How to manage swallowing problems during radiotherapy

Dysphagia is the medical term for having trouble with swallowing. You may experience this side effect caused by the tumour itself or as a side effect from  radiotherapy to the head, neck, chest or upper back.

When this side effect occurs your throat becomes swollen and sore due to radiation damaging healthy cells, resulting in inflammation of the oesophagus, the long tube that connects from the mouth to the stomach. 

This normally happens within 2-3 weeks after starting treatment and will likely get better 4-6 weeks after you have finished treatment. The risk for throat changes depends on how much radiation you are getting, and if you are also having chemotherapy. 

Symptoms of throat problems during radiotherapy 

  • Pain while swallowing 
  • Inability to swallow
  • Sensation of food sticking in the throat or chest
  • Drooling
  • Regurgitation (bringing food back up)
  • Frequent heartburn
  • Food or stomach acid backs up into the throat
  • Unexpected weight loss
  • Coughing or gagging when swallowing
  • Avoidance of certain foods that cause trouble swallowing

Speak to your cancer team if you experience any of these symptoms above, as they will know the best way to help you. In some hospitals, you'll see a dietician weekly during treatment. If not you can ask to see a dietitian if you're having problems.

You may not be able to avoid this side effect but there are some things you can do to ease the difficulties. 

Food & Drinks Tips 

  • Choose foods/drinks high in calories and protein. When it hurts to swallow, you may eat less and lose weight. It is important to maintain your weight.
  • Eat small meals several times a day instead of 3 large ones. 
  • Sit upright and bend your head slightly forward when eating. Do not lie down or recline for at least 30 minutes after eating.
  • Cut food into small pieces and chew thoroughly, or puree your food in a blender.
  • Moisten your food with gravy, sauces, broth, or milk to make it easier to swallow.
  • Drink sips of liquid between bites of food.
  • Soft foods are easier to swallow. Try yoghurt, pasta, cooked vegetables, canned fruit, soft-cooked eggs and soup.
  • Cool, but not frozen, foods may be soothing to an irritated throat.
  • Allow hot foods to cool to room temperature.
  • Drink six to eight glasses of fluids a day, unless your doctor has restricted the amount of fluids you can have. 

Things to Avoid

  • Avoid spicy foods.
  • Rough foods like crips, crackers, nuts.
  • Citrus foods like lemons and tomatoes, as they can irritate your throat and oesophagus.
  • Do not use alcohol or tobacco.
  • Use toothpaste and mouthwash that does not contain peroxide or alcohol.

Medicines  

  • If you have trouble swallowing pills, ask your nurse or pharmacist if you can crush them and take them with a teaspoon of ice cream or other soft food. 
  • Check to see if your medication comes in liquid form.
  • Use lozenges or throat sprays to help numb your mouth and throat. These may be very helpful before meals and at bedtime.
  • If you are unable to eat and are losing weight, nutritional supplements can be recommended by your cancer team.
  • If you have pain medication prescribed, it is usually best to take it 30 minutes to one hour before you eat.

Discover more oral care tips at - Oral Care for Cancer Treatment