Oncology Rehabilitation: An Integral Part of Integrative Care for Head and Neck Cancer Treatment

Head and neck cancers account for approximately 4% of all cancers diagnosed in the United States, according to the National Cancer Institute. In 2022, an estimated 66,470 people in the U.S. are expected to be diagnosed with head and neck cancer.

Surgery, radiation, and chemotherapy are common modes of treatment for head and neck cancers. These treatment options often impose on patients’ quality of life and leave patients to wonder what life after cancer may look like. Side effect management during and after head and neck cancer treatment is vital to maintain quality of life.

However, many times patients are unaware there are options to assist with their side effects.

As a speech-language pathologist (SLP) at Cancer Treatment Centers of America Atlanta, I am part of the Oncology Rehabilitation team, which includes physical therapists and occupational therapists, who are licensed and trained to assist patients with side effects of head and neck cancer treatment, support quality of life and help reduce the risk of treatment delays.

Our patients are sometimes surprised when they see rehab appointments on their schedule and say, “I can walk and talk — why do I need physical therapy and speech therapy?”

To answer this question, we explain that physical therapy can be beneficial to help manage the cancer-related fatigue that patients may begin to notice during radiation treatments. It is important that patients are physically active during treatment, but fatigue often makes it difficult to get up and move. Physical therapy can help break the fatigue cycle, increase shoulder and neck range of motion, and help patients regain arm function, which may be needed after head and neck surgery and/or radiation.

The American Head and Neck Society states that up to 75% of patients with head and neck cancer who have undergone surgery and/or radiation will have signs or symptoms of lymphedema. Lymphedema is secondary swelling caused by disruption to the drainage of the lymphatic system. Patients with head and neck who experience lymphedema often report having a “turkey neck”, or collection of fluid in their neck that they did not have prior to cancer treatment, and tightness with the swelling.

By working with a certified lymphedema therapist, who is an occupational or physical therapist specializing in lymphedema management, patients with head and neck lymphedema can get help with their symptoms. Lymphedema therapists will often teach patients techniques for manual lymphatic drainage and provide supportive tools, like compression garments, which patients can wear at night to help decrease fluid that accumulates when lying down.

Speech language pathologists (SLPs) are members of the oncology rehab team who assist patients experiencing difficulty swallowing (dysphagia), voice changes, loss of voice box, and changes in speech that can occur during and after head and neck cancer treatment. SLPs are trained to teach patients exercises to help maintain swallow muscle movement, which may be affected by surgery and/or radiation, and the ability to safely eat by mouth.

SLPs can also assist patients with changing their rate of speech to help improve intelligibility post head and neck surgery or even assist with learning new ways to communicate in cases where patients lose their voice boxes due to cancer.

Head and neck cancer treatments and the subsequent side effects can be overwhelming for patients and their caregivers due to the impact they have on routine activities. However, there are trained therapists who can help manage these side effects so they are not debilitating, which can enhance overall quality of life throughout the cancer journey. I encourage all patients to speak with their physicians to find out if oncology rehabilitation therapies may benefit them.

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