The goal of rehabilitation is to preserve the affected area during treatment.
The goals of head and neck cancer treatment are to control the disease and to help the patient return to normal activities as soon as possible after treatment. An important part of treating head and neck cancer is preserving the affected area through rehabilitation, says Mark S. Persky, MD, an ear, nose, and throat specialist (otolaryngologist) at NYU Langone Health.
Head and neck cancer usually, though not always, starts in the cells that line the moist, mucosal surfaces inside the head and neck (for example, inside the mouth, the nose, and the throat).
Depending on how the head and neck cancer is treated, patients often have issues that need to be rehabilitated. For example: “Surgery of the head neck may involve difficulty with moving the tongue and swallowing,” says Dr. Persky.
Other impairments that head and neck cancer patients might experience include:
Decreased sense of taste
Loss of voice
Reduced mouth opening
Neck and shoulder dysfunction
Types of Head and Neck Cancer Treatment Rehab
The type of rehabilitation will depend on the cancer and type of treatment. Rehabilitation may include:
Speech therapy. “We have very close association with speech and swallowing therapists, because if the tongue or the throat is undergoing surgery or radiation therapy, certainly the effects can affect how [patients] maintain their nutrition,” says Dr. Persky.
Dietary help. “Radiation therapy often involves intense inflammation of the oral cavity and of the throat, which makes nutrition very difficult,” says Dr. Persky. “Maintaining proper food intake, caloric intake, [and] protein intake is very important to keep the patient's nutrition adequate enough to withstand the treatment.”
Some patients receive nutrients via IV or need a temporary feeding tube. A feeding tube is a flexible plastic tube that is passed into the stomach through the nose or an incision in the abdomen.
Physical therapy. Monitored exercise can help with cancer-related fatigue and range of motion of the head and neck. These include “exercises to improve the function of the neck and of the mouth and of the tongue,” says Dr. Persky.
Massage therapy. Massage therapists help with the treatment of lymphedema, which is a swelling of the soft tissues due to the effects of the radiation and chemotherapy, says Dr. Persky.
Plastic or reconstructive surgery. Sometimes patients may need plastic or reconstructive surgery to rebuild bones or tissues. However, reconstructive surgery may not always be possible because of tissue damage from surgery or radiation. If reconstructive surgery is not possible, a prosthodontist may be able to make a prosthesis (an artificial dental and/or facial part) to restore swallowing, speech, and appearance.
“These are all things that are necessary and very important in maintaining the quality of life,” says Dr. Perksy.
Dr. Persky is an otolaryngologist and surgeon at NYU Langone Health in New York City.
00:00:01,720 --> 00:00:05,660
It's important to focus upon
rehabilitation in patients who
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are undergoing, or have undergone,
head and neck tumor treatment.
00:00:09,989 --> 00:00:14,980
00:00:14,980 --> 00:00:17,710
Surgery of the head and
neck may involve difficulty
00:00:17,710 --> 00:00:20,970
with moving the tongue with
articulation and swallowing.
00:00:20,970 --> 00:00:24,758
It may affect the ability to swallow
if throat muscles have been affected.
00:00:24,758 --> 00:00:28,157
It may affect the airway because
the swelling of the airway and
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the voice itself might be affected.
00:00:30,283 --> 00:00:35,160
So we integrate speech and language and
swallowing therapists in order
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to get the patient rehabilitated
during and after treatment.
00:00:40,260 --> 00:00:44,440
Radiation therapy often results in intense
inflammation of the oral cavity and
00:00:44,440 --> 00:00:47,420
of the throat,
which makes nutrition very difficult.
00:00:47,420 --> 00:00:51,920
Maintaining proper food intake,
caloric intake, protein intake, is very
00:00:51,920 --> 00:00:56,940
important to keep the patient's nutrition
adequate enough to withstand the treatment
00:00:56,940 --> 00:01:02,280
that they're undergoing as well to get
the patient rehabilitated after treatment.
00:01:02,280 --> 00:01:07,160
We have physical rehabilitation,
which is necessary as far as exercises
00:01:07,160 --> 00:01:11,660
to improve the function of the neck,
and of the mouth, and of the tongue.
00:01:11,660 --> 00:01:17,250
We have therapies to treat lymphedema,
which is a swelling of the soft tissues,
00:01:17,250 --> 00:01:20,390
because of the effects of
the radiation in chemotherapy.
00:01:20,390 --> 00:01:22,840
These are all things
that are necessary and
00:01:22,840 --> 00:01:25,580
very important to maintaining
the quality of life.
00:01:25,580 --> 00:01:29,903
And maintaining the ability to go through
the therapy at the time of treatment,
00:01:29,903 --> 00:01:32,031
as well as any of the after effects, and
00:01:32,031 --> 00:01:34,630
getting back to their
normal state of affairs.
00:01:34,630 --> 00:01:39,003
Head and neck cancers. Bethesda, MD: National Cancer Institute. (Accessed on March 29, 2019 at https://www.cancer.gov/types/head-and-neck/head-neck-fact-sheet.)
If you have head or neck cancer. Atlanta, GA: American Cancer Society, 2018. (Accessed on March 29, 2019 at https://www.cancer.org/cancer/oral-cavity-and-oropharyngeal-cancer/if-you-have-head-or-neck-cancer.html.)
Overview of the diagnosis and staging of head and neck cancer. Waltham, MA: UpToDate, 2019. (Accessed on March 29, 2019 at https://www.uptodate.com/contents/overview-of-the-diagnosis-and-staging-of-head-and-neck-cancer.)
Treating oral cavity and oropharyngeal cancer. Atlanta, GA: American Cancer Society. (Accessed on March 29, 2019 at https://www.cancer.org/cancer/oral-cavity-and-oropharyngeal-cancer/treating.html.)
Rehabilitation management of head and neck cancer. Rosemont, IL: American Academy of Physical Medicine and Rehabilitation, 2017. (Accessed on March 29, 2019 at https://now.aapmr.org/rehabilitation-management-of-head-and-neck-cancers)
A Comprehensive Review of Head and Neck Cancer Rehabilitation: Physical Therapy Perspectives. Mangalore, India: Srinivas College of Physiotherapy and Research Center, 2012. (Accessed on March 29, 2019 at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3477371)