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
• Swallowing test
• How to manage swallowing difficulties
• Having a feeding tube
• Types of feeding tubes

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.