Sore mouth and throat
Pain management
Many people feel pain in their mouth and throat during radiation treatment, which can impact eating and swallowing, talking and sleep. Sometimes people have pain before the treatment starts due to the cancer. Please let your doctor know if you have pain, and they can discuss medication options with you.
Some pain medications are best to take before meals to help with swallowing and eating. Please discuss your medications with your doctor. They can provide a medication plan for you.
Softening food
Eating can be challenging during radiation treatment, especially when chewing and swallowing becomes painful. Soft foods that are easy to chew and gentle on your mouth and throat can help make meals more manageable. The recipe book and video below offer ideas on foods and meals that are easier to swallow and more comfortable to eat.
- Beyond the Blender: Dysphagia cookbook (Griffith University)
If you’ve woken up on the weekend ready to sit down to a meal and you’re finding that your normal foods that are a little bit chewier or have sharper edges are difficult for you to swallow and chew, this might mean that you need to change some of the foods that you’re eating, but it doesn’t mean that you need to go from these sharp and crunchy foods straight to smooth food.
We can certainly talk about things in the middle.
Choosing softer foods or foods with less sharp edges means that when you are swallowing those foods, or chewing those foods, it’s causing less irritation in your mouth or to the skin, in your mouth and throat.
So our top tips would be to, remove some of those foods from your diet that have those really sharp edges, and also to add a bit of moisture to your foods in the form of sauces or gravy.
We want you to be creative, but maybe not too creative.
If you need more advice or more ideas, speak to your speech pathologist or your dietician.
Taste changes
You might notice changes in how food tastes after you start radiation treatment. It may seem bland, bitter, metallic, or you may lose your sense of taste altogether. These changes can make eating and drinking more difficult. The information below can help you understand what is happening and offer ways to manage it.
- Taste Changes (Queensland Health)
- Taste and Smell fact sheet (Cancer Council)
Dry mouth or thick saliva
Radiation can damage your salivary glands, leading to a dry mouth and thick, sticky saliva. This can make it harder to chew, swallow, speak, and keep your mouth clean.
It is important to continue with regular mouth washes (salt water or bicarb) 4 to 6 times a day.
Further information below can help you manage these symptoms and stay more comfortable.
Eating, drinking and swallowing
As radiation treatment progresses, side effects like pain, dry mouth, and thick saliva can make eating and drinking more difficult. If you’re finding it hard to eat, drink, or swallow, speak with your dietitian and speech pathologist. They can offer practical tips and support to help you manage these challenges.
The information below may also help you feel more confident and comfortable eating and drinking.
- Video: Nutrition During and After Treatment (Head and Neck Cancer Australia)
- Video: Nutrition, Swallowing and Managing Side Effects of Treatment for Head and Neck Cancer (Head and Neck Cancer Australia)
- Eating Advice during Radiotherapy (Queensland Health)
Nausea and vomiting
You may experience nausea and vomiting due to side effects from your treatment. This can be due to changes in taste and smell and thick throat secretions, or the impact of chemotherapy (if receiving).
These symptoms can reduce food intake and affect recovery. The strategies below can help support management of these symptoms.
- Nausea and vomiting (Queensland Health)
Loss of appetite
Loss of appetite during radiation treatment for head and neck cancer is a common and challenging side effect. It often results from a combination of physical changes and psychological factors such as stress and anxiety related to treatment.
- NEMO loss of appetite (Queensland Health)
Skin reaction
Radiation to the head and neck can make the skin sore, red, dry or itchy. These effects usually start after a couple of weeks and heal gradually after treatment ends. Please avoid sun exposure during radiotherapy and while you recover from your treatment.
Constipation
Constipation during radiation treatment is a common and uncomfortable side effect. It often occurs due to changes to your food and fluid intake, medication use (such as pain relief), and decreased physical activity during treatment.
- Constipation or Diarrhoea (Cancer Council NSW)
- Constipation during cancer treatment (eviQ)
Tube feeding
If you had a feeding tube inserted before treatment, your dietitian or nursing team will have shown you how to care for it, as well as how to give feeds and medications. The information below will help you follow these steps.
- Webinar: How to administer a gravity bolus feed via a nasogastric tube (eviQ)
- Webinar: How to administer a syringe bolus feed via a gastrostomy tube (eviQ)
- Webinar: How to administer medications via a feeding tube (eviQ)
Nasogastric tubes
Sometimes during treatment if your side effects are making it difficult to maintain your weight, your team may suggest supporting your nutrition with a nasogastric tube for a short period. The short video below describes the experience of a patient and his carer in having a nasogastric tube placed and the positive impact this had on allowing him to meet his nutritional needs.
I was on chemo and radiation.
All my taste buds were fried. I couldn’t taste anything. I had limited saliva ’cause that was gone as well. And I had a mouthful of ulcers.
It was like it was turned off, the desire to eat completely. So that’s when you need something else secondary to boost it all.
So if that’s a nasogastric, that’s what you have to do.
I was terrified to get it inserted ’cause I knew what it was gonna be like to get it inserted. But I knew I needed it.
It was painful, but it didn’t last that long. I remember holding my wife’s hand, getting it installed because I knew that I was there when she gave birth to the children and she squeezed my hands. So it was my turn to squeeze her hands.
I was glad to finally have some strength, to have food again through the tube and have my medication. Took a burden off my shoulders.
We didn’t notice a difference right then on that day, but probably within a week I definitely seen a difference.
He was a little bit happier that he could think a bit better. Yeah. And he wasn’t as grumpy.
If you are unsure about getting a tube installed, I would say just do it for the fact that you can still function.
You can still get sustenance. You can, at least… it’s one thing that can be lifted.
Get all the help you can ’cause you need it.
Movement and fatigue
Radiation therapy can stiffen the tissues in the head, neck and shoulders. It is important to continue posture, neck and shoulder stretches during your treatment. These activities are recommended for all individuals, regardless of whether you have had surgery prior to starting radiation therapy. Continuing with gentle exercises like daily walks can help with fatigue.