Hi Pam

My Alex is in the same boat. We have just passed our 2 years since diagnosis mark and about 18 months out of treatment. chemotherapy followed by chemoradiation finished in August 2010. PEG came out in May 2011. Like your father, Alex has almost no saliva and minimal teeth(getting less and less every month)

It was the speech pathologist who ordered the modified barium swallow to check Alex's swallowing function. His function is damaged either by the tumour, the chemo or the radiation - we are not sure.

After 2 years, he is still on nearly all liquid feeds (Ensure Plus). Initially, we were made to feel by the RO that Alex's lack of swallow and refusal to eat was somehow his fault and due to lack of will or dedication but our speech pathologist reassured us that this is not as unusual as the RO inferred. Given what Alex has endured, this is not really such a surprise.

Now, whilst Alex is not as diligent in his speech exercises as I would like, he has a better chance of flying than being able to just "suck it up and get over it" as one physician suggested just before he had strips torn from him.

Alex has a physical issue with swallowing (sorta like the swallowing sequence is out of kilter and one of the steps is completely missing) that does not seem to be improving in any great rush, so he is resigned to very slow progress, one step at a time.

My suggestion to you would be to ask about the barium swallow as others suggest, and then if there is a physical problem preventing your father from enjoying his food, support him, and protect him from the well meaning but really annoying people who think it is a matter of trying harder.

And make sure you are not one of those well meaning but really annoying people as I was .

Alex makes a good point when he rants about the WMBRAP - "do they think I have lost my mind as well? How is it that they think I am so stupid that I haven't considered (insert obvious soft food suggestions here) already?"