GP Update

Eating and swallowing after head and neck cancer

After treatment, head and neck cancer patients need a comprehensive follow up, as they may experience changes in their mouth which could affect the foods can eat


One complication can be Trismus where the maximum interincisor opening narrows to ≤ 35mm. This is due to damage to the muscles involved in mastication or fibrosis of the local tissue. Incidence varies significantly. Between 6% to 86% of patients can experience trismus if the field of radiotherapy or surgery includes temporomandibular joint and/or masseter/pterygoid muscles.

It leads to difficulty chewing, getting food into and out of the mouth and performing oral hygiene, and can affect approximately 30% of chemoradiation patients.

Xerostomia, known as a dry mouth is a key issue concerning lack of saliva, which can lead to difficulty swallowing and lack of taste or a strange taste in the mouth. It arises due to a deterioration of flow rate and amylase production possibly due to damage to salivary ducts, blood vessels and nerves. One way of alleviating this is to drink sips of water between mouthfuls of food, opting for softer food and having sauces on meals. Patients are encouraged to carry bottles of water around with them at all times to help maintain a healthy pH in the mouth.

How can GPs help?

It’s important for GPs to keep a look out for these symptoms as well as unintentional weight loss which often occurs consequentially. Nutritional supplements can be prescribed to compliment oral intake and nutrition support advice is available here. A referral to the dietetics team for further advice would be appropriate as they play a crucial role in helping patients adjust to changes in their body after treatment.

Health and well-being events run three times per year across RM partners hospitals which offer patients the opportunity to meet with others affected and give tips on management of symptoms.

A dedicated cookbook is also available online which gives recipes designed to combat some of the common side effects of all cancer treatments. For more information on eating and recipes from The Royal Marsden Cancer Cookbook, click here.

Make a referral

Find out how to refer your patients to The Royal Marsden.