Speech & Swallowing Support for Head and Neck Cancer Survivors

What is a speech language pathologist?

A speech language pathologist (SLP) is a provider that tests to see how you are swallowing, can find areas of weakness, and causes of why you are having trouble swallowing. They can give you exercises and techniques to help your swallowing. They can also help you work through speech problems and find ways to improve your communication.

What are some of the swallowing problems after treatment for head and neck cancer?

• Food or liquids falling out of the mouth.
• Food sticking in the mouth.
• Trouble chewing or moving food to the back of the mouth.
• Food getting stuck in the throat or going into the nasal cavity (nose).
• Aspiration (food going into the airway/down the wrong pipe).

Many of these problems are from muscle loss (atrophy) in the head and neck area because of lack of use or damage from treatment. Tissue damage from radiation can happen years after treatment.

What are the treatments for swallowing problems?

• Doing swallowing exercises before surgery and chemo-radiation can lessen the loss of swallowing muscles and improve swallowing function.
• Swallowing (eating/drinking) and exercises are the best ways to prevent swallowing problems.
• Electrical stimulation can be used for some patients to maximize the effect of the exercises. This is not an option for everyone, so talk with your providers.
• Products (saliva substitute, saliva stimulants), drinking more liquids, and making changes to your diet to cope with xerostomia (dry mouth).

What are the possible speech changes after treatment for head and neck cancer?

• Changes in how your lips and tongue move, which causes speech changes.
• Your voice may sound strained, harsh, or breathy.
• Changes in pitch and intensity.

What are the treatments for speech changes?

• Your SLP can give you exercises and techniques to work on the specific speech change you are having.
• Techniques can include slowing down your speech, speaking louder, reducing background noise, using context, and gestures.
• There are apps on your smart phone that can help with exercises.
• In some cases, it may help you to use communication tools. Tools include text to speech apps, electronic speech-generating devices, electrolarynx (a battery operated device to help a person talk), and a prosthesis (an artificial device to replace a body part).

When should I see an SLP?

• You may see an SLP soon after head and neck diagnosis or treatment. 
• You may see an SLP at any time after treatment if there are changes in your speech or swallowing or to see if any new treatments are available.
• If there has been a change in your swallowing function at any time after treatment, you may need to see an SLP.
• Some common swallowing concerns that call for testing by an SLP:
  • You had a change in the consistency (thickness or thinness) of the food that you can eat.
  • You need to swallow many times to clear food from your mouth and throat.
  • Your voice changes after swallowing and sounds wet or gurgly.
  • You clear your throat while eating.
  • You have lost weight without trying.
  • You need a feeding tube.
  • You have a history of aspiration pneumonia (infection in your lungs).

There are many ways that an SLP can help you with issues you may be having related to a head or neck cancer diagnosis. If you are having an issue with your speech or swallowing, ask to be seen by an SLP.