Swallowing Problems During Radiotherapy

What is Dysphagia and How Can You Cope With It?

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Radiation to the neck and chest frequently results in a sore throat and difficulty in swallowing. It can become difficult and painful to swallow solid foods during radiotherapy. Medically, this condition is known as dysphagia. Learn more about why this side effect occurs and what you can do to relieve swallowing problems if they develop.

When does swallowing difficulty start?

Problems with swallowing usually start after a few weeks of starting radiation.

They may persist for a few weeks after radiotherapy is completed.

Why do swallowing problems occur?

Radiation kills fast multiplying cells like tumor cells. But there are some normal tissues of the body, like the mucosa of the mouth and throat, which also have fast multiplying cells. These cells are also prone to more damage with radiation. The damaged cells cannot be replaced soon enough by the body and rawness develops in the mouth and throat leading to problems in swallowing.

What factors affect swallowing problems during radiation?

The three main factors that make swallowing problems worse are:

  • A higher dose of radiation
  • A large radiation field covering most of your neck or chest
  • The addition of chemotherapy along with radiation.

Dietary advice for those with swallowing difficulties:

When you have swallowing problems, switching to a soft diet that is easy to swallow will help. Here are some tactics:

  • You may want to start mashing or pureeing foods so they can be eaten easier, much like soft baby food.
  • Smoothies, cream-based soups, yogurt and pudding are easy to swallow and have protein and calories.
  • Smaller bites of food will make it easier to swallow. Be sure to swallow each bite completely before you take the next bite.
  • Use a straw for beverages.
  • There are thickeners you can add to liquids to make them easier to swallow.

Avoid foods that will irritate the raw skin of the throat and neck. These are:

Don’t avoid food. Proper nutrition is very important for your body to tolerate cancer treatment. Speak to your doctor about dietary supplements.

Medications for swallowing difficulties:

Swallowing problems due to radiotherapy are temporary - they subside on their own within 2 to 3 weeks after radiotherapy is completed. Till then, a few measures may help in reducing the severity of pain and irritation. These include:

  • Painkillers – pills can help reduce the pain when you swallow.
  • Liquid soothing agents – some medications may soothe the raw skin of the throat and mouth and coat the areas to prevent further irritation with food.
  • Gargles with aspirin – Gargles with aspirin pills dissolved in lukewarm water may reduce the inflammation in your throat and food pipe caused by radiation and make you feel better.

    Measures for severe swallowing difficulty:

    Occasionally, swallowing difficulties may be severe after radiation treatment. Such situations are rare in radiation for lymphoma because only moderate doses of radiation are used. Severe problems may require the placement of a tube through your nose for feeding, or hospitalization to maintain your nutrition through infusions. No matter how severe the problems are, nearly all patients recover within a few weeks.


    Swallowing Problems, American Cancer Society, 06/08/2015.

    Oral Complications of Chemotherapy and Head/Neck Radiation–for health professionals (PDQ®), National Cancer Institute, January 4, 2016.

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