Coping with Physical & Emotional Changes
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Trouble Swallowing

Nutrition for the Person with Cancer

When Treatment Causes Eating Problems

In this Section:

Changes in Taste and Smell

Poor Appetite

Constipation

Diarrhea

Sore or Irritated Mouth or Throat

Nausea and Vomiting

Dry Mouth or Thick Saliva

Trouble Swallowing

Unwanted Weight Gain

Fatigue

Cancer and its treatments can sometimes cause trouble with swallowing. If you are having trouble swallowing, try eating soft or liquid foods. You may be able to swallow thick fluids more easily than thin liquids. If you are unable to eat enough regular foods to meet your nutritional needs, drink high-calorie and high-protein liquids. Your doctor may refer you to a speech therapist. She or he can teach you how to swallow easier and how to decrease coughing and choking while eating and drinking.

For more information on difficulty swallowing, ask the American Cancer Society about Caring for the Patient With Cancer at Home: A Guide for Patients and Families.

What to Do

  • Follow your speech therapist’s instructions for any special eating techniques.
  • Drink 6 to 8 cups of fluid each day and thicken the fluid to the consistency that is easiest for you to swallow.
  • Call your doctor right away if you cough or choke while eating, especially if you have a fever.
  • Eat small, frequent meals.
  • Use canned liquid nutritional supplements if you are unable to eat enough food to meet your needs.
  • Chop or puree your food in a blender or food processor.

Try these thickening products

Gelatin: Use to form a soft gel with cakes, cookies, crackers, sandwiches, pureed fruits, and other cold food. Mix 1 tablespoon unflavored gelatin in 2 cups liquid until dissolved; pour over food. Allow food to sit until saturated.

Tapioca, flour, and cornstarch: Use to thicken liquids. Note that these must be cooked before using.

Commercial thickeners: Follow labeled instructions and use to adjust a liquid’s thickness.

Pureed vegetables and instant potatoes: Use in soups. Note that these change the food’s flavor.

Baby rice cereal. Use to make a very thick product.


What to eat when you have trouble swallowing (pureed and thick-liquid diet)* 
High-protein: Thickened milk, yogurt without fruit, cottage cheese, sour cream; pureed meat, poultry, and fish, casseroles, soft scrambled eggs; thickened broths and cream soups
Breads, cereals, pasta, and rice: Cooked cereals such as Cream of Wheat and cream of rice; slurried breads (A slurry is a thin paste of water and flour that is stirred into hot preparations as a thickener. A slurry on top of bread or cake makes it moist and easier to swallow.)
Fruits and vegetables: Pureed fruit and vegetables without seeds and skins; mashed potatoes
Drinks, desserts, and other foods: Thickened juices and nectars; thick milkshakes; thickened broths and cream soups, custard, pudding; slurried cakes and cookies if tolerated; syrups, honey, butter, margarine, spices

What to eat once you can tolerate a pureed-liquid diet (mechanical soft thick-liquid diet)* 
High-protein: Milk, yogurt, cheeses, sour cream; all eggs; ground meats and ground meat casseroles, fish, sandwiches made with ground meats or spreads
Breads, cereals, pasta, and rice: Soft breads; graham crackers, cookies; soft cold cereals in milk; pancakes, waffles; pasta, rice
Fruits and Vegetables: Bananas, canned fruit; soft, well-cooked, or pureed vegetables
Drinks, desserts, and other foods: All beverages, soft desserts that do not require much chewing (such as ice cream, sherbet, flavored gelatin, pudding, custard), soft cakes and cookies, syrups, honey butter, margarine, spices

*Adapted from Eldridge B, and Hamilton KK, Editors, Management of Nutrition Impact Symptoms in Cancer and Educational Handouts Chicago, Il: American Dietetic Association; 2004.

If thin liquids are recommended for you, select from the following: coffee, tea, soft drinks, liquid nutritional supplements, Italian ice, sherbet, broth, and thin cream-based soups.

If thick liquids are recommended for you, select from the following: buttermilk, eggnog, milkshakes, yogurt shakes, and ice cream.

Revised: 02/04/2008