Speech & Swallowing Support for Head and Neck Cancer Survivors
What is a speech language pathologist?
A speech language pathologist (SLP) can evaluate your swallowing function, identify areas of weakness and causes of the swallowing difficulties. They can provide exercises and techniques to improve your swallowing function. They can also evaluate speech problems and identify ways to improve your ability to communicate.
What are some of the possible swallowing problems after treatment for head and neck cancer?
- Food or liquids spilling from the mouth.
- Food sticking in the mouth.
- Difficulty chewing or moving food to the back of the mouth.
- Food getting stuck in the throat or going into the nasal cavity.
- Aspiration (food going into the airway).
Many of these problems are a result of muscle loss (atrophy) in the head and neck area from lack of use or damage from treatment. Tissue damage from radiation can develop many years after treatment.
What are the treatments for swallowing problems?
- Performing swallowing exercises before surgery and chemo-radiation can lessen loss of swallowing muscles and improve swallowing function.
- Swallowing (eating/drinking) and exercises are the best way to prevent swallowing problems. Use it or lose it!
- Electrical stimulation can be used for some patients to maximize the effect of the exercises. This is not an option for everyone, so discuss it with your providers.
- Products (saliva substitute, saliva stimulants), increasing liquids, and making dietary changes to cope with xerostomia (dry mouth).
What are the possible speech changes after treatment for head and neck cancer?
- Changes in lip and tongue mobility, resulting in imprecise speech.
- Voice sounds strained, harsh, or breathy.
- Changes in pitch and intensity.
What are the treatments for speech changes?
- Your SLP can identify exercises and techniques to work on the specific speech change you are experiencing.
- Techniques can include slowing down speech, speak louder, reduce background noise, use context, and gestures.
- There are apps for your smart phone that can help with these exercises.
- In some cases, you may benefit from using tools to help you better communicate. Tools include text to speech apps, electronic speech-generating devices, electrolarynx, and prosthesis.
When should I see an SLP?
- You may see an SLP for evaluation soon after head and neck diagnosis or treatment. You may also see an SLP at any time after treatment if there are changes in function or to see if any new treatments are available.
- If there has been a change in your swallowing function at any time after treatment, you may need to see an SLP.
- Some common swallowing concerns that should prompt an evaluation by SLP:
- You have had a change in the consistency of the food that you can eat.
- You need to swallow many times to clear food from your mouth and throat.
- You have a gurgly or wet sounding voice after swallowing.
- You clear your throat while eating.
- You have experienced an unintentional weight loss.
- You are dependent on a feeding tube.
- You have a history of aspiration pneumonia.
There are many ways that an SLP can help you with issues you may be having related to a head or neck cancer diagnosis. If you are having an issue related to speech or swallowing, ask to be seen by an SLP.
American Speech-Language-Hearing Association. Swallowing Problems After Head and Neck Cancer. Found at: https://www.asha.org/public/speech/disorders/Swallowing-Problems-After-Head-and-Neck-Cancer/
American Speech-Language-Hearing Association. Head and Neck Cancer. Found at: https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589943346§ion=Assessment
National Cancer Institute. Head and Neck Cancers. Found at: https://www.cancer.gov/types/head-and-neck/head-neck-fact-sheet