World Head And Neck Cancer Day 2023: Role Of Speech And Swallow Therapy Before And After Treatment
Patients undergoing treatment for head and neck cancer often experience physical and functional impairments including speech and swallow disability, that significantly impact their quality of life.
World Head And Neck Cancer Day is observed on 27 July every year
Head and neck cancer (HNC) is a type of tumour that affects the tongue, mouth, salivary glands, throat, sinuses, pharynx and larynx. These cancers pose a significant burden on our country, constituting around one-third of all cancer cases. While the primary causes of HNC in India include tobacco and alcohol consumption, other factors like smokeless tobacco products along with certain viruses and infections, also contribute to the high disease burden and increased number of patients requiring treatment.
The condition also leads to serious difficulties, including the loss of facial structure and functional disabilities. Additionally, patients undergoing treatment for head and neck cancer often experience physical and functional impairments including speech and swallow disability, that significantly impact their quality of life. In such cases, speech and swallow therapies play vital roles in supporting patients before and after their cancer treatment. Despite the multidisciplinary treatment approach for HNC, including surgery, radiation therapy, chemotherapy, and immunotherapy, other non-direct and less-invasive treatment methods, such as speech and swallow therapy, are often overlooked. These therapies aim to improve functional abilities, address physical limitations and enhance overall well-being.
Understanding what speech and swallow therapy is:
Head and neck cancer can affect the nose, lips, jaw, tongue, larynx, oral cavity and various other parts in this region based on the location of the tumour. The treatment for these tumours, surgical, chemotherapy and radiation therapy, results in temporary or permanent speech and swallow impairment. Radiation therapy is the most common type of treatment for head and neck cancer and can have adverse effects on the various organs near the tumour. Therefore, speech and swallow therapy must be provided to the patient at all stages of treatment to prevent serious damage to speech and swallow activities. However, in the case of surgical treatment, speech and swallow therapy may start a few days post-operation depending on the severity of the cancer and hospital norms.
A speech therapist evaluates the condition of the patient and remaining functioning to identify the damage caused and provide the appropriate therapy. The main objective of a speech therapist is to restore the ability to swallow. The therapy begins with the rehabilitation of swallowing. During the process of treatment, patients are fed using a feeding pipe. However, post-treatment, they may face difficulty in chewing and swallowing. As a part of therapy, the therapist prescribes the appropriate consistency of food which may not harm or cause difficulty to the patient followed by exercises to improve the functioning.
In the case of vocal rehabilitation, speech therapy focuses on improving the ability to communicate. In some cases, the larynx (voice box) of a patient is entirely removed resulting in loss of ability to speak after surgery. Therefore, pre-surgery, a speech therapist works for the re-establishment of communication by guiding to lift self-esteem and re-socialize. Speech therapy also presents methods to restore speech after surgery and provide necessary assistance and appropriate aids. This therapy completely depends on the severity of the cancer.
The role of speech and swallow therapy before and after head and neck cancer treatment is instrumental in enhancing patients' quality of life and promoting a smoother recovery process. Through personalized interventions, these therapies help patients regain functional abilities, manage pain, and address difficulties. Moreover, the emotional and psychological support provided by therapists contributes significantly to patients' overall well-being. By recognizing and incorporating the importance of speech and swallowing therapy in head and neck cancer care, we can empower patients to achieve optimal recovery and improve their quality of life during and after treatment.
(Dr. K. K. Handa, Chairman - ENT and Head Neck Surgery, Medanta, Gurugram)
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