Expert Sheds Light on Ways Patients With Cancer and Impaired Eating Function Can Approach Social Situations

A speech and swallowing specialist recommends that patients with head and neck cancer who have difficulties chewing and swallowing food eat before attending social situations to mitigate anxiety about eating around others.

Patients with head and neck cancer often face difficulties eating — be it from their cancer treatments or the disease itself. With eating being both a life-sustaining and social activity, issues with consuming food and drinks can severely impact quality of life, explained Heather Starmer, a speech and swallowing therapist.

“For many people, (eating difficulties) is a source of anxiety, as well as a contributor to depression,” Starmer, who is a clinical associate professor and director of the Head and Neck Cancer Speech and Swallowing Rehabilitation Center at Stanford, said in an interview with CURE®.

Some people develop pain and difficulty chewing and swallowing, which leads them to seek out medical help and ultimately receive a head and neck cancer diagnosis, whereas others may be less symptomatic at the onset of their disease but end up with difficulties eating as a result of chemotherapy or radiation treatment.

“Very commonly, we’ll see issues around pain — it’s sort of like they have a sunburn on the inside of their mouth and in their throat. So there’s pain with swallowing, issues with taste changes…and also dry mouth is a very common side effect from radiation that can cause a lot of difficulty with eating and swallowing,” Starmer explained.

These issues — along with chewing and swallowing mechanical difficulties — can prolong the length of time it takes someone to eat a meal, put them at risk for choking and limit the choices of the types of food that they can eat.

However, Starmer emphasized that there are steps patients can take to ease social anxiety they have about eating and make the process easier altogether.

When attending parties or social events, Starmer urges patients to remember why they are there.

“Even though (the event) is surrounded by or involving eating and drinking, in most cases, the people who they would be having those meals with are really much more interested in them as a person than they are about what is happening with their eating,” she said. “So really try to frame it and focus on the fact that it’s the human connection that is the most important part of the encounter.”

Additionally, Starmer said that patients can eat before they attend a social gathering, so that they are not hungry when they get there and may only need to eat a small amount when they get there. And, depending on their comfort level, individuals can also reach out to the organizer of the event ahead of time to plan what they will be able to eat comfortably.

“Depending on their comfort level, talking to the host or contacting the restaurant in advance (can be helpful). Most of the time, chefs and cooks at restaurants are willing to adapt things for people if they know that it needs to be done,” Starmer said.

If patients frequently deal with gagging when eating, they might want to let the others around them know.

“For some people, it’s really helpful to just be super open and honest with people saying, ‘I have this challenge. Don’t worry if you see XYZ.’ Or sit yourself closest to people who you are most comfortable with, so that you have that added level of comfort,” Starmer said.

Finally, Starmer encouraged all patients with a head and neck cancer diagnosis to seek out help from a speech and swallowing expert, who can educate them on what to expect from treatment and lead them through exercises and tips — like those Starmer provided — for making eating easier.

“Traditionally, we haven’t recognized the extent of just how important (eating) is, and we don’t think about it, but every social thing that we do revolves around eating and drinking,” she said.

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