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At NYU Langone’s Perlmutter Cancer Center, physicians, nurses, physician assistants, social workers, speech and swallowing therapists, and other rehabilitation specialists collaborate to provide support for people with laryngeal cancer throughout diagnosis and treatment and during follow-up appointments.
Doctors may see you every month during the first year after treatment, every 2 months during the second year, every 3 months during the third year, and every 6 to 12 months in the fourth and fifth years. During these appointments, your doctor may perform a physical exam, laryngoscopy, and imaging tests, such as CT or PET scans, to ensure the cancer has not returned.
Speech and Swallowing Therapy
Speech and swallowing therapists at NYU Langone may meet with you before treatment begins to evaluate how a laryngeal tumor is affecting your voice—the sound produced by your vocal cords—and your ability to swallow food and liquid. They may also discuss how different treatments can affect voice and swallowing function and how therapy can help you recover.
Speech and swallowing therapy may be used throughout treatment to preserve as much function as possible. It may also be used after treatment to help you regain or compensate for any lost function.
NYU Langone therapists can teach you exercises to strengthen the muscles in the tongue, mouth, and throat to help improve speech and swallowing. They can also help people who have had their entire larynx removed adapt to a variety of voice restoration options.
Rehabilitation for Muscle Stiffness
After you are evaluated by a physiatrist—a doctor who specializes in rehabilitation medicine—he or she can prescribe physical therapy at Rusk Rehabilitation. Therapy may involve range-of-motion exercises, stretches, and relaxation techniques.
Radiation therapy may cause thickening of the skin and soft tissues, or fibrosis. Physical therapists can relieve discomfort with myofascial release, a hands-on technique that involves manipulating and applying pressure to jaw and facial tissues to loosen them and improve range of motion.
If stiffness and fibrosis are interfering with your daily activities, your doctor can prescribe occupational therapy to help you regain your ability to perform everyday tasks independently, such as dressing, cooking, shopping, and working.
Surgery for advanced laryngeal cancer may include the removal of lymph nodes, which may affect lymph vessels in the neck. Radiation therapy may also affect these vessels. They carry lymph fluid, which contains bacteria and waste products, away from the body’s organs and tissues. Changes to these vessels can cause lymph fluid to build up, which can lead to swelling, stiffness, reduced range of motion, and discomfort in the face and neck. This condition is called lymphedema.
A physiatrist can evaluate you for the early signs of the condition and educate you on early symptoms such as stiffness, aching, tingling, or a feeling of fullness in the neck and face. The sooner treatment starts, the more likely the condition is to be controlled.
If you notice any symptoms, the physiatrist evaluates you, then prescribes physical therapy at Rusk Rehabilitation. Physical therapy includes range-of-motion and flexibility exercises, in conjunction with specialized massage therapy to help drain lymph fluid. You can also be taught how to manage this condition to prevent a recurrence.
Radiation therapy for laryngeal cancer sometimes causes dry mouth, which can result in tooth decay. For this reason, your doctor may recommend that you see an NYU Langone dentist regularly—before, during, and after treatment. Regular toothbrushing and flossing, daily fluoride treatment, mouthwash use, and frequent dental check-ups can help prevent these complications.
If laryngeal cancer or its treatment makes swallowing difficult, you may need a nutritional assessment and dietary plan.
Nutritionists at Perlmutter Cancer Center can help ensure you are getting the nutrients you need by recommending easy-to-swallow foods throughout your treatment and recovery. They can also explain which foods might irritate your mouth and throat and recommend dietary changes to ease dry mouth.
During or after treatment, some people may not be able to eat regularly for several weeks. For this reason, doctors may recommend placing a feeding tube directly into the stomach or intestine.
This tube, which is placed through a small incision in the abdomen, helps ensure that you receive adequate hydration and liquid nutrition. It is used in the hospital and at home as you recover. The feeding tube stays in place until you start eating again and maintain a healthy weight. Doctors and nurses can show you how to use and care for the feeding tube.
Neuropathy, or nerve damage, may be a side effect of the chemotherapy used to manage laryngeal cancer. It may cause numbness, tingling, pain, and weakness in the hands, feet, arms, legs, or other parts of the body.
Doctors at Rusk Rehabilitation may prescribe medication to ease the discomfort associated with neuropathy. They may also recommend physical therapy to help make sure that neuropathy doesn’t interfere with your balance, strength, or ability to walk and perform daily activities.
If you are experiencing fatigue due to cancer or its treatment, your doctor may recommend that you receive physical and occupational therapy at Rusk Rehabilitation. Strength and aerobic exercises can help improve your energy level and quality of life and enable you to return to your daily activities at home and in the community.
Social and Psychological Support
NYU Langone social workers are available to help you address any financial matters or logistical challenges—for example, traveling to your medical appointments—that may arise during your care.
Support groups and one-on-one counseling sessions with a psycho-oncologist, a healthcare provider trained to address the needs of people with cancer, are available at Perlmutter Cancer Center. Counseling can help you and your family cope with any stress or anxiety you may be experiencing.
Supportive and Integrative Care
The supportive care team at Perlmutter Cancer Center manages any ongoing cancer-related or treatment-related symptoms, such as pain, fatigue, loss of appetite, or stress, helping improve quality of life.
Integrative therapies, such as acupuncture, may lessen discomfort and relieve dry mouth, a side effect of radiation therapy. Yoga and massage therapy can help reduce stress and enhance wellbeing.
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