The changed meaning of food: Physical, social and emotional loss for patients having received radiation treatment for head and neck cancer

The lived experience of dysphagia following non-surgical treatment for head and neck cancer

“…Changes in the significance and meaning of food, and the personal and lifestyle impacts as a result of dysphagia were equally significant areas of concern for this group. This finding was consistent with earlier studies (Larsson et al, 2003;McQuestion et al, 2011;Ottosson et al, 2013) and re-emphasises the complexity of living with dysphagia following HNC management.…”

“…Consistent with previous research, participants reported living with an extensive range of physical changes to their swallowing ability (Larsson et al, 2003;McQuestion et al, 2011;Ottosson et al, 2013). However, whilst the physical changes to swallowing following nonsurgical treatment were an important concern for participants in this study, the results also revealed a considerable, ongoing emotional response to dysphagia.…”

“…In 2011, McQuestion, Fitch, andHowell (2011) discussed the "changed meaning of food" (p. 147) revealed through in-depth interviews with 17 participants who were only 3 months post-radiotherapy. In the interviews, the authors noted that participants reflected on both the acute and early recovery period.…”

Long-term Functional Outcomes and Patient Perspective Following Altered Fractionation Radiotherapy with Concomitant Boost for Oropharyngeal Cancer

“…The current data, however, does differ from most other radiotherapy research in relation to the pattern of declining function in the longterm, with the prevalence of swallowing difficulty in the current cohort observed to increase and more than 80% avoiding specific foods in their diet (eating limitation) (41). Oral pain, mouth sores, taste changes, oral dryness, and loss of appetite have previously been reported as side effects which heighten awareness of functional swallowing difficulties (42,43). Longterm xerostomia has been postulated as impacting on functional swallowing by decreasing bolus lubrication, and increasing bolus transit time (34), and has been reported by over 90% of the current cohort.…”

“…Each individual reported the use of multiple strategies to assist intake, and those which were most effective for each individual varied between patients. "Active planning' and the use of "trial and error" relating to strategies regarding food selection, consistency, preparation, caloric density, and the physical act of eating have similarly been described in heterogenous HNC populations (43)(44)(45). The information obtained from further, comprehensive study of patient strategies may help in the future to further optimise patient adjustment to the swallowing changes which continue in the long term post treatment.…”