If you’ve been diagnosed with head or neck cancer, your treatment plan will likely include speech therapy exercises. While speech therapy may seem like a nuisance, it’s important for your long-term health and quality of life, says Holly Hess, a speech and language pathologist at UVA.
If you have surgery or undergo radiation and/or chemotherapy, you may not be able to eat or feel like eating for a few weeks. This can cause muscles in your throat, neck and jaw to become weak and stiff. And if you don’t use these muscles often, you’ll start to lose muscle function. Speech therapy exercises help cancer patients regain and improve the function of these muscles and help with this side effect of cancer treatment.
What to Expect from Speech Therapy
Hess spends the bulk of the first meeting just listening to the patient’s concerns and talking about treatment and its side effects. Some patients find that they cough or choke when they try to swallow. Others notice it takes longer than usual to eat a meal, while others complain that it hurts when they eat or speak, that their jaw feels stiff or that their voice just sounds different. Then, Hess examines the patient and develops a plan to move forward.
“I’ll examine their mouth and listen to their voice and speech. Then, particularly if [problems] relate to swallowing, I’ll ask patients to eat and drink during the visit to assess how that works for them,” she says. Treatment plans will vary depending on each patient’s medical history and symptoms. “I may give them maneuvers that help them swallow more easily, more comfortably or more quickly,” says Hess.
Typically, you’ll see your speech therapist within the first month of diagnosis and treatment. “The standard is to try and see patients at the time when it’s going to help them the most, depending on their treatment,” she says. “They may have one visit during chemotherapy [or] radiation. They may only come in once during that period,” says Hess.
What are Speech Therapy Exercises?
Most speech therapy exercises are pretty simple and easy to learn. “They take about five to 10 minutes, and you do them three to four times a day,” she says. The repetition is important.
Hess says that while patients can expect to lose some function while they go through treatment, therapists expect patients to regain that function as they recover. The overall goal of speech and swallow therapy is to help patients maintain as much function as possible to reduce the impact of the side effects of the cancer treatment.
There are several different types of exercises. One typical swallowing exercise Hess prescribes is an effortful swallow. Using a little bit of water or melting ice chips, Hess coaches her patients to swallow with as much effort as possible. Patients repeat this 10 to 20 times, two to four times a day.
To help strengthen the tongue, Hess has patients place the tip of their tongue between their front teeth or gums and, with their mouth closed, try to swallow. Another exercise involves lying on your back on the floor and reaching your head up to look at your toes. “This strengthens the muscles under the mouth that … help pull open the sphincter in the esophagus,” says Hess.
She also recommends patient support groups, such as the Second Wind, Head & Neck Cancer Support Group, which “helps patients realize that there are other people fighting this fight too,” Hess says.
If you’ve been diagnosed with head or neck cancer, talk to your doctor about speech therapy options available to you.
Every year, UVA Cancer Center treats more than 200 new patients with head and neck cancer. Voice and swallowing therapy is just one of the many resources available.Learn More