Survivorship: Life After Head & Neck Cancer
There are many types of surgery used to treat head and neck cancers. These can result in trouble chewing, swallowing, speaking, and breathing. Other issues can include:
- Aspiration (the inhalation of food or liquids into the lungs, which can lead to pneumonia).
- Decreased range of motion in the neck and shoulders.
- Difficulty opening the mouth fully (trismus).
- First bite syndrome (pain brought on by salivation or chewing).
- Spinal accessory nerve palsy (weakness of muscles in the neck and shoulder area).
- Lymphedema (swelling as a result of lymph nodes removed in surgery).
- Dry mouth (xerostomia).
- Changes in how you taste, smell and hear.
- Changes in how you look and speak.
These effects may be temporary, last for months after treatment, or be permanent. Physical, occupational and lymphedema therapists, speech and swallowing experts, dietitians, plastic surgeons, prosthetic manufacturers, and pain management and orthodontic specialists can all be helpful in managing these concerns.
Be aware of signs of recurrence of the cancer, which may include weight loss, coughing or spitting-up blood, difficulty swallowing, difficulty opening the mouth fully, sores in the mouth that do not heal, a change in your voice or ear ache (particularly when swallowing). Contact your healthcare provider if any concerning symptoms occur.
It is important that you can get enough calories to prevent weight loss. If you have difficulty eating and/or maintaining your weight, you should consult with an oncology dietitian for help. Some survivors may need a feeding tube to provide nutrition if eating and/or swallowing are extremely difficult. If you are a smoker, ask your provider to help you quit. Smoking can greatly increase the risk of a second cancer or recurrence. Limit the amount of alcohol you drink, if any.
Good dental care and regular follow-up with a dentist is especially important after surgery and/or radiation. You are at a greater risk of developing tooth decay (cavities) because of the dry mouth that often results from surgery and/or radiation.
Quality of life can be a big concern for survivors of head and neck cancers. Depression and anxiety are common issues faced by survivors. You should feel free to discuss your concerns with your health care provider. Joining a support group can be a great way to see how others live life to the fullest after cancer. SPOHNC.org is a support organization specifically for people with head and neck cancers.
- Report any signs concerning for recurrence, including weight loss, coughing up blood, difficulty swallowing, difficulty opening the mouth, persistent sores in the mouth, change in voice or earache (especially when swallowing).
- Speak with a dietician for any nutrition concerns.
- There are a number of specialists who can help with the late effects of head and neck cancer treatment. Ask your oncology team to refer you to specialists based on your specific concerns.
- See your dentist twice a year and practice good oral care. Your dentist may recommend frequent fluoride treatments.
- Do not smoke. If you do smoke, ask you provider for help with quitting. Limit how much alcohol you drink, if any.
- Report any concerns of depression or anxiety to your healthcare provider. Consider counseling or support groups to help you cope.
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