What can be done to manage swallowing difficulties during radiotherapy

Can dysphagia be cured?

Dysphagia is the medical term for difficulty swallowing. You may experience this side effect caused by the tumour itself or as a side effect of 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. This results in inflammation of the oesophagus, the long tube that connects 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 of throat changes depends on how much radiation you are getting, and if you are also having chemotherapy. 

Symptoms of swallowing difficulties

  • 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

It is advised that you speak to your cancer care team if you are experiencing any of the symptoms above, as they will be able to advise you on what is best for you. In some hospitals, you may have the opportunity to see a dietician weekly during treatment. If not, you can ask to see one.

Although you may not be able to prevent this side effect, you can take steps to ease the discomfort. Below are some tips to consider.

Foods that are easy to swallow

1.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.

2. Eat small meals several times a day instead of 3 large ones. 

3. Sit upright and bend your head slightly forward when eating. Do not lie down or recline for at least 30 minutes after eating.

4.Cut food into small pieces and chew thoroughly, or puree your food in a blender.

5. Moisten your food with gravy, sauces, broth, or milk to make it easier to swallow.

6. Drink sips of liquid between bites of food.

7. Soft foods are easier to swallow. Try yoghurt, pasta, cooked vegetables, canned fruit, soft-cooked eggs and soup.

8. Cool, but not frozen, foods may be soothing to an irritated throat.
Allow hot foods to cool to room temperature.

9. Drink six to eight glasses of fluids a day, unless your doctor has restricted the amount of fluids you can have. 

    A list of things to avoid with dysphagia

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

      How to take Medicines with dysphagia

      1. 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. 

      2. Check to see if your medication comes in liquid form.

      3. Use lozenges or throat sprays to help numb your mouth and throat. These may be very helpful before meals and at bedtime.

      4. If you are unable to eat and are losing weight, nutritional supplements can be recommended by your cancer team.

      5. 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 

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