Last Modified: December 10, 2006
Dear OncoLink "Ask The Experts,"
I'm 29-years-old with squamous cell carcinoma of the tongue and neck. I have had 2 right neck [lymph node] dissections in the last year; with the second, I lost all my soft tissue on the right side and the sternocleidomastoid muscle. Now my right neck is hard as a rock (I guess due to scar tissue). I still cannot turn my head, especially to the left, and I have chronic pain of the right shoulder and neck. Will I ever see improvement and is there anything I can do? Is there any way to soften my neck so that it will feel anything like it once did?
Lora Packel MS, PT, Coordinator of Cancer Therapy Services for the Hospital of the University of Pennsylvania, responds:
Neck dissection surgery is a very effective treatment; however it can leave a person with discomfort, stiffness and weakness. Exercises to stretch the underlying tissue should begin shortly after surgery, continue throughout radiation, and then possibly for 6 months afterward. It is during this time that damaged tissue needs to be stretched appropriately so that it becomes more pliable or soft and allows for full range of motion.
If you weren't able to stretch right after surgery, there is still hope! You should seek out a physical therapist that specializes in cancer care. If there isn't one in your local area, search out a physical therapist who is an orthopedic clinical specialist (they will have the initials PT, OCS after their name). It is important for the therapist to address the soft tissue in your neck and shoulder as well as evaluate any weakness. One possible side effect of neck dissection is injury to the spinal accessory nerve, which can cause shoulder pain and limited strength. Your therapist will stretch out your tissues, build up the strength in your remaining neck muscles, and ensure that your shoulder is functioning well.
Don't give up hope! Seek out specialized care and you should see improvement.