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Rehabilitation

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Depending on the treatment and side effects, a patient’s ability to swallow, speak or eat may be compromised post-treatment. Chemoradiation therapy may be associated with long-term deficits in swallowing.1Logemann JA, Pauloski BR, Rademaker AW, et al. Swallowing disorders in the first year after radiation and chemoradiation. Head Neck. 2008 Feb;30(2):148-58. Therefore, even after rehabilitation, a clinician may recommend speech and swallowing evaluations as part of the follow-up assessments.2Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers V.2.2016. © National Comprehensive Cancer Network, Inc 2016. All rights reserved. Accessed December 2, 2016. To view the most recent and complete version of the guideline, go online to www.nccn.org.

Swallowing rehabilitation

Swallowing function can be impaired after surgery, radiation therapy or chemoradiation therapy.3Gaziano JE. Evaluation and management of oropharyngeal Dysphagia in head and neck cancer. Cancer Control. 2002 Sep-Oct;9(5):400-9.

Swallowing deficits can have a profound impact on eating. In one 2008 review, 56 percent of patients who received chemoradiation therapy did not have a normal diet one year post-therapy.1Logemann JA, Pauloski BR, Rademaker AW, et al. Swallowing disorders in the first year after radiation and chemoradiation. Head Neck. 2008 Feb;30(2):148-58.

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Rehabilitation can include any of the following types of exercises: swallow maneuvers, such as effortful swallow or Mendelsohn maneuver (prolonged swallow), range of motion exercises (e.g., jaw, tongue), tongue strengthening exercises and tactile stimulation.

Speech rehabilitation

Working with a speech/swallowing therapist may improve a patient’s ability to speak.5Gritz ER, Carmack CL, de Moor C, et al. First year after head and neck cancer: quality of life. J Clin Oncol.1999 Jan;17(1):352-60.

Depending on the changes that occurred to the patient’s anatomy (i.e., decrease in size of muscles, surgical removal of structures), your loved one may require voice rehabilitation. It has been reported that between 34 and 70 percent of head and neck cancer survivors develop speech impairment.6Chen H-C, Evans KFK, Salgado CJ, Mardini S. Methods of voice reconstruction. Seminars in Plastic Surgery. 2010:227-232. The cancer care team can use a wide variety of tools for voice rehabilitation, which range from the use of prosthetic devices to facilitate vocalization or surgical reconstruction.6Chen H-C, Evans KFK, Salgado CJ, Mardini S. Methods of voice reconstruction. Seminars in Plastic Surgery. 2010:227-232.

Prosthetics

Your loved one may require prosthetics to restore function or appearance, such as an electronic voice, dental prosthetics or glass eyes. He or she may need some training and rehabilitation to properly use and care for a prosthetic device. Prosthetics sometimes require adjustments, periodic replacement, upgrades or continued training to use properly or solve problems.

They teach you how to swallow all over again, but in the correct way.Barry W. (palatomaxillary and low grade adenocarcinoma of minor salivary gland cancer survivor)

References

1 Logemann JA, Pauloski BR, Rademaker AW, et al. Swallowing disorders in the first year after radiation and chemoradiation. Head Neck. 2008 Feb;30(2):148-58.

2 Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers V.2.2016. © National Comprehensive Cancer Network, Inc 2016. All rights reserved. Accessed December 2, 2016. To view the most recent and complete version of the guideline, go online to www.nccn.org.

3 Gaziano JE. Evaluation and management of oropharyngeal Dysphagia in head and neck cancer. Cancer Control. 2002 Sep-Oct;9(5):400-9.

4 Pauloski BR. Rehabilitation of dysphagia following head and neck cancer. Phys Med Rehabil Clin N Am. 2008 Nov;19(4):889-928.

5 Gritz ER, Carmack CL, de Moor C, et al. First year after head and neck cancer: quality of life. J Clin Oncol.1999 Jan;17(1):352-60.

6 Chen H-C, Evans KFK, Salgado CJ, Mardini S. Methods of voice reconstruction. Seminars in Plastic Surgery. 2010:227-232.