Learning About Speech and Swallowing Problems After Cancer Treatments

How can cancer treatments affect speech and swallowing?

Cancer treatment to the head and neck can cause some uncomfortable side effects. Chemotherapy or radiation of the head or neck can affect how well you can swallow or speak. The effects are more common in the days and weeks after treatment. But sometimes these changes can be permanent.

Surgery for head or neck cancer may also cause long-term changes in the way you eat, drink, and speak.

Cancer treatments can affect your sense of taste, which can make eating difficult. You may get a dry mouth, a cough, or a sore and swollen throat.

If you have chemotherapy or radiation, you may have other side effects that can affect how you speak and eat. These side effects can be mild or severe. They include:

• Swelling and redness in the lining of the mouth (stomatitis).
• A yeast infection in the mouth (thrush or candida).
• Tightness of the jaw.

If the side effects are so severe that you can't eat, you can get nutrients through a feeding tube. And speech therapy or special exercises or equipment can help if you're having trouble with your tongue or vocal cords.

Coping with side effects can be a challenge. But there are many things you can do at home to make your mouth and throat feel better.

What can you do if you have trouble swallowing or eating?

• Try to think of food as medicine. It's part of your treatment. You need plenty of calories and protein to get better.
• Try soft foods like cooked cereals, scrambled eggs, cottage cheese, or even baby food, which comes in many flavors. In general, soft, moist foods are easiest to swallow.
• Eat small meals and snacks throughout the day. And try thicker liquids. They are easier to swallow than thin liquids.
• Get extra protein by adding protein powder to milkshakes, breakfast drinks, or nutritional drinks.
• Stay away from spicy or acidic foods like citrus fruit. And don't eat anything too cold or too hot.
• If your symptoms are severe and you are losing weight, your doctor may have you work with a registered dietitian. A dietitian may suggest new eating strategies, supplements, a feeding tube, or I.V. nutrition.

What are some other tips to try?

• Ask your doctor if you can use a mouth rinse. The doctor may recommend that you make a rinse with 1/4 teaspoon baking soda, 1/8 teaspoon salt, and 1 cup of warm water. Use it to rinse your mouth 4 to 6 times each day. Spit out the rinse. Don't swallow it.
• Do not use a mouthwash or any other over-the-counter rinse that contains alcohol. These can dry out your mouth or cause more pain. Ask your doctor about other oral gels, lubricants, and mouthwashes that you might use.
• Drink plenty of fluids to prevent dehydration. Drinking through a straw may help with pain.
• Practice good oral hygiene. Use a very soft toothbrush to brush your teeth. You could also use a soft cloth. When your mouth is dry, you are more likely to get tooth decay or have other dental problems.

What happens if you have trouble speaking?

If you need surgery on your tongue or other parts of your mouth, such as removing lymph nodes or tumors, you may have trouble speaking. For some people, this is temporary. But for others, it can be permanent.

Surgery on your voice box or vocal cords can change the sound of your voice and make it hard to communicate. You may need to use an assistive device to speak after the surgery. Or you can learn a different way to communicate.

If you need a breathing tube after surgery, you will also learn how to speak with the tube in. You may need to use a special device to make sounds.

Your doctor or speech therapist may give you exercises to do at home. These exercises train your muscles to work together and help you swallow and speak more clearly. A speech therapist can also show you how to use equipment that may allow you to speak again.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and contact your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.