Swallowing ability, nutritional status, and functioning in adults with advanced cancer excluding head, neck, and upper gastrointestinal tract: a cross-sectional study in an outpatient palliative care setting.

The study included only 39 adults, all with stage IV cancer and 68.0% receiving chemotherapy, so it cannot be generalized to other cancer populations or more advanced palliative groups. It was cross-sectional and used a convenience sample, so it shows association only and cannot show that poor function or nutrition caused swallowing changes. Swallowing was assessed clinically with PARD and FOIS, not with instrumental studies such as videofluoroscopic swallowing study. The PARD protocol was not repeated across volumes as originally recommended because of nausea and vomiting, so the assessment was simplified for patient comfort. Participants had to be able to consent and were excluded if PPS was 20 or below or if they had head, neck, upper gastrointestinal, neurological, or craniofacial conditions, so the sample was not representative of all advanced cancer patients. Refusal was related to deteriorated health, so the sample may have included more stable patients. The sample was heterogeneous, and not all confounding factors may have been controlled.

Do not read this as proof that a swallowing intervention improves function or nutrition. The study was cross-sectional, used a convenience sample of 39 adults, did not use instrumental swallowing assessment, and all nutrition and hydration remained oral.