Joanne M Patterson1, Elaine McColl2, Janet Wilson2, Paul Carding3, Tim Rapley2. 1. Speech and Language Therapy Department, Sunderland Royal Hospital, Sunderland, UK. joanne.patterson@ncl.ac.uk. 2. Institute for Health and Society, Newcastle University, Newcastle upon Tyne, UK. 3. Speech and Language Therapy, Freeman Hospital, Newcastle upon Tyne, UK.
Abstract
PURPOSE: The study aims to describe patients' experiences of swallowing difficulties following (chemo)radiotherapy for head and neck cancer and to explore any changes over time. METHODS: A purposive sample of patients with swallowing difficulties was selected at a range of time points, from 3 to 18 months following treatment. Ethnographic observations of 12 patients were conducted in their own homes, over a mealtime situation. Nine new patients were interviewed about changes to their eating and drinking from pre- to post-treatment. Thematic analysis was used to code and analyse the data. RESULTS: Patients' reports of swallowing function were divided into four time zones: pre-treatment, during radiotherapy, early (0-3 months) and late (6-18 months) time points following treatment. The majority reported minimal problems at diagnosis, but marked impairment during and after radiotherapy, without a return to pre-treatment functioning. The focus was on severe physical side effects and changes to food preparation during radiotherapy and in the early phase of recovery. By 6 months, side effects began to subside, but swallowing was still difficult, leading to major changes to family life, socialisation and lifestyle. CONCLUSIONS: Swallowing problems after (chemo)radiotherapy are multi-faceted and highly individualised and restrict lives in the long term. Swallowing ability may improve in time, but does not appear to return to pre-treatment function. Further work is required to find ways of being able to best support patients living with this long-term condition.
PURPOSE: The study aims to describe patients' experiences of swallowing difficulties following (chemo)radiotherapy for head and neck cancer and to explore any changes over time. METHODS: A purposive sample of patients with swallowing difficulties was selected at a range of time points, from 3 to 18 months following treatment. Ethnographic observations of 12 patients were conducted in their own homes, over a mealtime situation. Nine new patients were interviewed about changes to their eating and drinking from pre- to post-treatment. Thematic analysis was used to code and analyse the data. RESULTS: Patients' reports of swallowing function were divided into four time zones: pre-treatment, during radiotherapy, early (0-3 months) and late (6-18 months) time points following treatment. The majority reported minimal problems at diagnosis, but marked impairment during and after radiotherapy, without a return to pre-treatment functioning. The focus was on severe physical side effects and changes to food preparation during radiotherapy and in the early phase of recovery. By 6 months, side effects began to subside, but swallowing was still difficult, leading to major changes to family life, socialisation and lifestyle. CONCLUSIONS: Swallowing problems after (chemo)radiotherapy are multi-faceted and highly individualised and restrict lives in the long term. Swallowing ability may improve in time, but does not appear to return to pre-treatment function. Further work is required to find ways of being able to best support patients living with this long-term condition.
Entities:
Keywords:
Chemoradiotherapy; Head and neck cancer; Qualitative; Swallowing
Authors: Bruce H Campbell; Kristine Spinelli; Anne M Marbella; Katherine B Myers; Joan C Kuhn; Peter M Layde Journal: Arch Otolaryngol Head Neck Surg Date: 2004-09
Authors: Rebecca L Nund; Elizabeth C Ward; Nerina A Scarinci; Bena Cartmill; Pim Kuipers; Sandro V Porceddu Journal: Int J Speech Lang Pathol Date: 2013-12-18 Impact factor: 2.484
Authors: Marianne Boll Kristensen; Tina Broby Mikkelsen; Anne Marie Beck; Ann-Dorthe Zwisler; Irene Wessel; Karin B Dieperink Journal: J Cancer Surviv Date: 2019-08-24 Impact factor: 4.442
Authors: Valentina Bressan; Annamaria Bagnasco; Giuseppe Aleo; Gianluca Catania; Milko P Zanini; Fiona Timmins; Loredana Sasso Journal: Support Care Cancer Date: 2017-02-15 Impact factor: 3.603
Authors: Sylvia L Crowder; Katherine G Douglas; M Yanina Pepino; Kalika P Sarma; Anna E Arthur Journal: J Cancer Surviv Date: 2018-03-20 Impact factor: 4.442
Authors: Molly K Barnhart; Rachelle A Robinson; Virginia A Simms; Elizabeth C Ward; Bena Cartmill; Sophie J Chandler; Robert I Smee Journal: Support Care Cancer Date: 2018-02-07 Impact factor: 3.603
Authors: Marianne Boll Kristensen; Irene Wessel; Anne Marie Beck; Karin B Dieperink; Tina Broby Mikkelsen; Jens-Jakob Kjer Møller; Ann-Dorthe Zwisler Journal: Nutrients Date: 2020-07-17 Impact factor: 5.717