Swallowing difficulties

Chewing and swallowing involve your lips, teeth, tongue and the muscles in your mouth, jaw and throat working together.

Many people with a head and neck cancer have difficulty swallowing (dysphagia) before, during or after treatment. This may be because of the cancer or the treatments, and it may be short term or long term. Being able to swallow is important to ensure you are eating and drinking enough.

Signs that swallowing is difficult include:

• taking longer to chew and swallow
• taking longer to eat a meal than your family and friends
• coughing or choking while eating or drinking
• food sticking in your mouth or throat
• pain when swallowing.

Learn more about:

• Treatments that may affect swallowing
• Swallowing test
• How to manage swallowing difficulties
• Using a feeding tube
• Types of feeding tubes

Treatments that may affect swallowing

Surgery to the jaw, mouth or throat areas – This may make chewing and swallowing difficult because tissue has been removed or reconstructed, or because the surgery has caused dry mouth.

Surgery to the larynx or pharynx – Surgery to the larynx or pharynx may cause food to go down the wrong way into the lungs. This is known as aspiration. Signs of aspiration include: coughing during or after swallowing; increased shortness of breath during or after a meal; and recurrent chest infections. A speech pathologist can check how your swallowing is working (see Swallowing test) and give you strategies to help you eat and drink safely.

Radiation therapy – This can cause dry mouth, pain, and changes to the strength of the muscles and nerves used in swallowing. These effects could be worse if you have chemotherapy at the same time as radiation therapy (chemoradiation).

Swallowing test

You may have a test before and after treatment to look at what happens when you swallow. A speech pathologist uses a movie-type x-ray known as a videofluoroscopic swallow study or modified barium swallow study to check that foods and liquids are going down the correct way. You may also have a fibre-optic endoscopic evaluation of swallowing test during a nasendoscopy to test how well you can swallow. The test results will help plan how any swallowing issues are treated.