Al generated image of nurse encouraging female cancer patient to drink.

Understanding Swallowing Difficulties

Certain cancers or side effects related to treatment can make swallowing difficult. The medical term is dysphagia. When swallowing becomes a challenge, it limits what you can eat and drink. This can lead to poor nutrition, dehydration and weight and muscle loss, which may affect strength, recovery, and your ability to cope with treatment. Beyond nutrition, swallowing difficulties from cancer can also affect your emotional health and well-being.

If swallowing is becoming more difficult, tell your medical team or cancer specialist as soon as possible. Early support can make a significant difference to your nutrition status, which can affect your strength, ability to tolerate treatments and quality of life. Here’s what you should know about swallowing difficulties and cancer.

AI generated image if female cancer patient eating soup.

What Causes Swallowing Difficulties in Cancer Patients?

Cancer can cause swallowing problems for various reasons, including physical changes, surgical effects, or treatment side effects that affect your mouth, throat, or oesophagus. These might include (1,2):

  • Tumours obstructing part of your mouth, throat, or oesophagus
  • Muscle or nerve damage from surgery
  • Mouth sores or dry mouth (less saliva) from chemotherapy or radiation treatment
  • Pain in your mouth, throat, or oesophagus from the cancer or its treatments
  • The feeling that food is stuck in your mouth or throat.

Cancer Types More Likely to Cause Swallowing Difficulties

Not all cancers cause dysphagia. It’s more common in certain head and neck or digestive system cancers where tumours restrict swallowing or block or press on digestive organs. Cancers most likely to cause swallowing problems include (1):

  • Head and neck cancer (mouth, larynx, pharynx),
  • Oesophageal cancer
  • Lung cancer if tumours in the chest press on your oesophagus
  • Thyroid cancer if tumours press on your windpipe or oesophagus
  • Pancreatic or stomach cancers because these affect digestion, which can indirectly hinder swallowing

Swallowing Difficulties Caused by Cancer Treatments

Treatments for any type of cancer can make swallowing more difficult (1).

  • Chemotherapy side effects often include sores in your mouth or throat and reduced saliva production, making chewing and swallowing painful and much more difficult. Nausea or taste changes, especially a bitter or metallic taste, can also make food taste unpleasant, trigger a gag reflex, or make you feel sick after eating. Pain medications, medicated mouth rinses, and dietary changes can often help manage these side effects. Sometimes changing from metallic cutlery can also help.
  • Immunotherapy can cause sores, pain, or burning in your mouth or throat. Medications may also cause dry mouth or mouth infections, all of which can make it challenging to chew and swallow. Switching to soft, moist foods and avoiding acidic or spicy foods can help.
  • Radiotherapy, particularly for cancers in the mouth, throat, or oesophagus, can also cause sores, dry mouth, and damage taste buds. In addition, radiotherapy to these areas can stiffen muscles or nerves necessary for normal swallowing.
  • Surgery to remove head and neck tumours can potentially damage muscles and nerves, affecting your ability to move food from your mouth down your throat and oesophagus. This can be temporary or long-lasting, and your doctor or cancer specialist may recommend speech and swallowing therapy to help you adapt.

Recognising the Signs of Swallowing Difficulty

Dysphagia symptoms can vary from person to person, depending on your cancer location and treatment. They may include (2):

  • Pain while swallowing
  • Coughing or gagging when swallowing
  • Feeling like food is stuck in your throat or chest
  • Food coming back up into your throat
  • Drooling
  • Dehydration
  • Unexplained weight loss

You might be tempted to ignore signs of a swallowing problem unless they become severe enough to restrict eating or drinking. However, even mild symptoms should be reported to your medical team. Early action can help prevent weight loss, loss of muscle mass and strength, malnutrition, dehydration, and other nutrition-related complications.

DID YOU KNOW?

Head and neck or digestive cancers and treatments may cause swallowing difficulties. Swallowing therapy and nutrition support can prevent choking and eating problems.

Temporary vs Long-Term Swallowing Problems

Cancer-related swallowing problems can be temporary or long-term. Your doctor or cancer specialist may be able to tell you what to expect.

Problems caused by side effects of chemotherapy, immunotherapy, or other cancer medications are usually temporary. Once your treatment ends, any nausea, dry mouth, taste changes, or mouth sores will likely go away within a few weeks to a few months, allowing you to eat, drink, and swallow normally. 

Dysphagia is more likely to be chronic (long-term) if it’s caused by a tumour that can’t be removed, or if surgery or radiation therapy has caused lasting muscle or nerve damage.  Some people regain swallowing function over time with swallowing therapy, diet modifications, and professional support; however, others may need to rely on tube feeding (enteral nutrition).

Enteral tube feed products are food for special medical purposes and must be used under medical supervision.

Tips for Managing Swallowing Difficulties

You may be able to resolve many swallowing problems by changing how and what you eat. These tips can help you eat safely and get the essential nutrients your body needs (2): 

  • Eat softer foods, purees, or thickened liquids, like oatmeal, mashed fruits or vegetables, smoothies, or cream soups.
  • Avoid hard or dry foods, like crackers or tough meats.
  • Eat smaller amounts more frequently, especially if nausea is a factor.
  • Sit upright while eating and take small bites.
  • For dry mouth, drink fluids between bites.
  • Use an adaptive drinking cup or other utensils if recommended by your care team.

In some cases, you may need more tailored advice from a speech and language therapist to ensure you are swallowing safely.

If you are unable to meet your nutritional needs through food alone, your dietitian or healthcare team may recommend using oral nutritional supplements (ONS).* These products are specially formulated to support your specific nutritional needs when normal food cannot, and some ONS are specifically designed to be suitable for patients experiencing swallowing difficulties/dysphagia. 

Speak to your cancer specialist team if you think you would benefit from referral to a speech and language therapist or dietitian.

*Oral nutritional supplements are food for special medical purposes and must be used under medical supervision.

When to Speak to Your Doctor

Contact your doctor or cancer specialist promptly if you develop swallowing difficulties, because early treatment can prevent choking, weight loss, or other problems. These symptoms are warning signs that need quick attention:

  • Persistent or worsening coughing after eating and drinking.
  • Weight loss or dehydration
  • Difficulty managing medications or oral diet/ fluids.
  • Pain or choking episodes

Key Takeaways

Swallowing problems are more common with cancer than people realise. They can develop from the cancer itself or treatment-related side effects, which can negatively affect your nutrition, weight, and well-being. 

Monitor symptoms and seek help from your cancer specialist team as early as possible. With the right support and advice, you can optimise your nutrition and well-being, which can have a positive impact on your quality of life throughout your cancer trajectory. 

References:

  1. [1] Cancer Research UK. Difficulty Swallowing (Dysphagia). Available at: https://www.cancerresearchuk.org/about-cancer/coping/physically/diet-problems/types/difficulty-swallowing (accessed August 25, 2026)
  2. [2] American Cancer Society. Swallowing Problems. Available at: https://www.cancer.org/cancer/side-effects/eating-problems/swallowing-problems.html (accessed August 25, 2026)

Disclaimer

This information is provided for educational purposes only. It is general in nature and is not intended to replace professional medical advice, diagnosis, or treatment. Always consult your healthcare team regarding any questions or concerns about your health or care.

  • Treatment
  • Side Effects
  • Nutrition

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