Swallowing treatment post-cancer

Abigayl Petermann Elder Care

My patient sits down in my office. He tells me about his history of head/neck cancer, the radiation, and the surgeries that he went through many years ago. I look over his recent swallow study and see that his muscles aren’t moving, the food isn’t going where it’s supposed to go, and he’s been given a recommendation for a modified diet or even tube feeding.

I ask him when he last had speech therapy to address his swallowing impairments.

“I’ve never had speech therapy.”

This statement never fails to startle me, although I’ve heard it numerous times over the past 13 months that I have worked at Elder Care.

Head and neck cancer (HNC) treatment, which frequently involves radiation and/or surgeries impacting the swallowing musculature, often results in reduced swallowing function, if not immediately after the treatment, in the months (sometimes years) that follow. This is because of these treatments on the muscle tissues and fibers involved in the swallowing process.

Speech-language pathologists (SLPs) are skilled at addressing a wide variety of impairments related to communication, cognitive-linguistic skills, and yes— even swallowing. They are experts at swallowing anatomy and physiology.

Because of the frequency of swallowing difficulties following HNC treatment, speech-language pathologists should be a regular part of the patient’s follow-up care, monitor swallowing changes, and provide evidence-based treatments to improve swallowing function. There are several exercise regimens and treatments that can maximize what each patient can consume safely and efficiently, as well as several compensatory strategies that can make a difference in how the patient can swallow. These treatments typically require high commitment from the patient and dedication to the home program provided by the SLP.

At Elder Care, we strive to provide excellent care to these patients based on the most recent information available about treatments and exercises that have an evidence base to back up their potential for meaningful improvement. Unfortunately, the longer these impairments go without intervention, the more difficult it is to effect change; and sometimes, the difficulties become worse, resulting in recommendations for alternative nutrition. Therefore, it is of the utmost importance that any swallowing difficulties be immediately addressed by an SLP and a personalized treatment program.

If you or a loved one have been treated for HNC and are having trouble swallowing, seek a referral for a swallow study and a referral to a speech-language pathologist for treatment as soon as possible. Elder Care offers speech therapy to adults in the community and would be pleased to schedule an appointment for you at 918-766-0391.

— Abigayl Petermann is a Speech-Language Pathologist with Elder Care.