Head and Neck Cancer: Will It Affect My Cognition and Ability to Chew and Swallow?

Head and Neck Cancer: Will It Affect My Cognition and Ability to Chew and Swallow?

Content derived from articles from Sohi Oh, MA, CCC-SLP & Erin Hawes, MA, CCC-SLP

Head and neck cancer is a broad term used to refer to cancers in the head/neck region of the body and typically include cancer of the mouth, throat, voice box, and nose. Head and neck cancer accounts for approximately 3% of all cancers annually and is often treated with radiation therapy, surgery, or chemotherapy and may be combined with other therapies and rehabilitation services including speech therapy. While in many cases of head and neck cancer people are still able to speak, speech-language pathologists (SLP) provide services addressing many other symptoms that may appear for those with head and neck cancer.

A speech-language pathologist may help those with these head and neck cancer symptoms including:

  • Changes in learning or memory        
  • Difficulty paying attention     
  • Changes in mental skills like planning, decision-making or juggling more than one task
  • Changes in how quickly you process information
  • Voice changes or hoarseness             
  • Trouble swallowing
  • Coughing or choking on food or liquid
  • Feeling that something is stuck in the throat after eating
  • Pain when swallowing

Head and Neck Cancer and Cognitive Changes
Cancer-related cognitive impairment (CRCI) is experienced by many cancer patients and can include changes in someone’s ability to learn new things, create and maintain memories, and even slow the speed of understanding information. These skills affect our ability to carry out our daily activities each day including prioritizing tasks, finding our way to locations in our city, or even remembering appointments or commitments with friends and family. Recent studies found that up to 30% of patients show signs of CRCI before any cancer treatment, 70% of patients display symptoms during treatment and up to 35% display symptoms after treatment. While these may get better after completing cancer treatment, some patients show lasting cognitive changes even after completing treatment.

There is help for patients experiencing lasting CRCI. Speech-language pathologists are experienced in the assessment and treatment of CRCI and other cognitive-communication disorders. The outpatient therapy team at VMC can provide personalized treatment to improve these important mental skills and quality of life.

Head and Neck Cancer and Chewing/Swallowing Abilities
As mentioned above, chemotherapy and radiation are treatments used successfully to improve recovery in head and neck cancers. However, these treatments sometimes affect chewing and swallowing abilities, referred to as dysphagia. It is estimated that 50-60% of head and neck cancer patients will experience some type of dysphagia and its effects may arise or continue to worsen even after treatment is complete. Chemoradiation may cause dry mouth, pain when swallowing, difficulty swallowing, and changes in taste (and sometimes food preferences). These changes in movement, as well as possible weakness and numbness in swallowing muscles may cause aspiration, meaning food or drink may travel up to, or into, the airway and lungs. Most importantly, the person may be unaware that food and drink are entering the airway due to weakness and loss of feeling in the mouth and throat. Aspiration places an already medically fragile person at high risk for pneumonia and further illness. Seeking speech therapy for dysphagia is very important to improving safety for recovering patients.

Recent evidence suggests that taking part in swallowing therapy with a SLP before starting cancer treatment or during chemoradiation can play an important role in keeping swallowing skills and improving quality of life for those with head and neck cancer. Patients who participate in preventive speech therapy services show: less time needing a feeding tube, greater likelihood that swallowing muscle mass and motion will be maintained, and an easier return to pre-radiation swallowing abilities.

For more information about speech-language therapy services to treat symptoms of head and neck cancer and treatment, visit valleymed.org/rehab or call 425. 690.3650

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