Rapid Improvement and Maintained Effect with Steroid for Severe Salivary Dysphagia Due to Hypopharyngeal Cancer: Report of a Case
- VernacularTitle:下咽頭がんによる重篤な唾液の嚥下困難の苦痛がステロイドで速やかに軽減し効果を維持できた1例
- Author:
Kenro Sawada
;
Tetsusuke Yoshimoto
;
Yayoi Mizumoto
;
Naomi Kumazawa
;
Kazumi Hasegawa
;
Kumi Gouji
- Keywords: pharyngeal cancer; Betamethasone; drooling; dysphagia; retention of saliva
- From:Palliative Care Research 2017;12(4):565-569
- CountryJapan
- Language:Japanese
-
Abstract:
Backgrounds: Salivary dysphagia due to digestive tract obstruction from pharyngeal and cervical esophageal cancer is a major cause of drooling, and the retention of saliva in the mouth is annoying to patients. Case report: An 87-year-old woman with recurrent hypopharyngeal cancer after radiation therapy complained that she could not sleep at night because of continuous sputa accumulation, and that she had to repeatedly eliminate saliva throughout day. Intravenous betamethasone at dose of 8 mg per day provided symptom relief the day after its administration. Her score on the Support Team Assessment Schedule, Japanese version (STAS-J) for salivary dysphagia decreased from 4 before treatment to 1 within two days after the initial administration. The dose was decreased to 2 mg per day six days after the start of administration, but the symptom relief continued. No symptom recurrence was seen for the two months that steroids were administered. Discussion: Our STAS-J finding indicates that the anti-inflammatory effect of betamethasone produces a rapid response that is maintained for months in cases of stenosis due to malignancy. Conclusions: Treatment with high dose steroid has the possibility of the relief of suffering caused by difficulty swallowing saliva.