Changes to eating after treatment for head and neck cancer
Surgery and 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.
Some of these changes are temporary and are caused by swelling in the mouth or throat immediately after treatment. As the swelling goes down, eating and drinking gradually improves. Although for some people, it may never be quite the same as before.
Your speech and language therapist and dietitian will help you learn to cope with any changes. They will assess your eating and swallowing at every stage and advise you on what you can do.
Swallowing test (videofluoroscopy)
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If you’re having swallowing difficulties, you may be asked to have a special x-ray test of your swallowing called a videofluoroscopy. It gives a picture of what is happening in your mouth and throat when you swallow. This helps the speech and language therapist see the best ways to make swallowing safer and easier for you.
The test takes about 30 minutes and is painless. You will be asked to swallow different types of food, from liquid to semi-solid (like yoghurt) and solid (like a biscuit). A special substance is added to the food to make it show up on the x-ray. This test is carried out in the radiotherapy department by a radiologist and the speech therapist, and is recorded on video.
If the results of the videofluoroscopy show that food or liquid is getting into the lungs, you may need to be fed directly into the stomach through a tube. Usually, this is only temporary until you re-learn to swallow with the help of exercises taught by the speech and language therapist. You’ll also be given advice on the type of food to eat - for example, drinks can be thickened to allow them to be swallowed safely.
Some people find that after their treatment, they can only eat slowly and they experience drooling (saliva drips outside the mouth). These changes may make you feel embarrassed and frustrated, and you may find it hard to eat with others.
It’s important to talk with your family and friends about how you’re feeling so that they can help. You can also talk to your specialist nurse. They will understand what you’re going through and may be able to offer help or put you in touch with other people who have experienced similar difficulties.
Tips for coping with eating problems
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Here are some suggestions for coping with eating problems.
Go for high-calorie foods that contain a lot of protein (such as meat, fish or cheese).
Cook with butter or oil.
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 your mouth, such as spicy/salty foods, citrus fruit or drinks (orange, lemon and lime) and tomato sauces.
If you have taste changes after radiotherapy, once your mouth is no longer sore you can increase the flavour of food by using marinades or strongly flavoured seasonings and herbs.
Choose foods that look and smell appealing to you.
Mix food with sauces to make them easier to swallow.
Eating several small meals or snacks during the day may work better for you than having three large meals.