I had Xrays and CTscans done a couple of days ago and my primary doc who is a surgeon called me this morning and said that he was " worried " as my chest Xray showed aspiration pneumonia. I have no fever, have had no trouble breathing, and other than a little more phelgm than usual, had no indication of any problem. I called a Dr. friend of mine who is a pulmonary specialist and she did not seem to be too concerned.
I am scheduled to see a speech/swallow therapist tomorrow and also will see my oncologist and discuss it with him.

Does anyone know what the deal is with pneumonia?

Danny G.
( not out of the woods yet )

Did you choke/cough when you eat or drink ? If so, it is possible that some of the food or liquid is going into your windpipe/lung and causing infections in the respatory system. This is the problem I am dealing with right now, I saw a speech therapist two weeks ago and found that I had problem with my swallow.

I did not have any problem with breathing but I do have low fever. Most of the time, it is between 99-100F, I did not feel the temp at all, but it is there. I am trying to adjust my diet as the first step, if it does not work, I will have swallow therapy soon.

Danny,
John has a very similar situation as yours. He is in speech therapy and I have watched the barium swallows done for him. When he swallows. his liquid pools in two little pockets in his throat and he has to cough to expel the it and reswallow. He does what they call silent aspiration. He does not feel it because of the radiation.Therfore he must do the two swallow step for each liquid. His solid food goes down much better and in one swallow. He is still doing exercises and I think he will be for some time to come (maybe forever). The threat of aspiration pneumonia is always there for him. He was told to watch a low grade temp etc. Don't get discouraged. Has your speech therapist taught you some eating modification techniques?
Let us know.
Meredith

Thanks Meredith,
I go back on Monday for another barium swallow study. After we see how that goes we will decide how to procede from there. I took my chest xrays to a friend today who is pulmonologist and she was not very concerned after looking at them.
I quit doing the swallow exercises a while back, thinking that my swallowing had improved so much. However now I will discuss the situation again on Monday with the speech path. and see if I need to start doing them again.

Danny G.

My husband also has the same basic problem with swallowing - food/liquid gets caught in this "gullet" (as he calls it) and he ends up coughing and choking on food quite a bit. The same goes for taking medication - sometimes he thinks the pill has gown down - but it comes back up and he has to "re-swallow" it. This all pretty much has been happening since he had the modified radical neck dissection surgery done on 2/6/03 - and has been having severe swelling on his face, throat, neck, etc. He has been seen recently by his surgeon and the radiation oncologist - and they seem to think nothing of this swelling problem - that he pretty much has to deal with it. But I am worried about this aspiration pneumonia (as it's called). Wouldn't there be any other symptoms besides a low-grade fever? How would a person know otherwise if someone has this problem?

Donnajean, sorry I don't know the answer to your question. Mine was detected on the Xray.
Today I had my barium swallow study done and, according to the therapist, I did not aspirate any liquid or food that I consumed. She therefore, made an assumption that it is probably reflux that is getting into my lungs and is suggesting to the surgeon to prescribe Nexium for me. I don't really mind that, except that it seems that she is taking quite a leap in assuming that reflux is the problem. The only person that ever suggested that I may have reflux was the speech pathologist who looked at a video of my vocal chords back when I was first seen at MDACC.
I don't want to start taking a daily prescription for something that I may not need.

Danny G.

Danny, That's interesting about the GERD being a culprit in this matter. I know my husband has had reflux and gastro-intestinal problems even before the diagnosis of cancer. Thanks for the tip - maybe he can talk to the doctor about this on his next visit. You seem to be doing better, and although I understand your concern about taking something that may not be needed - the therapist must have seen situations such as yours, and that's why the Nexium was recommended. At this point, I'm sure John would try just about anything if it could help his swallowing abilities. Good luck to you and let us know if this RX is working out for you.

Donnajean,
Actually there are studies suggesting that throat and esophageal cancers might be caused by GERD, so the reflux connection is very interesting in oral cancers. Since the gastro-enterologist dilated my esophagus three times recently and went up and down my esophaugs with his camera, I would think that he should know whether or not I do indeed have a reflux problem. I imagine that Nexium is no big deal, but , I repeat, I don't want to get into another prescription if it is not necessary.
My main problem continues to be my inability to eat much. I am swallowing a lot better, but just cannot seem to consume many calories. I still pretty much rely on drinking milk shakes and Boost Plus and a few tube feedings.

Thanks for your support and good luck with your husband,

Danny G.

Danny,
Where have you run across information linking reflux problems to throat cancer? My husband (Stage 4 tonsil cancer) also had quite a few acid reflux digestive problems in the months (years?) leading up to his diagnosis.

Thanks,
Anita

My ENT also suggested a high power antacid (I have forgoten which one because I never took it) because I had sensations of swallowing problems and feelings of swelling (not large scale) that affected swallowing. The ENT sent me a paper that suggested many symptoms of throat problems were caused by reflux especially when sleeping. In my case the sensation went away after a few more months.

Incidentally, I had problems with pills and certain foods getting "caught" while swallowing and frequently having food or liquids "go down the wrong pipe" (causing a coughing jag). I was worried about this but the ENT was not concerned. (his manner tends to not dwell on a problem if it is not serious. Some might not like his style but to put it in to perspective: One time when I told him I was "Worried" He gently grabbed both my sholders and said "you just let me do the worrying" which I thought was pretty neat )

I am happy to say that this problem has diminished. I believe it was a radiation or lymphedema (swelling) related problem. I recall it may have been more than a year after the end of treatments. Many of the subtle side effects can remain for a long time or perhaps are permanent.

Anita, What I have heard is that the reflux issue is related to cancers lower down than tonsil or mouth. A thought for you: I spent quite a bit of time trying to find the cause of my tonsil cancer with out much success. I believe the strong desire to know is common but my suggestion is to not chase that desire too hard. You'll find a lot of things that might have caused "it" but you'll probably never know for sure. At some point I would like to poll the OCF people about lots of things they may have been exposed to (like lead and arsenic, stress etc.) but even then it would hardly be scientific and as much as it bugs me I probably will never know what caused my cancer for sure.