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Head and neck cancer patients’ perceptions of swallowing following chemoradiotherapy

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Abstract

Purpose

The study aims to describe patients’ experiences of swallowing difficulties following (chemo)radiotherapy for head and neck cancer and to explore any changes over time.

Methods

A purposive sample of patients with swallowing difficulties was selected at a range of time points, from 3 to 18 months following treatment. Ethnographic observations of 12 patients were conducted in their own homes, over a mealtime situation. Nine new patients were interviewed about changes to their eating and drinking from pre- to post-treatment. Thematic analysis was used to code and analyse the data.

Results

Patients’ reports of swallowing function were divided into four time zones: pre-treatment, during radiotherapy, early (0–3 months) and late (6–18 months) time points following treatment. The majority reported minimal problems at diagnosis, but marked impairment during and after radiotherapy, without a return to pre-treatment functioning. The focus was on severe physical side effects and changes to food preparation during radiotherapy and in the early phase of recovery. By 6 months, side effects began to subside, but swallowing was still difficult, leading to major changes to family life, socialisation and lifestyle.

Conclusions

Swallowing problems after (chemo)radiotherapy are multi-faceted and highly individualised and restrict lives in the long term. Swallowing ability may improve in time, but does not appear to return to pre-treatment function. Further work is required to find ways of being able to best support patients living with this long-term condition.

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Acknowledgments

Dr Jo Patterson is funded by a National Institute for Health Research Clinical Lectureship.

Conflict of interest

None

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Authors and Affiliations

  1. Speech and Language Therapy Department, Sunderland Royal Hospital, Sunderland, UK

    Joanne M. Patterson

  2. Institute for Health and Society, Newcastle University, Newcastle upon Tyne, UK

    Elaine McColl, Janet Wilson & Tim Rapley

  3. Speech and Language Therapy, Freeman Hospital, Newcastle upon Tyne, UK

    Paul Carding

Authors
  1. Joanne M. Patterson
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  2. Elaine McColl
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  3. Janet Wilson
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  4. Paul Carding
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  5. Tim Rapley
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Corresponding author

Correspondence to Joanne M. Patterson.

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Patterson, J.M., McColl, E., Wilson, J. et al. Head and neck cancer patients’ perceptions of swallowing following chemoradiotherapy. Support Care Cancer 23, 3531–3538 (2015). https://doi.org/10.1007/s00520-015-2715-8

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  • DOI: https://doi.org/10.1007/s00520-015-2715-8

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