Changes to eating after treatment for head and neck cancer

Eating is an everyday activity that we rarely stop to think about. In fact, it is a very complex process with a precise sequence of actions, each needing a high level of muscular control. Surgery| and/or radiotherapy| to the head and neck area may interfere with some of the actions or movements of the mouth, tongue or throat, making it more difficult to eat or drink. Your doctor will want to make sure that food is going down into the gullet and not into your lungs, which would make you cough or choke.

Assessing your swallowing Back to top

If your doctor is concerned that food may be going down the wrong way, they will arrange for your swallowing to be assessed by a speech and language therapist. The therapist may arrange a special x-ray examination of your swallowing called a videofluoroscopy. This is completely painless. You will be asked to swallow different types of food, from liquid to semi-solid (like yoghurt), to solid (like a biscuit). A special substance is added to the food to make it show up on the x-ray film. This test is carried out in a special room by a radiologist and the speech therapist and is recorded on video.

If the results of the videoflouroscopy show that food or liquid is getting into the lungs, you may need to be fed directly into the stomach through a tube. Sometimes this may need to be permanent, but for most people it is only temporary until they re-learn to swallow with the help of exercises taught by the speech and language therapist. You will also be given advice on the type of food to eat – for example, drinks can be thickened to allow them to be swallowed safely.

The tissue will heal once your treatment is over and any swelling will go down gradually. Your swallowing will slowly improve, although this may take a long time and may never be quite the same as before. Your speech and language therapist will help you. They will assess your eating and swallowing at every stage and advise you on what to do.

It may be that you lose interest in food because your treatment has affected the way that things smell and taste. However, it is important to eat well| during and after your cancer treatment. This means getting enough calories and protein to prevent weight loss, increase your strength and rebuild normal tissues. Your dietitian will help you choose the right kinds of foods.

Ideas for food/eating Back to top

Some suggestions about food are offered below, and our section on diet and cancer| has helpful tips on how to eat well when you have a sore or dry mouth.

• Try different types of food or ways of preparing food.
• Choose foods that look and smell good to you.
• Try to choose high-calorie foods that contain a lot of protein (such as meat, fish or cheese).
• Cook more with butter or oil.
• Help to increase the flavour of food by marinating, or using strongly flavoured seasonings or herbs.
• If your mouth is sore, or swallowing is difficult, try soft foods such as milkshakes, custards, scrambled eggs or mashed vegetables. Avoid foods that may irritate, such as spicy/salty foods, citrus fruit or drinks (orange, lemon and lime) and tomato sauces.
• Mix food with sauces to ease swallowing.
• Eating several small meals or snacks during the day may work better for you than having three large meals.