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Why Head and Neck Cancer Patients Need Speech, Swallow Rehabilitation

October 08, 2019

By Nicole Silva
Speech Language Pathologist
Hartford HealthCare Cancer Institute

According to the American Cancer Society, head and neck cancer accounts for approximately 65,000 cases annually. In the United States, about 3 percent of all cancers are head and neck cancer .

Patients with head and neck cancer often face psychological and functional changes associated with the diagnosis and treatment of their disease. These changes can affect their quality of life and functioning in society.

A tumor in the head and neck region often changes speech and swallowing. The severity of these changes can vary with the tumor site and size. Besides changes created by the tumor, the treatment of head and neck cancers can also cause alterations in speech and swallowing function. Given that potential, rehabilitation and restoration of speech and swallowing abilities following treatment are essential to optimize quality of life.

A speech-language pathologist is a member of the interdisciplinary Hartford HealthCare Cancer Institute care team who assists in early identification and intervention, monitoring, maintenance and rehabilitation of a patient’s speech and swallowing function. A speech-language pathologist plays a central role in the screening, comprehensive assessment and creation of a treatment plan for patients with head and neck cancer. Speech and swallowing therapy for head and neck cancer patients is an important part of the cancer care plan before, during, and after treatment.

Research has shown that even people with normal swallowing before radiation benefit from meeting with the speech-language pathologist for proactive measures and education on how radiation and/or chemotherapy can affect speech and swallow function.  These problems can lead to symptoms like food sticking in the throat, food and/or liquid going down the wrong pipe or going up one’s nose when you swallow.

These problems also can lead to health problems such as pneumonia and malnutrition. Fortunately, a speech-language pathologist can recommend approaches to prevent these problems.

Active use of the swallowing muscles during radiation has been shown to protect them from weakening and scarring. Two activities will help you to activate these muscles:

• Continue eating and drinking by mouth. Though patients may need to alter their diet due to dry mouth and taste changes, they should eat and drink as normally as possible.  The speech-language pathologist can suggest ways to continue eating during treatment.
• Protect swallow muscles with swallowing therapy, which will focus on swallowing exercises to optimize the overall swallow function.  Research has shown that swallowing exercises need to be done throughout radiation to get the maximum benefit.  The speech-language pathologist will provide patients with the appropriate exercises based on the individual’s functioning.

Recent research has shown that patients continuing to eat and completing swallowing exercises have a 93 percent chance of returning to a normal diet after healing from radiation. A patient who doesn’t do that only has a 60 percent chance of returning to a normal diet.

At Hartford Healthcare Cancer Institute, each head and neck cancer patient receives a referral to the speech-language pathologist for a full evaluation of their swallowing function. Each patient undergoing radiation therapy receives a “How Radiation Impacts Your Swallow Function” booklet that reviews side effects of radiation therapy on the swallow mechanism, oral hygiene routine needed during radiation therapy, xerostomia (dry mouth) prevention strategies to handle taste change and information on swallow strengthening and oral range of motion exercises.

The speech-language pathologist’s goal is to provide each patient undergoing radiation and/or chemotherapy and their families with the proper education, care, intervention and support for maintaining or regaining oral nutrition. The speech-language pathologist is a therapist, an encourager, advocate and counselor helping patients to achieve their goals and regain a sense of normalcy after a life-altering diagnosis and treatment.

For more information on the Hartford HealthCare Cancer Institute, click here.