Swallowing dysfunction in cancer patients.
OBJECTIVE
Dysphagia (swallowing dysfunction) is a debilitating, depressing, and potentially life-threatening complication in cancer patients that is likely underreported. The present paper is aimed to review relevant dysphagia literature between 1990 and 2010 with a focus on assessment tools, prevalence, complications, and impact on quality of life in patients with a variety of different cancers, particularly in those treated with curative chemoradiation for head and neck cancer.


METHODS
The literature search was limited to the English language and included both MEDLINE/PubMed and EMBASE. The search focused on papers reporting dysphagia as a side effect of cancer and cancer therapy. We identified relevant literature through the primary literature search and by articles identified in references.


RESULTS
A wide range of assessment tools for dysphagia was identified. Dysphagia is related to a number of factors such as direct impact of the tumor, cancer resection, chemotherapy, and radiotherapy and to newer therapies such as epidermal growth factor receptor inhibitors. Concomitant oral complications such as xerostomia may exacerbate subjective dysphagia. Most literature focuses on head and neck cancer, but dysphagia is also common in other types of cancer.


CONCLUSIONS
Swallowing impairment is a clinically relevant acute and long-term complication in patients with a wide variety of cancers. More prospective studies on the course of dysphagia and impact on quality of life from baseline to long-term follow-up after various treatment modalities, including targeted therapies, are needed.
Judith E
JE
Raber-Durlacher
Mike T
MT
Brennan
Irma M
IM
Verdonck-de Leeuw
Rachel J
RJ
Gibson
June G
JG
Eilers
Tuomas
T
Waltimo
Casper P
CP
Bots
Marisol
M
Michelet
Thomas P
TP
Sollecito
Tanya S
TS
Rouleau
Aniel
A
Sewnaik
Rene-Jean
RJ
Bensadoun
Monica C
MC
Fliedner
Sol
S
Silverman
Fred K L
FK
Spijkervet
D000970:Antineoplastic Agents / Q000009:adverse effects; D015984:Causality; D059248:Chemoradiotherapy / Q000009:adverse effects / Q000706:statistics & numerical data; D015897:Comorbidity; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D006258:Head and Neck Neoplasms / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D009369:Neoplasms / Q000453:epidemiology* / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology; D015995:Prevalence; D011788:Quality of Life; D014987:Xerostomia / Q000453:epidemiology
D000970:Antineoplastic Agents; D066246:ErbB Receptors