Doctors, nurses, physician assistants, social workers, and rehabilitation specialists at NYU Langone’s Perlmutter Cancer Center collaborate to provide support for people with nasopharyngeal cancer. They offer a variety of services throughout diagnosis and treatment and during follow-up appointments.
The schedule for follow-up appointments tends to vary from person to person. Doctors may see you every month during the first year after treatment and then every 2 to 3 months during the second year after treatment. During the third year, they may see you every 4 to 6 months, and then every 6 to 12 months in the fourth and fifth years after treatment.
During these appointments, your doctor may perform a physical exam, an endoscopy, and imaging tests, such as PET/CT or PET/MRI scans. This helps the doctor monitor for any recurrence.
Because radiation therapy can damage the thyroid gland, which helps regulate metabolism, and the pituitary gland, which helps manage growth, metabolism, and fertility, your doctor may check the function of these glands with a blood test during follow-up visits. They may also examine your mouth, teeth, and ears, which can be affected by radiation therapy.
Speech and Swallowing Therapy
Speech and swallowing therapists at NYU Langone can meet with you before treatment to discuss how therapies for nasopharyngeal cancer may affect your ability to speak and swallow. For example, radiation therapy and chemoradiation can cause dry mouth and inflammation of the palate, the nasopharynx, and the rest of the throat, making speech and swallowing difficult.
Speech and swallowing therapy may be used throughout treatment to help you maintain as much function as possible. It may also be used during your recovery to help you regain or compensate for any lost function.
Our therapists can teach you exercises to strengthen the muscles in the tongue, mouth, throat, and larynx, also called the voice box, to help improve your ability to speak and swallow.
Your doctor may recommend that you see an NYU Langone dentist before, during, and after treatment, because radiation therapy for nasopharyngeal cancer can sometimes cause dry mouth, resulting in tooth decay. Regularly brushing and flossing your teeth, daily fluoride treatments, using mouthwash, and having frequent dental checkups can help to prevent these complications.
Because nasopharyngeal cancer and its treatments often cause swallowing problems, you may need a nutritional assessment and dietary plan. Nutritionists at Perlmutter Cancer Center can help ensure you are getting the nutrients you need in easy-to-swallow foods throughout treatment and recovery. This can help prevent weight loss and malnutrition.
Our specialists can also help you avoid foods that might irritate your throat and recommend dietary changes to help ease the discomfort of dry mouth.
During and after treatment, some people may not be able to eat a regular diet for several weeks. Sometimes doctors recommend placing a feeding tube directly into the stomach or intestine. This tube, which is inserted into the abdomen through a small incision, helps to ensure that you receive adequate hydration and liquid nutrition.
A feeding tube is used in the hospital and at home as you recover. It stays in place until you are at a stable weight and are eating normally by mouth. Our doctors and nurses can show you how to use and care for the feeding tube.
Rehabilitation for Muscle Stiffness
Sometimes radiation therapy and open surgery for nasopharyngeal cancer can cause stiffness in the face, jaw, neck, and shoulder muscles. After you are evaluated by a physiatrist—a doctor who specializes in rehabilitation medicine—he or she can prescribe physical therapy, in which you are taught range-of-motion exercises, stretches, and relaxation techniques that can provide relief.
Radiation therapy may also cause thickening of the skin and soft tissue, a condition called fibrosis, which can cause neck stiffness. Physical therapists can relieve discomfort with myofascial release, a hands-on technique that involves manipulating and applying pressure to jaw and facial tissue to loosen them and improve range of motion.
If stiffness and fibrosis are interfering with your daily activities, occupational therapy can also be prescribed. Occupational therapists can teach you strategies that help you regain independence in performing tasks, such as dressing, cooking, shopping, and working.
Radiation therapy and surgery for nasopharyngeal cancer involving the lymph nodes of the neck may cause scar tissue in nearby lymph vessels. These microscopic vessels carry lymph fluid, which contains bacteria and waste products, away from the body’s organs and tissue. Changes to these vessels in the neck can cause lymph fluid to build up, leading to swelling, stiffness, and a reduced range of motion and discomfort in the face and neck, a condition called lymphedema.
After an evaluation, a physiatrist can prescribe physical therapy at Rusk Rehabilitation. Physical therapy often includes range-of-motion and flexibility exercises. This is usually followed by specialized massage therapy, which helps drain the fluid.
Physiatrists or physical therapists can also teach you about the early warning signs of lymphedema, such as aching, tingling, or a feeling of fullness in the neck and face. The sooner treatment starts, the better the chances of relief.
Neuropathy is a condition in which nerves are damaged. This causes numbness, tingling, pain, and weakness, most often in the hands and feet. It may be a side effect of the chemotherapy drugs used to manage nasopharyngeal cancer.
Doctors at Rusk Rehabilitation may prescribe medication to ease the discomfort of neuropathy. They can also prescribe physical therapy to help ensure that neuropathy doesn’t interfere with your balance, strength, or ability to walk and perform daily activities.
If you are experiencing fatigue from the cancer or its treatment, our doctors may recommend that you receive physical and occupational therapy at Rusk Rehabilitation. These therapies may include strength and aerobic exercises to increase your energy levels and strategies to help you complete routine tasks.
The goals of therapy are to improve your quality of life and help you return to your daily activities.
Social and Psychological Support
Social workers at NYU Langone are available throughout your diagnosis, treatment, and follow-up care to help you cope with any financial matters or logistical challenges, such as traveling to your medical appointments, that may arise.
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 may help you and your family members cope with any stress or anxiety.
Supportive and Integrative Health Services
The supportive care team at Perlmutter Cancer Center provides ongoing therapy for any cancer- or treatment-related discomfort, such as pain, fatigue, loss of appetite, or stress, helping to improve quality of life.
Integrative health therapies, such as acupuncture, may lessen discomfort and relieve dry mouth, a side effect of radiation treatment. Yoga and massage therapy can help reduce stress and enhance wellbeing.
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