Oropharyngeal dysphagia: the experience of patients with non-head and neck cancers receiving specialist palliative care.
BACKGROUND
Difficulty swallowing is a well-documented symptom in head and neck cancer and oesophageal malignancy. The frequency of oropharyngeal swallowing difficulties in the palliative phase of other malignancies is less reported.


OBJECTIVE
1) To describe the patient experience of swallowing and associated difficulties while receiving specialist palliative care for malignancies other than those affecting the head and neck and 2) to identify the quality of life issues for the participants with dysphagia and compare with normative and dysphagic data provided by SWAL-QOL.


METHODS
Four month prospective pilot study - questionnaire design.


METHODS
Acute teaching hospital.


METHODS
Eleven patients receiving specialist palliative care.


METHODS
Participants were interviewed using a modified version of the SWAL-QOL, a validated quality of life assessment tool for use specifically with people with oropharyngeal dysphagia. Eight quality of life domains were explored as well as fourteen dysphagic symptoms.


RESULTS
Seven of the 11 participants had dysphagic symptoms detailed in the SWAL-QOL and a further two patients reported transient dysphagic symptoms since diagnosis of their disease. Nine participants reported an impact on their quality of life and three reported a considerable impact in four or more domains. Eight of the 11 participants had self-selected softer textured foods. A notable group were three patients with lung cancer and one with lung metastases with a history of vocal fold motion impairment, all of who had experienced dysphagic symptoms since diagnosis.


CONCLUSIONS
Patients with cancers not affecting the head and neck are at risk of developing symptoms of oropharyngeal dysphagia and subsequently, compromized nutrition, hydration and quality of life. Areas for further research are suggested.
Roe
Justin W G
JW
Speech and Language Therapy Department, Head and Neck Centre, University College London Hospitals NHS Foundation Trust, London. justin.roe@nhs.net
Leslie
Paula
P
Drinnan
Michael J
MJ
D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D003695:Delivery of Health Care / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D010166:Palliative Care / Q000592:standards*; D017060:Patient Satisfaction; D010865:Pilot Projects; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D019452:Terminally Ill / Q000523:psychology