Difficulty swallowing

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

Whether you have problems swallowing depends on which part of the head or neck you are having treatment to. It also depends on the dose of treatment. Difficulty swallowing may be worse and can last longer if you have chemotherapy at the same time as radiotherapy.

You may see a Speech and Language Therapist (SLT) before you start treatment if this is likely to affect your swallowing. An SLT can assess your swallowing during and after treatment. They can teach exercises to support you with swallowing difficulties. And they work with a dietitian if you are finding it difficult to eat. 

Talk to your healthcare team if you have problems swallowing.

Food and drink tips

You might find you need to make changes to the food and drink you usually eat. A soft, plain diet might be easier to manage while you are having treatment. 

Foods

Try different foods to find out which are easiest to swallow. This includes:

  • porridge
  • soup or broth
  • full fat milk
  • cheese

Avoid eating things that may irritate your throat. Such as: 

  • dry food
  • spicy food
  • very hot food or drink
  • 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.

For very sore throats

You might need to have strong painkillers if your throat is too sore to swallow food. You might need to have:

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

Medicines that can help

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

  • painkillers - taking these half an hour before eating can help
  • liquid medicines
  • aspirin gargles
  • anti thrush medicines

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

The soreness usually gets better within a few weeks of your treatment ending, but this depends on how much treatment you've had.

  • 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

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

  • Dysphagia management in head and neck cancers
    K Thankappan and others, 
    Springer Nature, 2018

Last reviewed: 
10 Nov 2020
Next review due: 
10 Nov 2023

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