Head and Neck Cancer
Tumors in the mouth and throat can cause mechanical obstruction to food and liquid swallows. However, more common are swallowing problems after the tumor has been removed or radiated (via radiation therapy). If the surgery to remove the tumor involved moving or cutting some swallowing nerves, swallowing problems may result. We will work closely with you to diagnose the type of swallowing problem you have and recommend how to treat the swallowing problem if this should occur during surgery.
Swallowing problems during and after radiation therapy to the mouth, nose, or throat are a common occurrence. During radiation therapy, the mouth and/or throat may become very sore making it painful to swallow. We encourage patients who experience this to swallow as much as they safely and comfortably can to maintain as much swallowing function as possible during this time. However, many patients may augment their nutrition with feeding tubes during this period. Again, we encourage even patients who have feeding tubes to eat and drink as much as they safely and comfortably can to keep using the swallowing muscles to avoid muscle degeneration. Pain with swallowing that may accompany radiation therapy usually improves within weeks to a few months after the completion of radiation therapy.
After radiation therapy, swallowing problems may persist or occur due to mechanical changes in the throat or to changes in the nerves and muscles that were in the field of radiation. We provide our patients who are undergoing radiation therapy a list of exercises to do with your mouth and throat that have been found to improve swallowing quality of life after radiation therapy. Some patients, with more severe swallowing problems, will need more extensive therapy and we may recommend outpatient swallowing therapy.
Swallowing tests (i.e., FEES and/or MBS) are often used to assess swallowing function before, during, and/or after your surgery and/or radiation therapy. We will work closely with you to help you find the appropriate level of food and liquid intake that you can comfortably and safely swallow. We may also recommend compensatory strategies to help you optimize what you can swallow. Although sometimes diet changes or compensatory techniques are needed to improve swallowing safety, aggressive home and/or outpatient therapies will be recommended and offered to help you achieve your optimal level of food and liquid intake.