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Swallowing after head and neck cancer
Surgery and radiation can change how the mouth and throat move. Help is part of the plan.
Awaiting clinical review. This page is written from general, widely accepted background on how eating and swallowing work. It has not yet been signed off by a named clinician, and it is not a substitute for asking one.
Why treatment can change swallowing
Swallowing uses the lips, tongue, jaw and throat. Cancer in these areas, and its treatment, can change how they move.
Surgery can change the shape of the mouth or throat. Radiation can make tissue sore, dry and later stiff.
An SLP is often on the team
Many cancer teams include a speech-language pathologist (SLP). They may see you before treatment starts, not just after.
They check how you swallow, and keep checking as things change.
What you might notice
- A dry mouth, or thick, sticky saliva.
- A sore mouth or throat, or mouth sores.
- Food that tastes different, or of very little.
- Dry or chewy foods that take longer to get down.
- A tight or stiff feeling in the neck or jaw, sometimes months later.
- Coughing when you eat or drink.
What can help
- Many cancer teams offer swallowing exercises before, during and after radiation. Studies on how much they help are mixed.
- An SLP can show the technique and check whether the exercises seem to help you.
- Softer or moister foods can make meals easier for a while. Ask what a swallow test showed, then choose what to try.
- Sips of water with meals can help a dry mouth.
- Gentle mouth care, as your cancer team advises, helps keep the mouth comfortable.
- A dietitian can help you keep eating enough while it is hard.
- Tell your team about pain. There are ways to make eating more comfortable.
Questions to ask your care team
- Can I see an SLP before my treatment starts?
- Which swallowing changes should I tell you about right away?
- What exercises are there, what do they involve, and what does the research say?
- Who can help with dry mouth and mouth care?
- What do people often notice months or years after treatment?
- Who do I call if I am eating or drinking much less?
When to get help
Get checked soon if you notice any of these. A doctor or SLP can look at what is going on.
You know your own body best. Bring what you notice to your care team, and decide together.
- Coughing or choking when you eat or drink.
- Food or pills that feel stuck.
- Losing weight without trying.
- Pneumonia or chest infections, especially if they come back.
When this is worth asking about
- You cannot breathe, speak or cough. Call 911.
- Pain stops you eating or drinking.
- You are losing weight, or drinking much less.
- You cough or choke with most meals or drinks.