Personal Documents Service that allows users to send documents as an attachment directly to your eReader. For more information on this service, visit http://www.amazon.com/gp/help/customer/display.html/ref=help_search_1-1?ie=UTF8&nodeId=200767340&qid=1395967989&sr=1-1
For more information on accessing a PDF on your Kindle™, visit www.amazon.com/manageyourkindle, log in to your account and click on Personal Document Settings.
Need more help? Visit https://www.amazon.com/gp/help/customer/display.html?nodeId=200375630

Android and PC

You can also download and open eBooks on Android devices and PCs with appropriate apps or software installed. Suitable eReader apps for Android include Google Play Books, FBReader and Moon+ Reader. Suitable software for PCs include Calibre and Adobe Digital Editions.


This information was last reviewed in June 2019
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