Cancer and its treatments can sometimes cause trouble with swallowing. If you’re having problems swallowing, try eating soft or liquid foods. You may be able to swallow thick fluids more easily than thin liquids. If you’re 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. This is an expert health professional who can teach you how to swallow better and how to decrease coughing and choking when you eat and drink.
What to do
- Follow your speech therapist’s instructions for any special eating techniques.
- Call your cancer care team right away if you cough or choke while eating, especially if you have developed a fever.
- Eat small, frequent meals.
- Use canned liquid nutritional supplements if you’re unable to eat enough food to meet your needs.
- Chop or puree your food in a blender or food processor.
- Drink 6 to 8 cups of fluid each day, and thicken the fluid to the consistency that’s easiest for you to swallow.
- If thin liquids are recommended for you, try these: coffee, tea, soft drinks, liquid nutritional supplements, Italian ice, sherbet, broth, and thin cream-based soups.
- If thick liquids are recommended for you, try these: buttermilk, eggnog, milk shakes, yogurt shakes, and ice cream.
Try these thickening products:
Gelatin: Use to help soften cakes, cookies, crackers, sandwiches, pureed fruits, and other cold food. Mix 1 tablespoon unflavored gelatin in 2 cups hot 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 label 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 (puréed and thick-liquid diet)+
|Puréed thick-liquid diet||Mechanical soft diet|
Thickened milk, yogurt without fruit, cottage cheese, sour cream
Puréed meat, poultry, and fish
Milk, yogurt, cheeses, sour cream
Ground meats and ground-meat casseroles, fish, sandwiches made with ground meats or spreads
|Breads, cereals, pasta, and rice||
Slurry^ of cooked cereals like Cream of Wheat and Cream of Rice
Graham crackers, cookies
Soft cold cereals in milk
|Fruits and vegetables||
Puréed fruit and vegetables without seeds and skins
Soft, well-cooked, or puréed vegetables
|Drinks, desserts, and other foods||
Thickened juices and nectars
Thick milk shakes
Thickened broths and cream soups
Slurried^ cakes and cookies
Syrups, honey, butter, margarine
Spices as tolerated
Soft desserts that don’t require much chewing (like ice cream, sherbet, flavored gelatin, pudding, custard), soft cakes and cookies
Syrups, honey, butter, margarine
^A slurry is a thin paste of water and cereal or flour that can be stirred into hot preparations as a thickener. A slurry on top of bread or cake makes it moist and easier to swallow.
+ Adapted from Grant BL, Bloch AS, Hamilton KK, Thomson CA. American Cancer Society Complete Guide to Nutrition for Cancer Survivors, 2nd Edition. Atlanta, GA: American Cancer Society; 2010.
- Benefits of good nutrition during cancer treatment
- Cancer and cancer treatment affect nutrition
- Before treatment begins
- Once treatment starts
- Managing eating problems caused by surgery, radiation, and chemotherapy
- For people with weakened immune systems
- How to cope with common eating problems
- Appetite changes
- Mouth dryness or thick saliva
- Mouth or throat pain or sores
- Swallowing problems
- Taste and smell changes
- Weight gain
- Nutrition after treatment ends
- To learn more
- Recipes to try during cancer treatment