Speech Therapy for Head and Neck Cancer

Learn more about speech therapy for head and neck cancer at Memorial Hospital.


Why should patients who have head and neck cancers see a speech therapist before beginning treatments?

It's important for them to come in before they start any course of treatment, or if not before, even when they begin their treatment just to do an assessment, so we can see what their baseline is and how they're swallowing. We want to make sure that we can educate them and make sure they're aware of all of the changes that are going to occur with their swallow over the course of their treatment and possibly their speech as well. It's really important for them to come in before so we can give them an idea of what is going to go on so they are very well informed, and we can discuss any other questions that they might have.

What are some common issues that you help patients with?

We know that radiation really impacts the muscle tissue (the tissue surrounding the muscles) wherever they are being radiated. Often that will cause muscles to become fibrotic. They become really hard and just like a patient who is going through any kind of like physical therapy, if something hasn't been moved or if a muscle becomes stiff, it's not going to be able to do what it's supposed to. So just like muscles in your legs and your arms, your tiny muscles in your throat become stiff and fibrotic. They don't move, so your whole swallow is going to be thrown off. You're going to be at more risk of choking or aspirating, meaning something is going to go down into the wrong pipe, which is your lungs. That can make you very ill. Your taste buds and sense of smell are going to be altered. You're going to have weight loss. All of those things are what we want to educate and inform patients about so that they know they may not be able to swallow midway through. You may need a g-tube temporarily just to give them an idea so they don't just wake up one morning and go, "What has happened to me?" Hopefully, they can take what I give them and their families and say, "Okay, she talked about how this might happen, and here we are. We can do this."

How can you help patients who have had their voice boxes removed?

Those patients can see a speech therapist, and we can assist them with finding their voice again. We can offer them the use of an electrolarynx which is a little battery-operated device that a patient would put underneath their chin on their neck that would assist in producing some voice. Patients also may have a little voice prosthesis that is inserted in through their trachea which is your airway. It will go through your trachea into your esophagus and will assist with them producing speech as well. At Memorial, we can manage those voice prostheses. They can come in, and I can help assist them with any difficulty. I change them out when their devices begin to lose their effectiveness, and they can come in and get any kind of help that they need.

Can you share a patient success story?

I still do have this patient who came to one of our voice club meetings. She was being treated across the river, and she wasn't aware that we were actually doing the voice prosthesis changes here. So she switched over, and I really introduced her to many different aspects of the tracheoesophageal prosthesis that she has. For example, she wasn't using a little HME, which is something that you put inside of your stoma (the little hole that's created following a laryngectomy). She was doing a lot of coughing. She had a lot of secretions. She just couldn't figure out what was going on and why. Coming here, I was able to educate her. She came in for many, many visits, and we worked very closely. I explained to her the importance of wearing an HME device, and drastically her coughing just reduced. It improved really her whole quality of life. She didn't have to interrupt conversations with people. She could communicate on the phone again. She could talk without having to stop. She had no idea that was a benefit or even available to her. Things that she had been afraid of before in the past no longer scared her. She was able to really improve just her overall quality of life, and she's turned into actually a very good friend of mine.

Talk about the New Voice support group at Memorial.

It's four times a year. Patients are invited and their friends and family. This is a very small group of individuals who have gone through a total laryngectomy, so it's very important for them to come together just to be next to somebody who has experienced everything that they have. Many patients go through different changes in their body as they age, and there really aren't a lot of books that say, "Hey, this is what's going to happen." So they experience things on their own. It's important that other people are there, and they can just network and say, "Hey, I'm going through this. Did you experience this?" They can offer some advice and some assistance and help with anything that they may have or questions that they may be afraid to ask somebody else...maybe something that's uncomfortable, but they all understand. It's a family really.