Chewing and Swallowing Problems During Cancer Treatment

Nutritional management of treatment side effects

There is more to nutrition during cancer and cancer therapy than getting enough calories and protein. The foods you choose also help you to cope with side effects, such as loss of appetite, nausea, vomiting, diarrhea, chewing and swallowing problems, and taste changes.

As each person's medical profile and diagnosis is different, so is their reaction to treatment. Side effects may range from severe to mild, or be absent. Talk with your cancer care team about possible side effects of treatment before the treatment begins.

Nutritional management of chewing and swallowing problems

Cancer treatments target fast-growing cancer cells in your body. Healthy cells that are fast-growing can also be damaged. Examples of fast-growing cells include cells in the mouth, digestive tract, and hair. These may be affected by cancer treatment and can cause problems, such as hair loss, nausea and vomiting, or a metallic taste in your mouth. Eating well from the start of cancer treatment has been found to help prevent mouth problems.

Stomatitis (mucositis) is the presence of sores in the mouth caused by some anticancer medicines, radiation therapy, and stem cell or bone marrow transplants. Along with being painful, mouth sores can become infected by the many germs that normally live in the mouth. These can make it hard to swallow and chew. If you have sores in your mouth, tell your doctor. You may need medicine if the sores are painful or prevent you from eating and drinking. It may be helpful to eat small, frequent meals. Make sure to stay hydrated by taking sips of fluids throughout the day.

These suggestions may help if you have mouth problems:

• Eat soft, soothing foods (cold or at room temperature), and puree cooked foods in a blender to make them smoother and easier to eat. Try foods such as:

  • Ice cream.

  • Milkshakes.

  • Nutritional supplemental drinks.

  • Baby food.

  • Soft fruits (bananas and applesauce).

  • Mashed potatoes.

  • Cooked cereals.

  • Soft-boiled or scrambled eggs.

  • Yogurt.

  • Cottage cheese.

  • Macaroni and cheese.

  • Custards.

  • Puddings.

  • Gelatin.

• Try to stay away from irritating, acidic foods and juices, alcohol, hot foods, spicy or salty foods, and rough or coarse foods, such as:

  • Tomato juice and citrus juice (orange, grapefruit, and lemon).

  • Raw vegetables.

  • Granola.

  • Popcorn.

  • Chips.

  • Toast.

• Ask your doctor about medicine or mouth rinse if you have mouth pain.

• Sit up straight to eat and drink. Stay sitting up for several minutes after you finish.

• Ask your doctor if you should see a speech therapist. These professionals can help you better manage swallowing and symptoms like coughing when eating.

• Try eating thicker liquids, or add a liquid thickener product to thin liquids. They make it easier to swallow than thin liquids.

• For mouth dryness:

  • Drink plenty of liquids.

  • Ask your doctor if you can suck on ice chips, ice pops, or sugar-free hard candy. You can also chew sugar-free gum. (Sorbitol, a sugar substitute that is in many sugar-free foods, can cause diarrhea in many people. If diarrhea is a problem for you, check the labels of sugar-free foods before you buy them, and limit your use of them.)

  • Moisten dry foods with butter, margarine, gravy, sauces, or broth.

  • Soften crisp, dry foods in mild liquids.

  • Eat soft and pureed foods.

  • Use lip balm or petroleum jelly if your lips become dry.

  • Carry a water bottle with you to sip from often.

  • Ask your care team if they recommend a mouth rinse. Don't use mouth rinses that contain alcohol.