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Oxaliplatin-related dysphagia: Mixed-methods study
  1. Ciarán Kenny1,
  2. Julie Regan1,
  3. Lucy Balding2,
  4. Stephen Higgins2,
  5. Norma O'Leary2,
  6. Fergal Kelleher3,
  7. Ray McDermott3,4,
  8. John Armstrong4,
  9. Alina Mihai4,
  10. Eoin Tiernan4,
  11. Jennifer Westrup4,
  12. Pierre Thirion4 and
  13. Declan Walsh5
  1. 1 Department of Clinical Speech and Language Studies, University of Dublin Trinity College, Dublin, Ireland
  2. 2 Our Lady's Hospice and Care Services, Dublin, Ireland
  3. 3 Tallaght University Hospital, Dublin, Ireland
  4. 4 Beacon Hospital, Sandyford, Ireland
  5. 5 Atrium Health, Charlotte, North Carolina, USA
  1. Correspondence to Dr Ciarán Kenny; ckenny9{at}tcd.ie

Abstract

Objectives To evaluate participant-reported atypical dysphagia symptoms and their association with oxaliplatin treatment.

Methods This 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.

Results Oxaliplatin 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).

Conclusions Swallowing 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.

  • Dysphagia
  • Cancer
  • Drug administration
  • Supportive care

https://doi.org/10.1136/spcare-2023-004486

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    Footnotes

    • X @ckennyirl

    • Contributors CK, JR and DW designed the study. CK conducted data collection, analysis and wrote the manuscript. All authors were involved in reviewing and approving the final manuscript draft.

    • Funding The corresponding author was funded by Atlantic Philanthropies to complete a doctoral dissertation. This research formed part of that doctoral dissertation.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.