Treatment is not something that everyone with dysphagia has to endure. For those that do, it can be a hugely intense period of time and particularly troublesome to eat and drink. When I speak of treatment, really, I'm referring to treatment of cancer. Of course, this occurs in many different forms and for many different cancers. However, in particular, it has notable impact on the swallow for those with head and neck cancer.
Treatment for head and neck cancer is decided upon by the medical team based on the kind, place and severity of cancer. Treatment can consist of various regimes potentially including but not limited to chemotherapy, radiotherapy, immunotherapy and/or surgery. The regime or schedule can consist of different strengths, frequency of sessions and duration of weeks based on the persons medical needs.
Naturally, as a Speech Pathologist, I've worked with a lot of patients who have undergone radiotherapy to the anatomy of the head and/or neck. During treatment, there can be various side effects depending on the kind of therapy and the targeted location. In this time, the side effects are often acute or immediate. Amongst various cases, some of these side effects can include;
dysphagia (!!)
fatigue
pain
dry mouth
thick saliva or secretions
mucositis or mouth ulcers
oral candida or thrush
nausea and vomiting
loss of appetite
skin irritation
lymphoedema
jaw stiffness or trismus
dysphonia or voice changes.
Now this all seems very daunting, and truth be told, it is, but that's what your multidisciplinary team is for. One key thing that I have learnt is to be prepared. Jump on the first symptoms you see or sense, especially when it comes to oral health and discomfort, and most importantly get on the front foot of your nutrition.
As intimidating as the list above is, the real point of this article is about how good nutrition pre, during and post treatment can change your experience and your recovery both physically and mentally.
As we've discussed in the past, when you have dysphagia it can be a bigger effort to prepare meals and keep up with daily nutrients and needs both as a carer and as a person with dysphagia. So when a person is experiencing difficulty swallowing and fatigue and pain, it adds further barriers to keeping up with healthy and rich meals.
However, when your body is well prepared and stocked up on what it needs to fight the good fight, there's a much better chance at managing symptoms and coming out on top. Symptoms are much better managed and tolerated when it has supplies to draw upon.
Given these things, it can be an all consuming job to keep up with and in which case, attitude can make all the difference. When you have an understanding and relationship with your body that encourages you you to feed it and nurture it with what it needs, your outcomes both physically and mentally can make all the difference. However, it can also be disenchanting to receive a diagnosis like cancer which can feel as though your body has betrayed you regardless of your lifestyle habits, routine or care that precedes such an event.
For this reason, attitude during treatment can be a significant game changer. Finding a passion and curiosity for preparing meals and enjoying the mealtime is so important to maintain. For those who I have seen fly through treatment, meal preparation has become a way of life and part of the daily routine. That's not to say that they are symptom free or that they don't find struggle in some of the symptoms listed above. However, in the best case, meal preparation has become a passion for trying new things, experimenting with flavours and textures, and finding joy in the smallest of successes.
Some of the richest connections I've had as a therapist and support during times of treatment has been through finding joy and success in food. Sharing ideas and recipes in a time that can be very daunting and dreary has brought a light and joy to the experience that I never knew existed. I've found a level of respect and inspiration in the people I've worked with which has inspired me to bring a passion and conscientiousness to my own work for others.
For people undergoing treatment and coming out the other end, there are many resources available to support this process. For more information, you can visit the website for the Australian Cancer Survivorship Centre: https://www.petermac.org/patients-and-carers/support-and-wellbeing/life-after-treatment
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