Managing Throat Scarring After Cancer Treatment: Tips for Better Swallowing

After electrocautery, if the throat is injured and the wounds heal with pitting and scarring, it may cause difficulty swallowing food?

Hello, my older brother was diagnosed with nasopharyngeal cancer last year and has undergone multiple rounds of chemotherapy and radiation therapy.
He is currently under continuous monitoring.
Initially, he could only drink water, but now he can consume porridge, although it must be thick in consistency for him to swallow it.
He is also very selective about food, and some items make him feel nauseous after eating.

From what we understand, the reason for this is that the chemotherapy and radiation have caused burns in his throat.
Even though the external skin has healed (his neck was affected and became dark), the internal injuries in his throat have resulted in scar tissue with pits and irregularities.
Food tends to get stuck in these pits, making swallowing very uncomfortable, and there is a concern about food decaying in his throat, which could lead to further complications.
Currently, he is mostly relying on nutritional supplements like Ensure for his nutrition.

I would like to ask if there are any treatments available for these pits and scars in his throat.
My brother is currently 64 years old.
Thank you!

Lilly, 60~69 year old female. Ask Date: 2024/04/15

Dr. Li Jiaxuan reply Otolaryngology

It is recommended to slightly supplement nutrition, as weight gain can lead to more plump mucous membranes.
Aside from that, there doesn't seem to be any particularly effective methods.
Wishing you well.

Reply Date: 2024/04/15

More Info

Managing throat scarring after cancer treatment, particularly following chemotherapy and radiation for nasopharyngeal cancer, can be a challenging process. The symptoms you're describing, such as difficulty swallowing and the sensation of food getting stuck, are common among patients who have undergone such treatments. This condition is often referred to as dysphagia, which can result from scarring and inflammation in the throat and esophagus due to radiation and chemotherapy.

Understanding the Cause of Scarring
The scarring in the throat, or fibrosis, can occur as a result of the radiation therapy that targets cancer cells but can also affect surrounding healthy tissues. This can lead to changes in the normal structure of the throat, resulting in a narrowed passage or uneven surfaces (the "坑坑疤疤" you mentioned). These changes can make swallowing difficult and uncomfortable, as food may get caught in these irregularities.

Tips for Managing Throat Scarring and Improving Swallowing
1. Consult a Speech-Language Pathologist (SLP): One of the most effective ways to manage swallowing difficulties is to work with a speech-language pathologist who specializes in dysphagia. They can provide tailored exercises to strengthen the swallowing muscles and techniques to make swallowing easier.

2. Dietary Modifications: Since your brother can only tolerate thick porridge, it may be beneficial to continue with a diet that includes soft, moist foods. Foods that are easier to swallow include:
- Pureed fruits and vegetables
- Smoothies
- Soups (thickened if necessary)
- Soft breads with spreads (like butter or cream cheese)
- Mashed potatoes or other mashed vegetables
Avoid dry, hard, or sticky foods that can exacerbate the feeling of food getting stuck.

3. Hydration: Staying well-hydrated is crucial. Drinking enough fluids can help keep the throat moist and may ease swallowing. Consider using thickening agents if necessary to achieve a consistency that is easier to swallow.

4. Swallowing Techniques: There are specific swallowing techniques that can help, such as:
- The "chin tuck" method, where the chin is tucked down towards the chest while swallowing, which can help protect the airway and make swallowing easier.

- Taking smaller bites and chewing food thoroughly before swallowing.

5. Medications: In some cases, medications may be prescribed to help manage symptoms. For example, if there is significant inflammation, corticosteroids may be considered. Always consult with the treating physician before starting any new medication.

6. Regular Follow-ups: Continuous monitoring by healthcare professionals is essential. Regular follow-ups can help assess the condition of the throat and make necessary adjustments to the treatment plan.

7. Consideration of Alternative Therapies: Some patients find relief through alternative therapies such as acupuncture or massage therapy, which may help alleviate some discomfort associated with scarring.

8. Nutritional Supplements: Since your brother is relying on nutritional supplements like Ensure, it’s important to ensure he is getting adequate nutrition. If solid foods remain challenging, these supplements can provide essential vitamins and minerals.

Conclusion
While the scarring in the throat may not completely resolve, there are multiple strategies to manage symptoms and improve swallowing. Working closely with healthcare providers, including a speech-language pathologist and a nutritionist, can significantly enhance your brother's quality of life. It’s important to remain proactive in addressing these issues, as they can impact overall health and well-being. Always consult with the healthcare team for personalized advice and treatment options tailored to your brother's specific situation.

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