Was your husband prescribed any swallowing strengthening exercises by the therapist? Having the swallowing exam is just the first step -- so that problem areas can be identified and a series of specific exercises given to address these issues. The typical exam consists of swallowing (or attempting to swallow) a thin liquid, a thick liquid, a puree and a cracker with a barium paste. You may also be asked to make certain sounds, all while being filmed with a fluoroscope. The doctor examines the latter and IDs areas of malfunction.

The act of swallowing is quite complex and many muscles and tendons are involved. Plus the epiglottis, which closes off the trachea during swallowing, is a dependent organ -- its correct function relies in great part on the functioning of the adjacent muscle bundles. If they are weak or damaged it may not close completely and you may end up aspirating food, with the consequent risk of pneumonia. Which happened to my husband despite his eating throughout treatment.

My husband was prescribed a series of exercises including suction, "hard" swallows, certain sounds, etc. to do 3x a day -- he started these in mid-November and still does them, although not as often. For a while they were quite hard, now they are very easy and done mostly to prevent any "creep up" of problems which can occur.

Perhaps ask your speech therapist to explain exactly where he/she saw your husband's swallowing problems and if any exercises can be done to address these. My husband's ENT monitors a number of HNC patients who have been treated elsewhere and some of these have had complete dysphagia (unable to swallow their own saliva, the ENT told us) and after several months of therapy are starting to show progress. It can be very slow and apparently, not very effective for some time as the muscles/nerves are being retrained. Like if you had a severe leg injury and had to have months of therapy, patience and persistence are part of the solution.

Sound to me as if you need a bit more information from the therapist and the Dr.. It is certainly possible that problems in the throat/epiglottal area and the esophagus both exist. I recall several people on this forum saying they had espohageal strictures ID'd late (after months of dysphagia) so both problems may have to be addressed in the months ahead.

However the good news is that the cancer seems to have been beaten -- now is the time to look forward with optimism...

Best,
Gail