What to Expect During and After Radiation Treatment for Head and Neck Cancer
While this list is not exhaustive, it does present some of the more common side effects individuals experience when participating in radiation and chemotherapies for head and neck cancer. If you or a loved one is experiencing these side effects, communicate with your physicians and other multidisciplinary team members as quickly as possible to prevent exacerbation and severity.
Xerostomia
or dry mouth occurs due to participation in radiation therapy. Saliva helps with chewing and swallowing, washes away oral debris, prevents bacteria build up in the mouth, and assists with immune system support. Xerostomia can cause pain, increased difficulty chewing and swallowing, increased prevalence of oral infection, cracked or sore lips/tongue, and thrush (yeast infection of the mouth).
If experiencing dry mouth, try:
- Small frequent sips of water throughout the day
- Moist foods
- Cut foods into small pieces
- Add sauces, gravies, and dressings
- Increase frequency of oral care daily
- Limit caffeine and alcohol consumption
- Consider using products like Biotene or Xylimelts
Oral Mucositis
is characterized by painful inflammation and ulceration of the mucosal lining of the mouth. OM can be represented by a burning sensation in the mouth and be very painful.
If experiencing mucositis, try:
- Using straws
- Warmer foods
- Avoid foods with sharp edges or rough textures that could irritate the skin inside the mouth and throat
Trismus
Or reduced jaw opening can occur as radiation causes changes to the muscles involved in chewing and temporomandibular joint (TMJ) function. Trismus can cause increased difficulty chewing, swallowing, performing oral hygiene, and generating speech. Stretches and exercises can help address and treat trismus during and after cancer treatments. Consult your speech-language pathologist to determine what exercises may help prevent the onset of trismus
Dysphagia
Or swallowing problems can occur because of a tumor location or as a result of participation in cancer treatment. Surgical reconstruction can also result in swallowing problems. Swallowing problems can appear suddenly or gradually. Cancer treatments may reduce swallowing sensations, preventing patients from recognizing that foods or liquids are not being consumed correctly. It is essential for caregivers to immediately notify an SLP or physician when they notice weight loss, choking, coughing, pocketing of food in cheeks, nasal regurgitation, excessive chewing, or a wet or gurgling voice after or during eating or drinking.
Changes in taste
or dysgeusia can occur due to participation in radiation and chemotherapies. It can happen gradually and cause foods to taste metal-like, chalk-like, burn the inside of the mouth, or taste bad. If experiencing these symptoms when eating, try:
- Avoiding using metal utensils; try plastic instead
- Adding increased seasoning like salt, sugar, or sour
- Foods at colder or hotter temperatures
- Omit spicy or sour flavors
Weight Loss
As an individual progresses through radiation therapy, swallowing may become so painful that obtaining enough calories to sustain global functioning may not be possible. Depending on specific treatment plans and physician preference, an individual undergoing radiation treatment may need to utilize a feeding tube to prevent malnutrition, dehydration, and disruption in radiation treatment. While participating in radiation therapy, working with a nutritionist who can assist with managing caloric intake to prevent weight loss is imperative. Regardless of whether or not an individual has a feeding tube placed, patients must continue to eat and drink as much as possible by mouth to prevent disuse atrophy to the swallowing musculature.
Current research recommends head and neck cancer patients see a speech language pathologist before, during, and after treatment. Contact our office today if your loved one has received a head and neck cancer diagnosis.
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