Do You Have Difficulty Swallowing After Surgery?
Depending on the surgery required for your head and neck cancer, swallowing difficulties may follow, either from swelling or due to the structural changes that result from the surgery. The medical term for this is called dysphagia, and the severity and duration varies from person to person in relation to their specific surgery. Some may have trouble containing or transporting solids or liquids through their oral cavity. Others may have difficulty with clearing the food and liquid through their throat without having it enter the airway. If food or liquid enters the airway this is called aspiration. There are some people with dysphagia who cannot swallow at all. Over time, dysphagia can lead to weight loss and chest infections.
Your doctor may refer you to a speech-language pathologist (SLP) if you experience trouble swallowing after your cancer treatment. A speech-language pathologist can professionally assess, treat and guide you through the recovery process. The cancer treatments that typically lead to dysphagia involve surgeries that remove structures vital to swallowing and airway protection, radiation that impacts the throat muscles’ ability to effectively contract, or chemotherapy. The severity of dysphagia can range, so your SLP will first determine which stage of swallowing is affected (oral phase, pharyngeal phase, or esophageal phase) before providing you with treatment options.
The assessment process with your SLP will determine your individualized rehabilitation plan based on your personal obstacles. Based on the severity of your dysphagia, your SLP will develop a rehabilitation program that consists of strategies to compensate for the deficits, these may consist of postural changes, compensatory strategies or diet changes to maximize the safety and efficiency of your ability to maintain oral intake. Additionally, your SLP will also provide you with rehabilitation exercises to stretch and strengthen the muscles of the swallowing mechanism that were affected in your head and neck cancer treatment. With new techniques and exercises you are retraining yourself to swallow safely and efficiently.
Some swallowing problems may require medical intervention, like an esophageal dilation. This is sometimes required when structures that normally allow food into the esophagus are impaired. During this process, the doctor may gently insert a balloon into the throat to expand the esophagus. In other cases, devices with different sizes may be used to gradually widen the throat. If that is not an option, surgery or medication are also possible treatment options.
As a last resort, feeding tubes placed into the stomach are an option for severe dysphagia, as well as additional surgeries based on the cause of the individual’s swallowing difficulties. If you or a loved one are looking into rehabilitation after head and neck cancer treatment, read more about speech and swallow therapy from our collection of resources.
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