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 tumour 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; coughing or choking while eating or drinking; or food sticking in your mouth or throat like a ball.

Learn more about:

Treatments that make swallowing difficult

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

Surgery to the larynx or pharynx – The larynx and epiglottis act like valves and shut off the airway when swallowing so liquid or food don’t go into the lungs. Surgery to the larynx or pharynx may cause food to go down the wrong way into the lungs (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 will help to manage this side effect 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 also 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 (VFSS) or modified barium swallow (MBS) to check that foods and liquids are going down the correct way. If more information is needed, you may have a fibre-optic endoscopic evaluation of swallowing (FEES) test during a nasendoscopy. The test results will help plan your treatment.

How to manage swallowing difficulties

  • See a speech pathologist for ways to change your chewing and swallowing action to help reduce discomfort or food going down the wrong way (aspiration). They can also show you swallowing exercises to complete during treatment and ways to change your posture. To find a speech pathologist, speak with the health care team at your treatment centre or visit Speech Pathology Australia.
  • Continue to eat and drink whenever possible during treatment to keep your swallowing muscles moving and working. This will reduce the likelihood of long-term swallowing problems.
  • Ask your doctor for medicines to relieve discomfort when swallowing. Some medicines come as mouth rinses.
  • Talk to a speech pathologist about ways to adjust the consistency of food to make it easier to swallow.
  • Talk to a dietitian to make sure you are getting enough nutritious food and drinks.

For more on this, see the recipes in Beyond the Blender: Dysphagia Made Easy.

Click on the icon below to download a PDF booklet on head and neck cancers

Printed copies are available for free - Call 13 11 20 to order

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


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 September 2019
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