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Radiation Associated Dysphagia

I didn’t have trouble swallowing right after my radiation treatment, so why now, years later?


Many people believe that once you have completed radiation treatment, then you are out of the woods. Unfortunately, people can develop side effects from radiation, including difficulty swallowing, months – even years – following the completion of their treatment.


What is late Radiation-Associated Dysphagia?

Also called “late RAD,” radiation-associated dysphagia refers to the stiffening of the muscles and tissues of the mouth, throat and/or esophagus. This can result in impaired or painful swallowing.


What are some complications of late RAD?

· Fibrosis: Stiffening of muscles and tissues

· Xerostomia: Dry mouth

· Odynophagia: Pain when swallowing

· Trismus: Difficulty opening your mouth

· Globus: Sensation of food sticking in your throat or esophagus

· Stricture: Narrowing of the esophagus causing food to get stuck or pass slowly


What can I do if I have late RAD?

You are not alone. Swallowing difficulties not only negatively impact quality of life and social interactions, but they can lead to health issues such as weight loss, dehydration & even pneumonia.

To address your swallowing difficulty, it can be beneficial to seek referrals, helpful resources & a support network.

· Speech-Language Pathologist (SLP)

· Ear, Nose & Throat Physician (ENT)

· Registered Dietician (RD)

· Gastroenterologist (GI)


Find a Swallowing Support Group

How can I prevent late RAD?

If you are just beginning treatment for head and neck cancer, there may be some things that you can do to prevent or slow down the development of RAD. You should start by getting a referral to a Speech-Language Pathologist (SLP) who has expertise in treating dysphagia in patients with head and neck cancer for an evaluation of your current swallowing ability. The National Foundation of Swallowing Disorders can provide a referral to an SLP who is board-certified in the treatment of swallowing disorders.

An SLP can determine what diet texture you can eat/drink safely and if there are any strategies, precautions or treatments that may benefit you. Here are a few examples of what you might expect from a referral to an SLP:

· Assessment of your swallow: A clinician will either x-ray your throat/esophagus or pass a scope through your nose while you swallow.

· Diet modifications: Some people may need softer/smoother foods or thicker liquids to swallow safely. Non-oral nutrition (feeding tube) may be considered if indicated.

· Compensatory strategies: There may be postures or techniques that can help protect your airway and help you more easily swallow foods/liquids.

· Swallowing interventions: There are exercises for your tongue and throat that may be helpful depending on the severity of your swallowing problem. If you have a narrowing of your esophagus, a doctor may consider a dilation/stretching.


Additional Resources:

· https://www.spohnc.org

· https://headandneckcancerguide.org

· https://swallowingdisorderfoundation.com


Author’s Bio:

Danielle Thompson, M.A. CCC-SLP is a Senior Speech-Language Pathologist who currently practices at University of California San Diego Health. UCSD is the area’s only academic medical center, burn unit and one of the few level 1 trauma centers in the region. Danielle has been providing patient care in the acute medical setting for 10 years and is currently working towards a board-certified specialty in swallowing disorders. She is a member of ASHA’s special interest group 13 for dysphagia, a member of Support for People with Oral and Head & Neck Cancer as well as the National Foundation of Swallowing Disorders.  She recently completed a leadership project and poster presentation on interdisciplinary education and training for total laryngectomy inpatients. Contact info:  d5thompson@ucsd.edu  



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