title: Head and neck cancer patients' perceptions of swallowing following chemoradiotherapy.
abstract: OBJECTIVE
  The study aims to describe patients' experiences of swallowing difficulties following (chemo)radiotherapy for head and neck cancer and to explore any changes over time.
  
  
  METHODS
  A purposive sample of patients with swallowing difficulties was selected at a range of time points, from 3 to 18 months following treatment. Ethnographic observations of 12 patients were conducted in their own homes, over a mealtime situation. Nine new patients were interviewed about changes to their eating and drinking from pre- to post-treatment. Thematic analysis was used to code and analyse the data.
  
  
  RESULTS
  Patients' reports of swallowing function were divided into four time zones: pre-treatment, during radiotherapy, early (0-3 months) and late (6-18 months) time points following treatment. The majority reported minimal problems at diagnosis, but marked impairment during and after radiotherapy, without a return to pre-treatment functioning. The focus was on severe physical side effects and changes to food preparation during radiotherapy and in the early phase of recovery. By 6 months, side effects began to subside, but swallowing was still difficult, leading to major changes to family life, socialisation and lifestyle.
  
  
  CONCLUSIONS
  Swallowing problems after (chemo)radiotherapy are multi-faceted and highly individualised and restrict lives in the long term. Swallowing ability may improve in time, but does not appear to return to pre-treatment function. Further work is required to find ways of being able to best support patients living with this long-term condition.
authors: Speech and Language Therapy Department, Sunderland Royal Hospital, Sunderland, UK. joanne.patterson@ncl.ac.uk.
authors: Joanne M
authors: JM
authors: Patterson
authors: Institute for Health and Society, Newcastle University, Newcastle upon Tyne, UK.
authors: Elaine
authors: E
authors: McColl
authors: Institute for Health and Society, Newcastle University, Newcastle upon Tyne, UK.
authors: Janet
authors: J
authors: Wilson
authors: Speech and Language Therapy, Freeman Hospital, Newcastle upon Tyne, UK.
authors: Paul
authors: P
authors: Carding
authors: Institute for Health and Society, Newcastle University, Newcastle upon Tyne, UK.
authors: Tim
authors: T
authors: Rapley
mesh_terms: D000328:Adult; D000368:Aged; D059248:Chemoradiotherapy / Q000009:adverse effects* / Q000523:psychology; D003679:Deglutition / Q000187:drug effects / Q000528:radiation effects; D003680:Deglutition Disorders / Q000209:etiology / Q000503:physiopathology*; D004326:Drinking / Q000187:drug effects / Q000528:radiation effects; D004435:Eating / Q000187:drug effects / Q000528:radiation effects; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010465:Perception
keywords: Chemoradiotherapy; Head and neck cancer; Qualitative; Swallowing