Do all patients receiving radiation to the head or neck need a feeding tube?
October 27, 2025
Medically Reviewed | Last reviewed by and on October 27, 2025
Historically, most head and neck cancer patients who needed radiation therapy have had a feeding tube installed as a matter of course.
¡°The thinking was, ¡®Well, you¡¯re not going to be able to swallow anyway, so let¡¯s just go ahead and put in a feeding tube so you don¡¯t have to,¡¯¡± explains , a radiation oncologist who specializes in the treatment of head and neck cancers.
That mindset has since shifted dramatically.
Fuller and Speech Pathology and Audiology Chief , explain why in a . Here are three highlights from that discussion.
Shifting our approach from reactive to proactive
Over the years, the value of preserving swallowing function ¡ª rather than just trying to recover it once it¡¯s been lost ¡ª has become clearer.
¡°There will always be a subset of patients who need a feeding tube,¡± notes Fuller. ¡°But we don¡¯t have to give up ahead of time. We want to do everything we can to protect you from long-term side effects that may reduce your quality of life.¡±
Benchmarking to preserve current function
One way that doctors safeguard patients¡¯ swallowing abilities is by assessing them early on. An evaluation with a speech pathologist establishes a functional baseline before cancer treatment even starts.
¡°The vast majority of our patients have the ability to eat through treatment,¡± Hutcheson explains. ¡°They may need some subtle modifications, but we can facilitate that. People still need to swallow, despite a feeding tube. So, let¡¯s benchmark that to make sure it¡¯s intact ¨C or understand the modifications needed to keep you swallowing.¡±
This step is important, Hutcheson notes, because care teams need to know if they are trying to preserve an ability that¡¯s still fully functional or if they¡¯re trying to improve an ability that has already been compromised.
¡°Cancer and its treatment can cause unavoidable injuries to tissues that make swallowing painful or slow,¡¯¡± she says. ¡°We don¡¯t want to add a layer of dysfunction on top of that due to lack of use.¡±
How critical is early intervention?
One clinical trial being led by Hutcheson is exploring a related question: Is it better to give patients swallowing exercises to hold onto their abilities before problems arise, or only after they¡¯ve started?
¡°This study is following close to 1,000 patients at 13 institutions across North America,¡± she explains. ¡°The goal is to see if delivering more intensive intervention earlier on results in fewer days on a feeding tube, and if how you do it matters. How much flexibility is there?¡±
¡°Our rate of feeding tube use is dropping,¡± notes Fuller, ¡°because new techniques have reduced the amount of radiation being delivered to the swallowing muscles that can cause problems. It used to be that about 70% of our patients needed a feeding tube. Now it¡¯s down to about 30%. That¡¯s moving the needle, but we want it to be zero. So, there¡¯s still room for improvement.¡±
To hear the entire discussion with Fuller and Hutcheson, .
or call 1-877-632-6789.