Dysphagia in head and neck cancer: Prevention and treatment

Heather M. Starmer

Research output: Contribution to journalReview articlepeer-review

Abstract

PURPOSE OF REVIEW: Swallowing difficulties are among the most problematic outcomes associated with head and neck cancer (HNCA) and the strategies employed to treat it. With a rising incidence of human papilloma virus-associated HNCA, a larger number of patients are expected to survive their cancer, and therefore will be more susceptible to long-term treatment toxicities. Optimization of long-term swallowing outcomes is an important objective for those working with patients with HNCA. RECENT FINDINGS: The role of the swallowing therapist in the management of patients with HNCA cannot be overstated. This begins with pretreatment evaluation of swallowing. At the time of initial assessment, education should be provided regarding treatment toxicities and the importance of prophylactic swallowing exercises and oral intake. Recent evidence suggests that maintaining an oral diet and engaging in swallowing exercise during radiation have a positive impact on diet level, swallowing physiology, patient-perceived swallowing-related quality of life, and reduced feeding tube use. Although treatment strategies such as radiation de-intensification and transoral surgical treatments show promise for reducing toxicities, evidence regarding their impact is still being amassed. SUMMARY: Maintaining an oral diet and performing prophylactic swallowing exercises are currently the most evidence-based strategies for dysphagia prevention in HNCA.

Original languageEnglish (US)
Pages (from-to)195-200
Number of pages6
JournalCurrent Opinion in Otolaryngology and Head and Neck Surgery
Volume22
Issue number3
DOIs
StatePublished - Jun 2014

Keywords

  • Chemoradiation
  • dysphagia
  • head and neck cancer
  • organ preservation
  • swallowing

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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