The Importance of Rehabilitation During Head and Neck Cancer 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:

• Pain

• Difficulty chewing

• Decreased sense of taste

• Sticky saliva

• Loss of voice

• Reduced mouth opening

• Speech dysfunction

• Neuropathy

• Neck and shoulder dysfunction

• Everyday functioning

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.

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