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Swallowing after head and neck radiotherapy

You might have difficulty swallowing during and after radiotherapy to your head or neck. There are a number of things you can do to help yourself cope.

Swallowing problems during head and neck radiotherapy

Radiotherapy treatment for cancer in the head or neck area can cause swelling and soreness in the throat. Your throat may be very sore and you may find it difficult to swallow solid foods.

The amount of difficulty you have depends on the part of your head or neck being treated. It also depends on the dose of your treatment. 

You can ask to see a dietitian at the radiotherapy clinic if you have problems with eating and drinking. Difficulty swallowing may be worse and can last longer if you have chemotherapy at the same time as radiotherapy.

Food and drink tips

You might find you'll need to make changes to the food and drink you normally have. A soft, plain diet might be easier to have while you are having treatment.

Foods

Try different foods to find out which are easiest to swallow. Avoid eating things that may irritate your throat. This includes:

  • dry foods
  • highly spiced foods
  • very hot foods or drinks
  • alcohol, particularly spirits

Drinks

You might need high calorie drinks to boost your calorie intake, such as:

  • Build Up
  • Complan
  • Fortisip

Other high calorie food supplements are available on prescription. You can ask your specialist nurse, radiographer or dietitian to advise you.

Remember to drink plenty of other fluids too. The soreness usually gets better within a few weeks of your treatment ending, but this depends on how much treatment you've had.

Soft diet or tube feeding

You may need to eat a soft diet for some weeks if you have soreness following radiotherapy and chemotherapy given together. Some people need to go into hospital for feeding through a tube.

You may need to have fluids through a drip into a vein if you get dehydrated.

For very sore throats

You might need to have strong painkillers if your throat is too sore to swallow food. You might also need one of the following:

  • liquid feed through a drip into a vein or tube down your nose to your stomach
  • a feeding tube put into your stomach through the skin and muscle of the abdomen (called a percutaneous endoscopic gastrostomy or PEG tube)

Your radiotherapy doctor (clinical oncologist) may stop your treatment for a while to allow you to recover but this is rare.

Medicines that can help

Your doctor or nurse might prescribe medicines to reduce the soreness, including:

  • painkillers
  • liquid medicines
  • aspirin gargles
  • anti thrush medicines

You could take painkillers about half an hour before meals to make eating less uncomfortable.

Last reviewed: 
14 Mar 2016
  • The oral management of oncology patients requiring radiotherapy, chemotherapy and / or bone marrow transplantation – clinical guidelines
    The Royal College of Surgeons of England and The British Society for Disability and Oral Health, updated 2012

  • National Radiotherapy Implementation Group Report – Image Guided Radiotherapy (IGRT) guidance for implementation and use
    NHS National Cancer Action Team. August 2012

  • ESPEN (European Society Parenteral Nutrition and Metabolism) Guidelines on Parenteral Nutrition: Non-surgical oncology
    F Bozzetti and others
    Clinical nutrition, 2009

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