Eating changes and nasopharyngeal cancer

Nasopharyngeal cancer and its treatment can affect the way you eat and drink.

You might have difficulties with:

• swallowing
• taste changes
• weight loss
• a dry mouth

There are things you and your healthcare team can do to help you cope with these problems.

Difficulty swallowing

Radiotherapy

Radiotherapy for nasopharyngeal cancer can make your throat very sore. You are likely to have difficulty swallowing for a while. This can be very hard to cope with and may get you down. It usually gets better within a month of finishing treatment. But for some people it may take longer.

Your team gives you soothing mouthwashes and throat sprays. There are also numbing sprays and protective mouth gels which can help.

Your doctor gives you painkillers if your mouth and throat are very sore from radiotherapy. Taking these regularly as prescribed can help to control the pain and make you feel better.

Soft diet or liquid nutrition

Your dietitian will assess you before you start treatment. They will suggest whether you need a feeding tube put into your stomach. This is usually a gastrostomy (PEG or RIG) tube. This goes through your skin into your stomach. You have liquid nutrition through the tube. This helps to reduce weight loss during treatment. Some people having chemoradiotherapy for nasopharyngeal might have a PEG or RIG tube.

You may still be able to manage small amounts of soft or pureed food, and sips of fluid. As your sore throat starts to recover, you will be able to increase the amount you eat. Eventually your doctor will take out the feeding tube.

After surgery

Some people may have surgery to remove a small cancer that has come back in the nasopharynx. Chewing and swallowing are difficult after having surgery. This starts to get better as you recover and the swelling has gone down.

You might have a gastrostomy (PEG or RIG) tube if you have surgery to remove cancer from your nasopharynx.

Keeping your mouth clean

Even if you are not eating, it is still very important to keep your mouth and teeth clean. This helps to stop infection developing. It also helps you to feel better. Your nurse will give you mouthwashes to use and tell you how best to keep your mouth clean.

Speech and language therapists and dietitians

Speech and language therapists play an important role during your treatment. They will help you with swallowing difficulties (dysphagia) and help you eat and drink safely. They can give information to your family or carer on how to support you with swallowing difficulties.

A dietitian can also give advice on what to eat when you have swallowing problems.

Changes in taste or loss of taste

Radiotherapy and some chemotherapy drugs may also affect your taste buds. Some people say their food has a metallic, bitter or salty taste. Others notice that all foods taste the same.

If you have surgery or radiotherapy to your nasopharynx, your sense of smell might be affected. In turn, this can affect your sense of taste.

You might also lose your appetite. This is because the smell of food contributes to our appetite and how food tastes.

Weight loss

Sometimes people have lost weight by the time they are diagnosed with cancer. This might happen when you have difficulty swallowing, which can put you off eating.

After your treatment, you need to build yourself up again. This can be difficult if you are still off your food.

You or the person who usually provides your meals might need to think about your diet. Often we choose low fat products, so it can be difficult to stop when trying to put on weight. It may help to speak to your dietitian who can advise you on what to eat.

If you struggle with a loss of appetite, eating little and often is easier to cope with than a huge plate of food.

Your doctor or dietitian can give you some nutrition supplements. These drinks have vitamins, protein and carbohydrates that you need for a balanced diet. If you are trying to put on weight, you can sip these throughout the day in between meals. The drinks come in different flavours, both savoury and sweet.

You can also get powdered protein or carbohydrate supplements. These can be sprinkled on foods and drinks.

A dry mouth

Radiotherapy to your head and neck can cause a dry mouth. You might hear your doctor or nurse call this xerostomia (pronounced zero-stow-mee-a). It can make eating and talking very uncomfortable. This can last for several months, but some people find the dryness is permanent.

Your doctor can prescribe artificial moisteners for your mouth, or stimulants for your salivary glands. You might find it helps to carry a bottle of water with you, so you can keep taking small sips to moisten your mouth. This should make you more comfortable.

You are also more likely to get an infection or tooth decay if your mouth is dry. So you need to keep an eye on this and have regular check ups with your dentist.

Cancer Research UK nurses