Eating and drinking when you have mouth and oropharyngeal cancer
Mouth and oropharyngeal cancer and its treatment can affect your eating and drinking.
You might have difficulties with swallowing, taste changes, weight loss, and a dry mouth. There are things you can do to help you cope with these problems.
Your nurse and doctor can also offer help if you are having problems with eating. They can refer you to a dietician if you are not already seeing one.
A speech and language therapist can help if you are having problems with swallowing.
Difficulty swallowing
You may see a speech and language therapist (SLT) and a dietician before you start treatment if this is likely to affect your swallowing. The SLT can assess your swallowing during and after treatment. And your dietician can help if you are finding it difficult to eat and drink enough.
Radiotherapy
Before radiotherapy begins, it may be necessary to remove some of your teeth, making chewing hard foods difficult. Radiotherapy to your head or neck can make your throat very sore. Eating and drinking will be difficult or painful within the first few weeks of treatment. Your doctor will give you strong painkillers to help with this. Your team can also give you a gel to protect your mouth.
Surgery
Surgery involving the jaw, mouth, throat, or tongue will make eating, drinking and swallowing difficult. This is due to the removal of tissue during surgery, changes in sensation, swelling, and sometimes pain. The recovery period varies from person to person, and the type of surgery you’ve had.
Changes to your diet
Your dietitian will assess you before you start treatment. They will suggest whether you need a feeding tube put into your stomach.
This might be a tube:
- from your nose to your stomach (nasogastric tube)
- directly into your stomach (gastrostomy or PEG tube)
You have liquid nutrition through the tube. This helps to reduce weight loss during treatment.
You may still be able to manage small amounts of soft or pureed food, and sips of fluid. As your sore throat starts to recover, you will be able to increase the amount you eat. Eventually your doctor will take out the feeding tube.
Keeping your mouth and teeth clean
Even if you are not eating, it is very important to keep your mouth and teeth clean. This helps to stop infection. It could also help you feel a bit better.
Taste changes
Radiotherapy and some cancer drugs can affect your taste buds. So your sense of taste might change as soon as you start treatment, or some time afterwards.
Some people say their food has a metallic, bitter or salty taste. Others say that all foods taste the same. Taste changes are often temporary with chemotherapy or targeted cancer drugs.
Radiotherapy to some parts of the head and neck can cause long term side effects. These can sometimes be permanent. Before you start your treatment, ask your doctor if it’s likely to affect your taste.
Surgery for tongue cancer might make your tongue feel numb and can reduce your sense of taste.
Dry Mouth
Radiotherapy to your head and neck can cause a dry mouth. You might hear your doctor or nurse call this xerostomia (pronounced zero-stow-mee-a). It can make eating and talking very uncomfortable. This can last for several months, but some people find the dryness is permanent.
Your doctor can prescribe artificial saliva for your mouth or stimulants for your salivary glands. You might find it helps to carry a bottle of water with you all the time, so you can keep taking small sips to moisten your mouth.
A dry mouth can cause other problems, such as mouth infections or tooth decay. It is important to have regular check ups with your dentist.
Loss of appetite and weight loss
You may lose your appetite if you are having treatment for mouth and oropharyngeal cancer, so you might lose weight. For example, if you are in pain or find it difficult to swallow you might not feel like eating or drinking.
Talk to your radiographer, doctor, dietitian or nurse if you’re having problems.
The hospital team can prescribe painkillers if needed to help you get through this difficult time.
You can take food supplements, such as high calorie drinks until your mouth feels better. Your doctor can prescribe these for you too. You may lose weight even if you take these supplements. So do tell your healthcare team if this is the case.
Your nurse or dietician can give you advice about eating and drinking. Ask your doctor or nurse about seeing a dietitian for advice about eating and drinking.
Difficulty chewing
Surgery inside your mouth or jaw might make your mouth numb or painful. This makes chewing difficult. You might find it hard to move your lips or hold food in your mouth when eating. You might need to eat a soft diet for a few weeks while your mouth heals. After some time, usually you can chew again normally.
Numbness might be due to damage to the nerves in your head and neck. In this case difficulty with chewing might last longer.
Some people need to have reconstructive surgery after cancer surgery. Or you might need a new mouth structure (dental prothesis) to put in your mouth to help you chew and swallow.
Loss of smell
Surgery or radiotherapy for mouth and oropharyngeal cancer can damage your sense of smell. This can lower your appetite and weight.
If cancer or its treatment changes how well you can smell, it can be more difficult to cope with than many people expect.
Loss of smell can sometimes lead to loss of appetite and weight loss because eating is no longer as enjoyable.
You can vary textures within a meal or try spicy foods for a sensation on your tongue. This can help you to enjoy eating again.
Smell retraining might be possible. Ask your doctor if this would be helpful for your situation.
Difficulty opening your mouth due to a stiff jaw
Certain muscles in your face help to move your jaw. The muscles can become stiff during radiotherapy or surgery to the head and neck area. This is called trismus.
It might be difficult to eat or chew if you are unable to open your mouth properly. Your doctor, speech and language therapist, physiotherapist or dentist may suggest some gentle jaw exercises to help prevent this from becoming a permanent problem. They will do an assessment and suggest using a device called a TheraBite. You may have to use this long term to improve your mouth opening.
