The following is a summary of “Dysphagia in Solid Tumors Outside the Head, Neck or Upper GI Tract: Clinical Characteristics” published in the December 2022 issue of Pain and Symptom Management by Kenny et al.
Cancer patients frequently have dysphagia, although the underlying pathophysiology and patient-specific symptoms were unclear. For a study, researchers sought to determine the features of dysphagia in patients with solid tumors outside the head, neck, and upper gastrointestinal system.
A parent study carried out in two acute hospitals and one hospice included 73 people with dysphagia (46 men and 27 women aged 37-91). The swallow profile was assessed using cranial nerve function, the Oral Health Assessment Tool (OHAT), the Mann Assessment of Swallowing Ability (MASA), and the Functional Oral Intake Scale (FOIS).
Prior to study entry, only 9/73 (12%) participants had dysphagia that was recorded. MASA risk ratings revealed that n=61/73 (84%) had a risk of dysphagia, and n=22/73 (30%) had a risk of aspiration. Modifying the texture of either food or liquids was necessary for n=34/73 (47%) and n=1/73 (1%). For both meals and fluids, compensatory methods were required by n=13/73 (18%) and n=24/73 (33%), respectively. Deficits in the cranial nerves were seen in n=43/73 (59%). Xerostomia was seen in two-thirds of those who had oral health issues. Hospice and palliative care were particularly impacted by worse dysphagia on MASA, which was linked to illness progression. Poorer MASA raw score (P<0.001, OR 2.2, 95% CI 1.5-3.4), higher aspiration risk (P=0.005, OR 2.1, 95% CI 1.3-3.6), and lower FOIS (P=0.004, OR 2.0, 95% CI 1.2-3.2) were all indicators of worse performance status.
Dysphagia care in cancer patients necessitates thorough examination to identify clinically crucial needs, including food texture adjustment and advise on safe swallowing. For the objective, better assessment tools should be created. Since they worsen dysphagia, oral health issues in the population should be periodically examined.
Reference: jpsmjournal.com/article/S0885-3924(22)00874-0/fulltext
