Oxaliplatin-related dysphagia: Mixed-methods study

Author:

Kenny CiaránORCID,Regan Julie,Balding Lucy,Higgins Stephen,O'Leary Norma,Kelleher Fergal,McDermott Ray,Armstrong John,Mihai Alina,Tiernan Eoin,Westrup Jennifer,Thirion Pierre,Walsh Declan

Abstract

ObjectivesTo evaluate participant-reported atypical dysphagia symptoms and their association with oxaliplatin treatment.MethodsThis observational study recruited 73 adults with solid tumours outside the head, neck or upper gastrointestinal tract. All had dysphagia, were in hospital or hospice and were treated by Medical Oncology, Radiation Oncology or Palliative Care. Participants reported their experiences of swallowing difficulties by semistructured interview. Oral Health Assessment Tool was used to ensure swallow difficulties were not due to mucositis. Responses were transcribed and analysed by content analysis. Atypical difficulties were examined for association with oxaliplatin treatment by Fischer’s Exact.ResultsOxaliplatin treatment was associated with three unusual dysphagia symptoms: problems with cold or hot bolus (p=0.01), pins and needles (p=0.001) and throat spasm (p=0.035). Carbonation was problematic for one participant. Chemotherapy commencement coincided with swallow problem onset for 67%. Dysphagia symptoms were unrelated to mucositis (p=0.165).ConclusionsSwallowing difficulties in oxaliplatin-treated patients are atypical and attributable to chemotherapy commencement. Previous research suggests that dysphagia is triggered by cold exposure, but hot and carbonated boluses also caused problems here. Dysphagia symptoms and triggers should be studied more fully to help patients safely enjoy their meals and prevent food avoidance, which could exacerbate malnutrition.

Funder

Atlantic Philanthropies

Publisher

BMJ

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