Head and neck cancers can lead to speech and voice problems and to difficulties with swallowing, eating and drinking. As part of the multi-disciplinary team supporting people with head and neck cancer, speech and language therapists (SLTs) play a crucial role in supporting people’s rehabilitation and end-of-life care. This includes helping people to communicate and to eat and drink safely
The Impact Of Head And Neck Cancer On Communication And Swallowing
Head and neck cancer is used to describe a range of tumors that occur in cavities and glands across the head and neck. They can lead to problems with communication and swallowing before, during and after treatment. Treatments for these cancers may include surgery to remove structures essential for functions (e.g. voice box - a laryngectomy), radiotherapy, chemoradiotherapy or a combination of treatments. These commonly affect a person’s ability to speak, use their voice, swallow, smell and breathe, significantly affecting quality of life. Left unsupported, these difficulties can also affect a person’s ability to participate in social activities and to return to work.
The Role Of Speech And Language Therapists
Speech and language therapists play a unique and essential role in assessing, diagnosing and managing communication,
speech, voice and swallowing problems resulting from head and neck cancer. They work in close partnership with the
patient, their families and other members of the multi-disciplinary team and, as part of this, they:
• Assess and provide patients and their families with information regarding the potential impact of treatment on their
functioning and assist in multi-disciplinary team treatment decision-making
• Provide pre-treatment strategies to reduce the impact of radiotherapy on swallowing
• Help develop and support the communication skills of both the patient and communicative partners
• Assess and provide therapy for speech and voice changes following treatment
• Lead responsibility for the decision-making process of selection of prosthesis, care and management in Surgical Voice
Restoration (SVR) service post laryngectomy
• Identify and treat swallowing difficulties, using highly specialist assessment techniques, and manage the associated
risks of persistent swallowing problems
• Contribute to palliative and end-of-life care, maximizing and facilitating communication and managing swallowing
problems, promoting quality of life
This has a range of benefits:
Promoting Positive Outcomes – Speech and language therapy intervention places the health and safety of patients at the forefront, through the diagnosis and management of swallowing difficulties, reducing the severity of side effects, while facilitating optimal communication, encouraging patients to achieve their full potential.
Reducing Negative Outcomes – Speech and language therapy intervention can reduce medical complications such as aspiration pneumonia; reduce hospital admissions and bed days through timely assessment and management of swallowing problems. Speech and language therapy can reduce isolation and distress by maximizing communication effectiveness.
Speech and language therapists are involved in all stages of the patient care pathway:
• Pre-diagnosis
• Diagnosis and care planning
• Treatment
• Post-treatment
• Monitoring and survivorship
• Palliative care