It takes a team: Addressing head and neck cancer symptoms
If you have head and neck cancer, you may be dealing with a number of unpleasant symptoms as a result of the disease itself and/or its treatments. An interdisciplinary care team can help you manage side effects and maintain your quality of life. In addition to your oncologists, clinical areas like the ones below can support you in various ways.
Speech and language pathology
Some side effects of head and neck cancer include xerostomia (dry mouth), mucositis (mouth sores or ulcers), dysphagia (difficulty swallowing), and trismus (restricted mouth opening). These can cause changes in taste, smell, appetite and speech.
A speech language pathologist can help with swallowing difficulties that may limit your ability to eat and drink safely, as well as speech production, vocal production and language needs, says Jennifer Cargile, a speech language pathologist at our hospital near Atlanta. Depending on what side effects you’re experiencing, this clinical area can provide:
- Treatment during radiation therapy to help ensure continued range of motion (ROM) of oral and pharyngeal structures to help prevent dysphagia.
- Treatment to rehabilitate the muscles of the swallow.
- Ways to modify textures of foods and liquids to help prevent aspiration (food and liquids going into the lungs).
- Treatment aimed at opening the jaw wider to allow for clearer speech and the ability to chew foods easier.
- Techniques to help improve communication with others.
During head and neck cancer treatment, you may experience difficulties with chewing and swallowing, as well as dry mouth, painful swallow and taste changes. Chemotherapy and radiation therapy can exacerbate these symptoms. “All of these symptoms combined, limit a patient’s ability to meet their nutrition goals. This can increase a patient’s risk of malnutrition and ultimately delay treatment,” says Sharon Day RD, CSO, CNSC, Director of Nutrition at our hospital near Phoenix.
A registered dietitian can evaluate your individual goals for calories/protein (kcals/pro) and discuss current and anticipated barriers to adequate nutrition, says Day. For head and neck cancer patients specifically, a dietitian may recommend:
- Soft and saucy foods for dry mouth and problems with swallowing or chewing.
- Smoothies or shakes that fit within your preferences while also meeting your goals for kcals/pro, if you can’t eat solid foods.
- Ways to enhance meal variety and flavoring to help achieve nutrition goals, if you have taste preferences.
- Alternative nutrition when the above recommendations are not adequate and continued medical therapies are anticipated.
Naturopathic medicine may help reduce side effects like taste changes, dry mouth, and GI tract inflammation, and help you maintain your appetite and energy levels during and after head and neck cancer treatment. A naturopathic clinician may use the following evidence-based tools to help prevent and reduce the severity of radiation and chemotherapy-induced mucositis: L-glutamine powder, turmeric extract (Curcuma longa), honey, vitamins, minerals and other soothing and demulcent botanicals.
“These botanicals and supplements can help to enhance the protective layer of the GI tract; alleviate irritation of the mouth, esophagus and stomach; prevent and reduce radiation-induced mucositis; and treat and prevent nutrient deficiencies while undergoing cancer treatment,” says Summer Baptist, ND, LAc, naturopathic oncology provider at our Georgia hospital.
The physical side effects/impairments associated with head and neck cancer can impact every aspect of your life, including eating, talking, and even the ability to smile or laugh out loud. As a result, the disease can pose significant emotional and psychological challenges. Many people grieve the loss of health and of what was normal.
Due to the visible nature of some side effects, like radiation burns, disfigurement or loss of teeth, low self-esteem is common. Those who need a feeding tube because of swallowing difficulties may fear that it’s the beginning of the end. If a tracheotomy is placed and breathing is impaired, it can increase fears and anxiety. If a person loses part or all of their voice, communication barriers can lead to depression.
In fact, one of the most significant consequences of the disease is decreased socialization, says David Wakefield, Ph.D., a mind-body therapist at our hospital in Tulsa. “When people go through a crisis the number one predictor in how well an individual will make it through a crisis is directly related to how much social support they have,” he says.
A mind-body therapist, such as a clinical psychologist, can help you deal with these issues, says Dr. Wakefield. Some mind-body medicine interventions for head and neck cancer patients include:
- Counseling and support groups to deal with adjustment issues and improve coping skills.
- Cognitive restructuring to help you re-frame life or see life from another perspective.
- Emotions management to deal with all of the emotions related to the grieving process.
- Deep breathing or breathing exercises.
- Visualizations, guided image, relaxation skills and meditation to help reduce stress and tension.
- Yoga, Qi Gong and stretching.
- Humor therapy or renting funny movies.
It takes a team
The symptoms of head and neck cancer can challenge all aspects of daily life. Symptoms are also interrelated, and ignoring one can worsen others or cause more to appear. An interdisciplinary care team is essential to addressing the various dimensions of the disease so you can maintain your quality of life. Remember to keep your health care team informed about any new symptoms you notice, or if symptoms persist.