Head and neck cancer can result in significant changes to swallowing, speech, and voice. The size and location of the tumor may invade muscles, nerves and other structures involved in swallowing. Because of the small and complex anatomy of the head, throat, and swallowing mechanism, treatment of head and neck cancer is also likely to impact swallowing function. Surgical removal of the cancer may necessitate either a temporary or long-term feeding tube depending on the size of the tumor and surgery required to treat it. Radiation and chemoradiation can also result in both short- and long-term effects on swallowing. During treatment patients often experience throat pain, dry mouth, changes in taste, thick secretions, and swelling in their mouth and throat. These side effects can make it difficult to swallow during and after treatment. Additionally, there is a risk for formation of scar tissue in the swallowing muscles post-radiation that can cause a new onset of dysphagia years after treatment.
Symptoms of Head and Neck Cancer Dysphagia
Patients with head and neck cancer may notice a variety of symptoms including throat pain, ear/jaw pain, feeling of a “lump” in the throat, voice change, and difficulty swallowing. Swallowing symptoms including feeling like food or pills stick in the throat, liquids going down the wrong pipe, increased mealtimes, weight loss, and needing to drink more liquids than usual during meals.
Head and Neck Cancer Dysphagia Diagnosis
Cancer diagnosis is made by physicians and requires imaging such as CT or PET scans, and a tissue biopsy. Once a cancer diagnosis is confirmed, patients may see a speech-language pathologist to evaluate their swallowing. Evaluations include either a flexible endoscopic evaluation of swallowing (FEES) or modified barium swallow study (MBS).
Following cancer treatment, patients may have the same dysphagia symptoms mentioned above - foods lodging in the throat, choking with liquids, and difficulty swallowing pills. Patients may also notice weight loss/difficulty maintaining weight, or recurrent lung infections. However, it is also important to know that some cancer treatments can affect the sensory function of the throat, so patients may not experience typical dysphagia symptoms, or may even feel they do not have a swallowing problem. Because of these sensory changes, following radiation or chemoradiation it is important to be evaluated yearly by a speech-language pathologist to identify changes early and allow for prompt treatment.
Learn more about our specialized chemoradiation dysphagia program and how our specialized SLPs care for your swallowing before, during, and after your cancer treatment.
Treatment for Head and Neck Cancer Dysphagia
Treatment of swallowing problems depends heavily on underlying deficits, which will be determined by an evaluation. Depending on the nature of the swallowing problem, patients may be treated with a combination of swallowing therapy, dietary and texture modifications, swallowing strategies, and surgery such as esophageal dilations.