Who are my doctors during head and neck cancer treatment?

arkj prgram head neck rehab Feb 13, 2023

Who are all these doctors and do I need a speech pathologist? 

Once you receive a diagnosis of head and neck cancer your life is taken over by doctor  appointments, copays and phone calls. So when a speech pathologist calls you most of the time you say “I can talk just fine, I don’t need you.” However, that is a huge mistake. So who do you need in your care team?

Once it is confirmed you do have cancer. The journey begins in meeting people who will change your life. 

  1. Ear, Nose and Throat Doctor: These doctors are called ENTs. Their job is to know as much as they can about the nose, mouth and the throat. They are specialist. They will often be the first one your primary care refers to. Perhaps they will evaluate you and order a biopsy or CT scans of the head and neck to further evaluate the lump or bumps. What is a biopsy? A sample of cancer cells that is sent off to the lab to decide what grew in your body. By knowing what grew, the doctors can offer you the best treatment approach for the long term. Following diagnostics, if you are a candidate or they recommended surgery they are the ones to perform your surgery. Your surgery should be completed by an ENT, not a general surgeon. Why? Well when your doctor is only responsible for being amazing at surgeries related to the head and neck things just turn out better.
  2. Radiation Oncologist: This is probably your second pit stop. This doctor is a doctor who will decide if your type of cancer will benefit from radiotherapy. If yes, you will see this doctor once a week for the duration of your recommended radiotherapy. You will go through a series of appointments prior to radiotherapy that include the words “mapping” and “mask fitting”. These are appointments in which your doctor will be planning your course of treatment to kill the cancer cells. The mask is exactly as it sounds. A mask to cover your face and keep you still on the table while the radiotherapy does it's work.
  3. Oncologist: This doctor is chemotherapy doctor. Their goal is to determine if your type of cancer needs chemotherapy. This doctor will work closely with your radiation oncologist to ensure your planning is completed. They will often be the physician to order the PET scan to ensure the cancer is localized or only in one area of the body. You may seem he or she one time a week. Most oncologist have a team so don't be surprised if you don't see that doctor every week. You will see however a nurse practitioner or someone who works directly with your doctor on a daily basis. 
  4. Dentist: Yes, you must have a dentist. This person will evaluate and determine if you need any teeth pulled prior to treatment. When you receive radiation therapy to the oral cavity (mouth) your dentist will explain to you the long term effects on losing your saliva. When you lose your saliva your teeth don’t like it! There are trays you will be prescribed to wear and need to do so as recommended.
  5. Speech Pathologist: This is the person who will be your biggest cheerleader. I am biased because this me. They will be honest, they will advocate for you when things go wrong and they will not lead you in the wrong direction. You do need them. Not to to talk but to swallow. Your swallowing will be forever changed after this treatment and it’s a huge deal for your life. So show up to this appointment. It should be scheduled ideally before you begin treatment or the first week of your treatment. You will see your speech pathologist weeks 2, 4, 6 or 1, 3, 5, 7! And then you will take a break. If your doctor did not refer you to a speech pathologist then you need this referral! Get your daughter or wife on the phone to make it happen. 
  6.  Physical Therapist: This is another person who will route for you and be a huge part of your recovery. The physical therapist will evaluate and offer exercises for turning your neck and stretching daily. 

While all of these appointments are daunting and exhausting, remember this. It will pass. This is a crappy season in your life. You have cancer but with a cohesive team life will be get better. Don't ever stop believing that it will improve. The patients who make it through this treatment with the best outcomes are the fighters and the get "sh**" done patients.