Why am I seeing a speech-language pathologist for head and neck cancer? 

After a diagnosis of head and neck cancer, it is recommended you are followed by a speech-language pathologist. Speech-language pathologists are important members of your interdisciplinary team that specialize in swallow, speech, and voice. SLPs can provide pre-treatment education, conduct swallow studies, rehabilitate the swallow utilizing evidence based exercises, actively and safely stretch muscles of the jaw, and can manage head and neck lymphedema and voice prosthesis. Eating and completing swallow exercises during treatment has been proven to yield better post treatment outcomes with the swallow.2

Cancer, surgeries, and radiation therapy can impact the:

1. Pharynx (throat)
2. Larynx (voice box)
3. Oral Cavity (tongue, gums, cheeks, floor of mouth) 
4. Lymph nodes 

Patients treated for head and neck cancer are at risk for developing symptoms such as:  

1. Dysphagia (difficulty swallowing)
2. Trismus (difficulty or pain opening the mouth)
3. Lymphedema (swelling of tissues due to disruption to the lymphatic system)
4. Dysphonia (difficulty with voicing)  

Research has shown that there are both short term and long term side effects that impact the functional swallow after radiation therapy.3 One study reports between 60-75% of patients with head and neck cancer will develop difficulty swallowing.1 While there are common side effects that can be anticipated during and following treatment, it’s important to note the severity of dysphagia and the presence of trismus and lymphedema varies from patient to patient secondary to site of cancer, site of treatment, surgical interventions, and radiation dosage. 

Taylour Campbell, MS CCC-SLP

Sources:

1 Govender, R., Smith, C.H., Taylor, S.A. et al. Swallowing interventions for the treatment of dysphagia after head and neck cancer: a systematic review of behavioural strategies used to promote patient adherence to swallowing exercises. BMC Cancer 17, 43 (2017). https://doi.org/10.1186/s12885-016-2990-x

2 Hutcheson, K. A., Bhayani, M. K., Beadle, B. M., Gold, K. A., Shinn, E. H., Lai, S. Y., & Lewin, J. (2013). Eat and exercise during radiotherapy or chemoradiotherapy for pharyngeal cancers: use it or lose it. JAMA otolaryngology-- head & neck surgery, 139(11), 1127–1134. https://doi.org/10.1001/jamaoto.2013.4715

3 Hutcheson, K. A., Lewin, J. S., Barringer, D. A., Lisec, A., Gunn, G. B., Moore, M. W., & Holsinger, F. C. (2012). Late dysphagia after radiotherapy-based treatment of head and neck cancer. Cancer, 118(23), 5793–5799. https://doi.org/10.1002/cncr.27631