Swallowing ability, nutritional status, and functioning in adults with advanced cancer excluding head, neck, and upper gastrointestinal tract: a cross-sectional study in an outpatient palliative care setting.

Abstract

Purpose: This study sought to analyze the swallowing function of cancer patients undergoing palliative care according to the degree of functionality and nutritional status.

Methods: observational, cross-sectional study, conducted with advanced cancer patients outside the head and neck and upper gastrointestinal tract, in an outpatient palliative care setting at a Brazilian oncology center, conducted between March 2022 and August 2023. In the first stage, sociodemographic, clinical, functional, and nutritional data were collected. Subsequently, a speech therapy assessment was performed to classify swallowing disorders and feeding route associated with swallowing ability. Descriptive, univariate, and multivariate analyses were conducted using logistic regression.

Results: 39 individuals participated in the study, the majority were female, with functional performance between fair and good, moderately undernourished. Regarding the assessment of swallowing abilities, the sample mostly exhibited fully functional swallowing, followed by functional swallowing with occasional minimal cues, additional time, or avoidance of specific foods. As for the classification of swallowing, most participants had either normal swallowing or functional swallowing, with only one patient presenting mild oropharyngeal dysphagia. Multivariate analysis revealed a significant association between a decline in swallowing ability and poorer functional performance and nutritional status.

Conclusion: Poorer swallowing ability in patients with advanced cancer, excluding those with head, neck, and upper gastrointestinal tract cancers, was associated with lower global functionality and nutritional status.