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Rehabilitation

20453432Depending on the treatment and treatment-related side effects, the ability to speak or eat may be compromised post-treatment. Working with a speech pathologist may improve a patient’s ability to speak.6 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.

Swallowing function can be impaired even several years after the completion of surgery, radiation therapy or chemoradiation therapy.7 Gaziano JE. Evaluation and management of oropharyngeal dysphagia in head and neck cancer. Cancer Control. 2002 Sep-Oct;9(5):400-9. Rehabilitation can include any of the following type of exercises: swallowing maneuvers, such as effortful swallow or Mendelsohn maneuver (prolonged swallow); range of motion exercises (e.g., jaw, tongue); tongue strengthening exercises; and tactile stimulation.2 Pauloski BR. Rehabilitation of dysphagia following head and neck cancer. Phys Med Rehabil Clin N Am. 2008 Nov;19(4):889-928.

Depending on the changes that occurred to your anatomy post-treatment (e.g., decrease in size of muscles, surgical removal of structures), you may require voice rehabilitation. Between 34 to 70 percent of head and neck cancer survivors will develop a speech impairment.8 Chen HC, Evans KFK, Salgado CJ, Mardini S. Methods of voice reconstruction. Seminars in Plastic Surgery. 2010;227-232. A wide variety of tools can be used as a part of voice rehabilitation. These range from the use of prosthetic devices to help with vocalization to surgical reconstruction.8 Chen HC, Evans KFK, Salgado CJ, Mardini S. Methods of voice reconstruction. Seminars in Plastic Surgery. 2010;227-232.

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In addition, pyschosocial9 Shah JP, Lydiatt W. Treatment of cancer of the head and neck. CA Cancer J Clin. 1995;45:352-368. rehabilitation should be considered; approximately 20 percent of patients had depression after the completion of therapy for head and neck cancer, and 28 percent had depression approximately 10 years after diagnosis and treatment.10, Katz MR, Kopek N, Waldron J, Devins GM, Tomlinson G. Screening for depression in head and neck cancer. Psycho Oncology. 2004 Apr;13(4):269-80.11 Terrell JE, Fisher SG, Wolf GT. Long-term quality of life after treatment of laryngeal cancer. The Veterans Affairs Laryngeal Cancer Study Group. Arch Otolaryngol Head Neck Surg. 1998 Sep;124(9):964-71. If the patient is experiencing anxiety, he or she may want to obtain group therapy or individualized counseling or psychotherapy.12 Semple CJ, Dunwoody L, Sullivan K, Kernohan WG. Patients with head and neck cancer prefer individualized cognitive behavioural therapy. Eur J Cancer Care (Engl). 2006 Jul;15(3):220-7.

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

3 Argiris A, Karamouzis MV, Raben D, Ferris RL. Head and neck cancer. Lancet. 2008;371:1695-1709.

4 Epstein JB, Emerton S, Kolbinson DA, et al. Quality of life and oral function following radiotherapy for head and neck cancer. Head Neck. 1999 Jan;21(1):1-11.

5 Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers V.2.2014. © National Comprehensive Cancer Network, Inc 2014. All rights reserved. Accessed June 18, 2014. To view the most recent and complete version of the guideline, go online to www.NCCN.org. NATIONAL COMPREHENSIVE CANCER NETWORK®, NCCN®, NCCN GUIDELINES®, and all other NCCN Content are trademarks owned by the National Comprehensive Cancer Network, Inc.

6 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.

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

8 Chen HC, Evans KFK, Salgado CJ, Mardini S. Methods of voice reconstruction. Seminars in Plastic Surgery. 2010;227-232.

9 Shah JP, Lydiatt W. Treatment of cancer of the head and neck. CA Cancer J Clin. 1995;45:352-368.

10 Katz MR, Kopek N, Waldron J, Devins GM, Tomlinson G. Screening for depression in head and neck cancer. Psycho Oncology. 2004 Apr;13(4):269-80.

11 Terrell JE, Fisher SG, Wolf GT. Long-term quality of life after treatment of laryngeal cancer. The Veterans Affairs Laryngeal Cancer Study Group. Arch Otolaryngol Head Neck Surg. 1998 Sep;124(9):964-71.

12 Semple CJ, Dunwoody L, Sullivan K, Kernohan WG. Patients with head and neck cancer prefer individualized cognitive behavioural therapy. Eur J Cancer Care (Engl). 2006 Jul;15(3):220-7.

13 Alexander MV, Zajtchuk JT, Henderson RL. Hypothyroidism and wound healing: occurrence after head and neck radiation and surgery. Arch Otolaryngol. 1982 May;108(5):289-91.

14 American Cancer Society (ACS). Cancer Facts and figures 2012. Atlanta, GA: American Cancer Society, Inc. 2012.