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Difficulty Swallowing and Thick Saliva

Learn about difficulty swallowing and thick saliva in people with cancer in this guide from The ONE Group (Oncology – Nutrition – Exercise) at Penn State College of Medicine.

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What you should know

Difficulty swallowing

Cancer and its treatments can sometimes cause difficulty swallowing.

Thick saliva

Thick saliva can be a side effect of cancer treatment.

The thick saliva and mucus in your mouth may make it more difficult for you to swallow.

Having thick saliva increases your risk of cavities and mouth infection.

What you can do: Improving your eating behavior

General tips

  • Eat small and frequent meals.
  • Drink plenty of fluids – around eight glasses of 8 ounces of water per day.
  • Drink beverages between meals, not during them, to feel less full.

If you’re having trouble swallowing

  • Drink liquids at room temperatures to make them easier to swallow.
  • Try eating soft or liquid foods. You may be able to swallow thicker fluids more easily than thinner liquids.
  • If you’re unable to eat enough regular foods to meet your nutritional needs, drink high-calorie and high-protein liquids (see recipe below).
  • Your doctor may refer you to a speech therapist who can teach you how to swallow better and how to decrease coughing and choking when you eat and drink.

If you have thick saliva

  • Use a saline solution to rinse your mouth. Rinse your mouth multiple times per day.
  • Use ice water or ice chips to moisten your mouth.
  • Practice good oral hygiene by brushing teeth and keeping gums and tongue clean.
  • Avoid alcohol and tobacco to reduce thick saliva. Reduce caffeine and sugar.

If a thick liquid or puree diet is recommended

Protein: To add more protein to your diet, you can eat and drink thickened milk, yogurt, cottage cheese, sour cream, scrambled eggs, pureed meat, poultry and fish.

Grains: To integrate whole grains, add cooked cereals like cream of wheat and cream of rice to your diet.

Fruit and vegetables: Puréed fruit and vegetables without seeds and skins should be easy to swallow. You also can try mashed potatoes.


High-Protein Banana Yogurt Smoothie

Mix all ingredients in a blender:
8 oz. Greek yogurt
3 bananas
½ cup milk
2 tbsp. peanut butter

1 tbsp. flaxseed
1 tbsp. cocoa powder



  • Academy of Nutrition and Dietetics
  • American Cancer Society
  • American Institute for Cancer Research
  • Cancer Nutrition Consortium
  • National Cancer Institute