Head & Neck

Survivorship

The areas affected by head and neck cancer are responsible for some of the most vital functions you do every day, such as breathe, eat, drink, swallow and communicate. The treatment also can alter your appearance which, in turn, affects feelings about self-image and confidence. Although the goal is to control the head and neck cancer, your health care team works hard to preserve as much function of these affected areas as possible so that you can return to normal activities after treatment.

Rehabilitation

Rehabilitation is a key part of the treatment process. Depending on the location of the cancer and the type of treatment, rehabilitation may include physical therapy, dietary counseling, speech therapy, and/or learning how to care for a stoma. A stoma is an opening into the windpipe through which a patient breathes after a laryngectomy (surgery to remove the larynx).

You may need reconstructive and plastic surgery to rebuild bones or tissues (see Reconstruction). Reconstructive surgery may not always be possible because of damage to the remaining tissue from the original surgery or from radiation therapy. In that case, a prosthodontist may be able to make a prosthesis (an artificial dental and/or facial part) to restore satisfactory swallowing, speech and appearance. When a prosthesis is necessary, special training on how to use it is given.

If you have difficulty speaking after treatment, you may need speech therapy. A speech-language pathologist likely will visit you in the hospital. Speech therapy usually continues after you leave the hospital.

To help you eat after treatment, you may receive nutrients directly into a vein after surgery or through a feeding tube until you can eat on your own. If you have difficulty swallowing after surgery, a nurse or speech-language pathologist can help you learn how to swallow again.

Follow-up care

People who have been treated for head and neck cancers have an increased chance of a new cancer developing, usually in the head, neck, esophagus or lungs. Regular follow-up care is essential after treatment to make sure that the cancer has not returned, or that a second primary (new) cancer has not developed. Excessive alcohol use and smoking are risk factors for head and neck cancers, so your doctor will likely encourage you to quit these habits to decrease your chances of developing a new cancer.

Depending on the type of cancer you have, medical checkups may include exams of the stoma (if you have one) and of the mouth, neck and throat. Regular dental exams may also be necessary. Your doctor may perform a complete physical exam, blood tests, X-rays, and computed tomography (CT), positron emission tomography (PET) or magnetic resonance imaging (MRI). If you have a history of smoking, talk to your doctor about whether to have an annual lung cancer screening.

Your doctor may monitor thyroid and pituitary gland function, especially if you received radiation therapy.

Getting and staying healthy

For many people, surviving cancer is an incentive to live a healthy lifestyle. People recovering from head and neck cancer are encouraged to follow established guidelines for good health, such as not smoking, limiting alcohol, eating well and managing stress. Regular physical activity can help rebuild your strength and energy level. Your health care team can help you create an appropriate exercise plan based on your needs, physical abilities and fitness level. A healthy lifestyle after a head and neck cancer diagnosis can reduce symptoms and improve quality of life, and may help lower the risk of some cancers.

Tips for a healthy lifestyle:

  • Get to and stay at a healthy weight.
  • If you have eating problems or face any other challenges to good nutrition, talk to your doctor or ask for a referral to a registered dietician.
  • Aim for at least 150 minutes of physical activity every week, with a doctor’s approval.
  • Avoid tobacco and smokeless tobacco products. Research has shown that continued smoking and use of smokeless tobacco by a person with head and neck cancer may reduce the effectiveness of treatment and may increase the chance of a second primary cancer.
  • Anxiety or depression is common in survivors of head and neck cancer. Tell your doctor if you have ongoing feelings of sadness or distress.
  • Avoid alcohol, including mouthwash containing alcohol.
  • Maintain oral health by taking good care of teeth and dentures.
 

Understanding Survivorship

“Survivorship” means different things to different people. For some, survivorship begins with a cancer diagnosis and includes the entire process of living with, through and beyond cancer. For others, they may not consider themselves a “survivor” until after they finish treatment and are declared cancer free.

No matter how you define survivorship, it’s important to realize it can be one of the most complex aspects of the cancer experience. And, like many aspects of cancer, it is different for every person. Survivors may experience a mixture of strong feelings, including joy, concern, relief, guilt and fear.

Some people say they appreciate life more after a cancer diagnosis and have gained a greater acceptance of themselves. Others become stressed because they have become accustomed to their routine of health care visits and find it challenging to cope with everyday life. Often, relationships built with the cancer care team provide a sense of security during treatment, and people miss this source of support. This may be especially true as new worries and challenges surface over time, such as any late effects of treatment, emotional challenges including fear of recurrence, sexuality and fertility concerns, and financial and workplace issues.

Every survivor has individual concerns and challenges, and it helps to prepare with a good coping strategy. Here are a few tips:

  • Recognize your fears and talk about them with a member of your health care team or a support group.
  • Understand the challenge you are facing.
  • Think through solutions.
  • Ask for and accept the support of others.
  • Feel comfortable with the course of action you choose.

 

 

Additional Resources

 

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