Symptoms - Difficulty Swallowing

Some people with lung cancer have trouble swallowing. This condition is called dysphagia. Swallowing problems can be caused by the cancer itself, especially if it has spread to, or near, the esophagus. Cancer treatments can also cause swallowing problems.^1,2

Research suggests that difficulty swallowing increases the risk of poor health outcomes. Talk to your doctor if you notice trouble swallowing. They can suggest ways to manage and treat your symptoms.^3,4

What does difficulty swallowing feel like?

When you swallow food or liquid, many muscles and nerves work together. The food or liquid must move from your mouth, through your throat (pharynx), and down your food tube (esophagus) to your stomach. Swallowing problems can happen at any of these steps.^5,6

When there is a problem with this process, you may feel:^5,6

• Slow or uncomfortable swallowing
• An inability to swallow
• Feeling like food is stuck in your throat or chest
• Coughing or choking when you try to swallow
• Food or stomach acid coming up into your throat
• Too little or too much saliva

Most people have experienced what dysphagia feels like. You may have eaten something too fast and felt like it “went down the wrong pipe.” This is normal if it does not happen often. But ongoing difficulty swallowing can be a sign of a serious condition.^5,6

Dysphagia can lead to serious health problems. Without treatment, it can potentially be fatal. It can lead to health problems such as:^2,5,6

• Dehydration
• Malnutrition and weight loss
• Choking
• Inhaling food and/or liquid into the lungs (silent aspiration)
• Introducing bacteria into the lungs by inhalation (aspiration pneumonia)

Why does lung cancer cause difficulty swallowing?

Many health conditions can cause swallowing problems. This includes several types of cancer. Cancers of the head and neck are one of the most common forms of cancer that cause swallowing problems. But people with lung cancer can also experience these problems.²

About 4 percent of people with lung cancer have trouble swallowing. The risk may be higher for younger people, those whose cancer has spread outside of their lung, and those living with multiple health conditions.³

Experts do not yet know exactly why lung cancer can cause swallowing problems. Possible reasons include:^2,7,8

• Lung cancer tumors pressing on the esophagus and blocking food or liquids
• Lung cancer spreading to the mouth, throat, or esophagus
• Radiation therapy causing dry mouth, which can make swallowing harder
• Chemotherapy or other treatments causing mouth sores
• Other problems such as mouth or esophagus infections

How is difficulty swallowing treated?

Swallowing problems are linked to worse health outcomes for people with lung cancer. This includes longer hospital stays, higher risk of complications, and shorter survival rates. This may be mainly due to the risk of weight loss, which can worsen health outcomes.^3,4

Treatment will depend on the causes and severity of your dysphagia. Your doctor may suggest making certain lifestyle changes, including:^2,5,6

• Eating a special diet of soft foods or liquids that provide enough nutrients
• Taking small bites or mashing foods
• Trying thicker liquids that are easier to swallow
• Having more frequent small meals
• Avoiding alcohol and spicy foods
• Avoiding hard, dry foods
• Sitting upright to eat and drink

Treatment options also may include:^5-8

• Exercises to coordinate swallowing muscles and nerves
• Swallowing techniques to change how you place food in your mouth or position your body
• Medications to reduce stomach acid or inflammation
• Esophageal dilation to gently stretch the esophagus
• Feeding tube to provide nutrients without the need to swallow
• Surgery to open the esophagus, often by placing a metal or plastic tube (stent)

Managing dysphagia can improve health outcomes in people with cancer. Talk to your doctor about your risk or if you notice any trouble swallowing. Ask them about a referral to a specialist, such as a speech-language pathologist. These professionals can help you learn techniques to make swallowing easier.^3,8