When people with head and neck cancer receive radiation therapy, it often makes swallowing difficult. Researchers studied 64 cancer patients to see if doing swallowing exercises during treatment and avoiding feeding tubes helped them recover better. After one year, patients who did at least half of their prescribed swallowing exercises reported better swallowing function and could eat more normal foods. Patients who avoided feeding tubes also had better physical swallowing ability. The findings suggest that staying active with swallowing exercises during cancer treatment may lead to better eating ability long-term.

The Quick Take

  • What they studied: Whether doing swallowing exercises during radiation therapy and avoiding feeding tubes helps head and neck cancer patients swallow and eat better one year after treatment ends
  • Who participated: 64 people with head and neck cancer who received radiation therapy. About 41% of them completed at least half of their prescribed swallowing exercises, and 12% needed feeding tubes during treatment.
  • Key finding: Patients who did their swallowing exercises reported much better swallowing function (91 out of 100 versus 80 out of 100 on a quality scale). Those who avoided feeding tubes had better physical swallowing ability when tested by doctors.
  • What it means for you: If you or someone you know is getting radiation for head and neck cancer, doing swallowing exercises as prescribed may help you eat normally again sooner. Avoiding a feeding tube when possible appears beneficial, though sometimes feeding tubes are medically necessary. Talk with your cancer care team about your specific situation.

The Research Details

This was a secondary analysis of a randomized controlled trial, which means researchers looked at data that was already collected from a previous study where patients were randomly assigned to different treatment groups. The study followed 64 head and neck cancer patients who received radiation therapy. Researchers tracked whether patients did at least 50% of their prescribed swallowing exercises during radiation treatment and whether they used feeding tubes. They then measured swallowing function at one year after treatment using several different tests and questionnaires.

The researchers used multiple ways to measure swallowing outcomes. Some tests asked patients how they felt about their swallowing ability and diet (like whether they could eat solid foods). Other tests involved doctors watching patients swallow and measuring how well their throat muscles worked. This multi-method approach gives a complete picture of swallowing recovery.

Using multiple measurement methods is important because swallowing involves both physical function and how people feel about their ability to eat. A patient might feel confident eating, but have some physical swallowing problems, or vice versa. By measuring both, researchers can understand the full picture of recovery. Following patients for a full year is also important because swallowing problems after radiation can develop slowly over time.

This study has several strengths: it was based on a randomized controlled trial (a gold-standard research design), it followed patients for a full year (long enough to see lasting effects), and it used multiple validated measurement tools (tests that doctors trust and use regularly). The main limitation is the relatively small sample size of 64 patients, which means results should be confirmed with larger studies. The study also only looked at one group of cancer patients, so results may not apply to all types of head and neck cancer.

What the Results Show

Patients who completed at least half of their swallowing exercises during radiation reported significantly better swallowing function one year later. On a 100-point quality-of-life scale, those who did their exercises scored 91 points compared to 80 points for those who didn’t—a meaningful difference that patients could actually notice in their daily eating.

Patients who did their exercises also reported better diet quality, meaning they could eat more normal foods rather than soft or liquid diets. This is important because eating normal foods improves quality of life and nutrition.

Patients who used feeding tubes during treatment had worse physical swallowing function when tested by doctors one year later. These patients showed more problems with food or liquid entering their airway (called aspiration), which is a safety concern. They also had lower scores on multiple swallowing tests, suggesting their throat muscles weren’t working as well.

The study found that only 1 out of 64 patients still needed a feeding tube one year after treatment, even though 8 patients needed one during treatment. This suggests that most patients can eventually return to eating by mouth, though some need temporary feeding tube support during the acute treatment phase. The findings suggest that feeding tube use during treatment may be associated with worse long-term swallowing recovery, though it’s unclear whether the tube itself caused the problem or whether sicker patients were more likely to need tubes.

Previous research has suggested that swallowing exercises and maintaining oral intake (eating by mouth) during radiation therapy help with short-term swallowing problems. This study extends that finding by showing the benefits last at least one year after treatment. The negative association with feeding tubes is somewhat surprising and suggests that when possible, maintaining some oral intake during treatment may be beneficial for long-term recovery, though feeding tubes are sometimes medically necessary.

The study included only 64 patients, which is a relatively small number. Results might be different with a larger group. The study only looked at one type of cancer treatment approach, so findings may not apply to all head and neck cancer patients. The study couldn’t prove that exercises directly caused better outcomes—only that they were associated with better outcomes. Some patients who were sicker may have been less able to do exercises, which could explain some of the differences. The study didn’t track exactly how many exercises each patient did, only whether they did at least 50%.

The Bottom Line

If you have head and neck cancer and are receiving radiation therapy, work with your medical team to do swallowing exercises as prescribed during treatment. The evidence suggests this may improve your ability to eat normally after treatment (moderate confidence level). Try to maintain some eating by mouth during treatment if medically safe, as avoiding feeding tubes appears associated with better long-term swallowing function (moderate confidence level). However, if your doctor recommends a feeding tube for safety or nutrition, follow that advice—sometimes feeding tubes are necessary and beneficial.

This research is most relevant for people with head and neck cancer receiving radiation therapy. It’s also important for their family members and caregivers who support them during treatment. Healthcare providers treating head and neck cancer should consider these findings when counseling patients about swallowing exercises and feeding tube decisions. People with other types of cancer or swallowing problems should talk with their doctors about whether these findings apply to their situation.

Swallowing improvements from exercises may start within weeks of beginning treatment, but the full benefits appear to develop over months. One year after treatment is when researchers measured outcomes in this study, suggesting that’s a reasonable timeframe to expect significant improvement. However, some patients may see benefits sooner or take longer—individual recovery varies.

Want to Apply This Research?

  • Track daily completion of prescribed swallowing exercises with a simple yes/no checklist. Note the specific exercises done (e.g., ’tongue strengthening,’ ‘swallowing practice’) and time spent. Aim to record at least 50% completion of prescribed exercises as a meaningful goal.
  • Set a daily reminder for swallowing exercises at the same time each day (e.g., after meals). Use the app to log completion immediately after finishing exercises. If struggling to maintain 50% adherence, use the app to identify which days you’re missing and adjust your routine—perhaps doing exercises at a different time or with a family member’s support.
  • Track swallowing-related quality of life monthly using simple questions: ‘How confident do I feel eating solid foods?’ and ‘What types of foods can I eat?’ Compare these answers over 3, 6, and 12 months to see improvement trends. Share this data with your healthcare team at follow-up appointments to discuss progress and adjust your swallowing therapy if needed.

This research applies specifically to people with head and neck cancer receiving radiation therapy. If you have head and neck cancer or swallowing difficulties, consult with your oncologist and speech-language pathologist before starting or changing any swallowing exercise program. Feeding tube decisions should always be made with your medical team based on your individual health status. This information is educational and should not replace personalized medical advice from your healthcare providers.