The human body houses three principal salivary glands and numerous smaller ones within the head and neck area, which produce saliva. A common complication for patients undergoing treatment for head and neck cancers, including radiation therapy, is the development of thickened saliva or pharyngeal secretions. This issue often arises midway through radiation therapy and may worsen as treatment continues. Although this side effect typically lessens after treatment ends, some patients still experience thickened saliva to varying degrees.
The Vital Roles of Saliva
Saliva plays crucial roles you might not have considered. It enhances taste and is essential for speaking, chewing, and swallowing. Saliva moistens food, facilitating its passage to the throat and esophagus, while enzymes in saliva begin the digestion process. It also protects the mouth’s teeth and gums, preventing infection. Saliva fights tooth decay by neutralizing mouth acids, slowing bacteria growth, and removing food particles. Additionally, it aids in healing mouth tissues.
Due to saliva’s significant functions, thickened saliva leads to various challenges, such as difficulty swallowing (dysphagia), nausea, vomiting, and reduced nutritional intake. During treatment, a care team, including a speech therapist and a nutritionist, collaborates with patients to manage thickened saliva symptoms. This management enables patients to continue eating and drinking safely and effectively.
Signs & Symptoms
Patients primarily experience the presence of sticky, and seemingly copious amounts of thick saliva that sits in the throat.
Other Symptoms
- Difficulty swallowing
- Difficulty expectorating (spitting)
- Tacky spit
- Dry mouth sensation
Causes of Thickened Saliva
Dehydration, certain medications, or radiation for cancer treatment can cause thickened secretions. Radiation, especially for head and neck cancers, destroys cancer cells and healthy cells, including those in salivary glands. Damaged glands produce less saliva, and it’s often thicker. Patients usually notice thicker saliva 2–3 weeks after starting radiation.
Diagnosis
Upon diagnosing thickened pharyngeal secretions, doctors and care teams suggest management options depending on symptom severity. For patients with swallowing difficulties, thickened secretions exacerbate the problem. A speech and swallow therapist works closely with these patients to ease symptoms and improve hydration.
How to Manage Thickened Saliva
Managing thickened pharyngeal secretions varies by patient, but the focus is on reducing their discomfort and maintaining nutritional intake and adequate hydration.
Ways to Alleviate Symptoms
Each patient will manage their symptoms differently. Despite this, the goal remains the same: to keep the mouth moist and lubricated in order to minimize the symptoms and negative effects of thickened secretions. We have listed a few methods patients can use to alleviate their symptoms.
- Remaining hydrated (drink at least 8 to 10 cups of fluid per day): At night, keep a glass of water next to the bed in order to help combat the problem. During the day, keep a water bottle handy to help wash the thick secretions down and overcome the symptom of dry mouth.
- Using a home humidifier: In particular, it is helpful to keep the humidifier next to the bed at night, as the patient does not consume adequate fluids for an extended period of time while sleeping.
- Drinking warm liquids: This may help to thin secretions.
- Eating tart foods and fluids: This can help stimulate the salivary glands.
- Sucking on long acting lozenges: These may help keep moisture in the mouth.
- Avoiding caffeine: Caffeine may contribute to dehydration.
- Avoiding alcohol: Alcohol also contributes to dehydration.
Managing thickened saliva from radiation therapy is crucial for maintaining swallowing, nutrition, and mouth health. A multidisciplinary approach, including hydration, nutritional support, and strategies for oral moisture and comfort, helps improve patients’ quality of life. While experiences vary, the overarching goal is to ease discomfort and ensure sufficient nutrition and hydration, supporting recovery and well-being.
