Effects of radiotherapy on swallowing

Side-effects of radiotherapy

This information sheet is for people undergoing radiotherapy to the head or neck. It aims to explain some of the side-effects on swallowing that you may experience.

What can help swallowing?

Swallowing is a very complex process which can be affected by radiotherapy. The side-effects of radiotherapy on swallowing can build up as treatment progresses, so you may need to adapt what you eat or drink as you go through treatment. Your speech and language therapist and dietitian will regularly review you during your radiotherapy treatment and advise you as needed regarding swallowing and diet.

If your radiotherapy is targeting your mouth, parotid gland or nasopharynx you may experience:

• Dry mouth.
• Thickened saliva.
• Reduced / altered taste.
• Soreness in your mouth – this can affect your ability to eat certain textures of food.
• Jaw stiffness affecting your ability to chew hard foods.

If your radiotherapy is targeting your throat, you may experience:

• Discomfort when swallowing.
• Dry throat.
• Thickened saliva.
• Coughing or choking when swallowing – this is known as aspiration.
• Food sticking in your throat.

Signs of aspiration include:

• Coughing when swallowing (the feeling of something going down the wrong way).
• Choking.
• Wet voice quality.
• Increased breathing rate when eating/drinking.
• Watery eyes.

Inform your speech and language therapist or doctor if you notice any of these signs.

Following the recommendations of the doctor, speech and language therapist and dietitian can help your swallowing.

They may suggest:

• Taking regular painkillers and mouthwashes as prescribed by the doctor to help reduce pain when swallowing.
• Having foods that are the texture recommended by the speech and language therapist might be easier to swallow, for example you may need soft or pureed food if you cannot manage solid/ hard foods.
• Using sauces, gravy or custard on food can make them softer and easier to swallow.
• Taking sips of drinks through a meal to help food go down more easily when you swallow.
• For some people, thickened drinks may be easier to swallow. Your speech and language therapist will advise you on this as necessary.
• Sitting upright when eating and drinking with your chin slightly down.
• Having small sips and mouthfuls when eating and drinking.
• Taking your time when you eat and drink.
• The speech and language therapist may recommend manoeuvres to use to help your swallow.
• You may find eating little and often is more appropriate for you if swallowing is causing you discomfort or if it is very effortful to swallow.

If you have any questions please speak to your speech and language therapist directly or contact the speech and language therapy department on 01223 216200.