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
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).
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.
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 do and ways to change your posture. To find a speech pathologist, speak with the team at your treatment centre or visit Speech Pathology Australia.
- Continue to eat and drink whenever possible throughout your treatment to keep your swallowing muscles moving and working. This will reduce the likelihood of long-term swallowing problems.
- Ask your doctor to recommend medicines that relieve discomfort when swallowing. Some of these 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 drink.
- See the recipes in two free online books from Griffith University – From Treatment to Table and Beyond the Blender: Dysphagia Made Easy.
Podcast for people affected by cancer
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A/Prof Richard Gallagher, Head and Neck Surgeon, Director of Cancer Services and Head and Neck Cancer Services, St Vincent’s Health Network, NSW; Dr Sophie Beaumont, Head of Dental Oncology, Dental Practitioner, Peter MacCallum Cancer Centre, VIC; Dr Bena Brown, Speech Pathologist, Princess Alexandra Hospital, and Senior Research Fellow, Menzies School of Health Research, QLD; Dr Teresa Brown, Assistant Director, Nutrition and Dietetics, Royal Brisbane and Women’s Hospital, QLD; Lisa Castle-Burns, Head and Neck Cancer Specialist Nurse, Canberra Region Cancer Centre, The Canberra Hospital, ACT; A/Prof Ben Chua, Radiation Oncologist, Royal Brisbane and Women’s Hospital, GenesisCare Rockhampton and Brisbane, QLD; Elaine Cook, 13 11 20 Consultant, Cancer Council Victoria; Dr Andrew Foreman, Specialist Ear, Nose and Throat Surgeon, Royal Adelaide Hospital, SA; Tony Houey, Consumer; Dr Annette Lim, Medical Oncologist and Clinician Researcher – Head and Neck and Non-melanoma Skin Cancer, Peter MacCallum Cancer Centre and The University of Melbourne, VIC; Paula Macleod, Head, Neck and Thyroid Cancer Nurse Coordinator, Northern Sydney Cancer Centre, Royal North Shore Hospital, NSW; Dr Aoife McGarvey, Physiotherapist and Accredited Lymphoedema Practitioner, Physio Living, Newcastle, NSW; Rick Pointon, Consumer; Teresa Simpson Senior Clinician, Psycho-Oncology Social Work Service, Cancer Therapy Centre, Liverpool Hospital, NSW.
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