Rehabilitation is Vital After Surgery for Head and Neck Cancer
Head and Neck Rehabilitation
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Following surgery for cancer of the oral cavity, pharynx (throat) or other parts of the head and neck region, comprehensive rehabilitation is critical. This includes speech therapy, swallowing rehabilitation and dental and maxillofacial rehabilitation. In addition, most patients also need physical therapy, based on a carefully designed program at a cancer center or other facility with professionals trained in cancer rehabilitation.
Physiatrists at Philadelphia's Fox Chase Cancer Center follow specialized guidelines for head and neck cancer patients that help many reach their full potential after surgery. A physiatrist is a doctor who specializes in physical medicine and rehabilitation.
Appropriate rehabilitation can prevent many problems. These include a partially locked jaw, restricted neck movement and shoulder dysfunction on the side of the surgery. Such functional impairments severely limit a patient's ability to participate in daily activities, including work and hobbies.
A Tailored Rehabilitation Plan
Your individual rehabilitation plan starts with an evaluation by a skilled physiatrist as well as highly trained speech and physical therapists. Before surgery, the physiatrist reviews the surgical plan with your surgeon to discuss any possible side effects with you.
The rehabilitation team becomes fully aware of any neuromusculoskeletal (of the nervous and muscular systems) problems that exist before surgery. For example, arthritis or bursitis might make rehabilitation more challenging. With this information, the team is able to develop appropriate strategies that focus on reducing pain, restoring impaired functions and preventing future complications that might occur if muscle or scar tissue is formed.
Working to Improve Function
What is Dysphagia?
Dysphagia is when a person is having difficulty swallowing. Some examples of symptoms of dysphagia: difficulty moving food from the mouth to the throat, difficulty chewing, frequent coughing when eating, slow eating or difficulty consuming normal sized meals, foods sticking in throat, choking or near choking, and/or regurgitation. Dysphagia can lead to weight loss and even pneumonia and should be evaluated promptly. Dysphagia is often a side effect of most types of head and neck cancer treatments.
What is Trismus?
Trismus is when a person is unable to fully open their mouth. Surgery to certain parts of the mouth and/or radiation to the head and neck can lead to trismus. This type of dysfunction can get worse with time and therapy is important to prevent complications.
What is Dysphonia?
Dysphonia describes a change in voice quality that is abnormal such as hoarseness, strain, or breathiness. This type of dysfunction can occur as a result of surgery or radiation to the voice box, neck or chest (sometimes used to treat thyroid cancer, larynx cancer or lung cancer).
During surgery to remove the tumor, many patients undergo reconstructive, or plastic, surgery as part of the same operation. At cancer centers such as Fox Chase, expert doctors in reconstruction are a key part of your surgical team. These procedures involve taking skin and/or muscle grafts from the shoulder girdle region, or possibly additional grafts, including bone, from an arm or leg to reconstruct a facial or neck structure.
Restoring mobility is almost always necessary after head or neck surgery. This is because removing lymph nodes, soft tissue and muscle from that area may affect the spinal accessory nerve, which controls the trapezius muscle. This muscle makes it possible to raise the head and shoulders.
Special exercises and head and neck cancer go hand in hand. Proper rehabilitation can improve function by stretching tightened muscles and by strengthening muscles. The same applies to range of motion of the neck, which can be lost if the healing tissues grow tight. Massage techniques to prevent scar tissue from limiting movement are also valuable.
Fox Chase Cancer Center physiatrists work closely with the rest of your head and neck cancer treatment team and if needed, Fox Chase's Pain and Palliative Care Program and social work services. Their goal is to ensure you have adequate pain control and emotional support. With good follow-up and the wide range of techniques available at Fox Chase, there is no reason for patients to live with uncontrolled pain. In addition, our social workers offer counseling for addiction, a problem affecting many patients with head and neck cancer.
For more information about head and neck cancer treatment and rehabilitation at Fox Chase Cancer Center or to make an appointment, call 1-888-FOX CHASE (1-888-369-2427).