Dysphagia is a frequent complication in cancer of the head and neck. What about other types of cancer?
Very little data is available about the prevalence of dysphagia and swallowing difficulties in cancer patients. Symptoms may go undetected or underestimated and therefore remain untreated. Given the possible repercussions, screening is essential.
Fourteen types of cancer assessed
An Australian cancer treatment centre recently analysed data from 239 patients with fourteen different types of cancer. The detailed questionnaire revealed the prevalence of dysphagia.
Dysphagia linked to seven types of cancer
Results: 54% declared symptoms of dysphagia, 20% with liquids and 46% with solids only. Head and neck cancer patients reported most dysphagia symptoms (89%), followed by lung cancer patients (78%), bone or soft tissue (73%), upper gastrointestinal tract (67%), colorectal (62%), skin (55%), and breast (31.8%).
Some 41% of survey respondents presented severe dysphagia, 33% moderate and 26% mild. When head and neck cancer patients were excluded, the figures were 33%, 37% and 30% respectively.
Oral complications contribute to dysphagia
The most frequent oral complications for all types of cancer were: taste alteration (62%), dry mouth (xerostomia) (56%), voice alteration (37%), smell alteration (35%), thick saliva (33%), dental or denture issues (25%), pain in mouth and throat and reduced opening of jaws (trismus) (19%).
Symptoms such as xerostomia, dental issues, pain in the mouth and throat and thick saliva make chewing and swallowing difficult. Over 20% of those with a dry or painful mouth had severe dysphagia.
This study demonstrates that dysphagia (in particular for solid foods) and oral complication are widespread among cancer patients and not restricted to those treated for head and neck cancer. Symptoms coexist and are often linked.
Complications linked to side effects are often inevitable and it is therefore essential to increase awareness and improve acknowledgement of these symptoms to ensure appropriate treatment.
The prevalence of patient-reported dysphagia and oral complications in cancer patients. Frowen J, Hughes R, Skeat J. Support Care Cancer. 2019 Jun 15. https://www.ncbi.nlm.nih.gov/pubmed/31203510