Most patients with head and neck cancer will experience swallowing and speech changes after their cancer treatment is complete.

When a patient faces head and neck cancer, speech language pathologists play an important role from the beginning in order to help patients through swallowing and speech concerns.

“We offer counseling before treatment so the patient knows what to expect. We will then evaluate a patient for issues with swallowing and speech after treatment so we can provide recommendations based on what we find,” said Lisa Bast, speech language pathologist with Marshfield Clinic Health System.

Evaluating the swallow

Speech language pathologists will use various techniques to determine if you can swallow food.

A video fluoroscopic swallow study is the most common way to evaluate swallowing. Your speech language pathologist will provide you liquids and foods with barium in them. A radiologist will then take X-rays of your throat as you swallow. The barium in the food allows the speech language pathologist to see the movement of the food and liquid from your mouth into your esophagus.

A fiberoptic endoscopic evaluation of swallowing involves a small camera that is passed through the nose and comfortably situated in the throat. The speech language pathologist will then watch your swallowing function while foods and liquids are swallowed.

Options for swallow or speech concerns

If your speech language pathologist has concerns with your swallow, there are some options available including:

• Education and training for swallowing techniques.
• Exercises to help improve function and allow you to eat.
• Manual therapy techniques for your face, mouth and neck to help maximize range of motion and function.

“Eating is one of the most basic things we as humans do every day,” Bast said. “However, when we suddenly can’t eat anymore, it really changes how we live on a daily basis.”

If it is determined that you will not be able to swallow or will continue to have issues, your speech language pathologist will work with you to determine the best way for you to get nutrition. This may include finding foods that are safe for you to eat or alternative feeding methods like a feeding tube.

Your speech and voice may change due to the location and nature of the surgery or post-radiation effects. Your speech language pathologist can offer training for additional communication techniques.

To learn more about swallow and speech concerns following head and neck cancer, talk to your medical oncologist/hematologist.