At NYU Langone’s Head and Neck Center, which is part of Perlmutter Cancer Center, doctors, nurses, physician assistants, social workers, and rehabilitation specialists offer a variety of support services at the time of diagnosis, throughout treatment for oral cancer, and during follow-up appointments.
The schedule for follow-up appointments varies from person to person. Our doctors may see you every one to two months during the first year after treatment, with the time between exams becoming longer thereafter. For example, our doctors may see you every 2 to 3 months during the second year, every 4 to 6 months during the third year, and every 6 to 12 months in the fourth and fifth years after treatment ends.
During these appointments, your doctor may perform a physical exam and imaging tests, such as CT, MRI, or PET/CT scans, to ensure the cancer has not returned. He or she examines your mouth and teeth, which can be damaged by radiation therapy.
Doctors may also perform blood tests to check thyroid function, if you have received radiation therapy. This treatment can potentially damage the thyroid gland, which helps regulate metabolism.
Speech and Swallowing Therapy
Speech and swallowing therapists at NYU Langone may meet with you before treatment to assess how oral cancer affects your ability to speak and swallow.
They can also discuss how therapies for oral cancer may affect these abilities. For example, surgery and reconstruction in people who have oral cancer can result in structural changes or temporary swelling of tissue that makes speech and swallowing challenging. Radiation therapy can cause swelling and discomfort of the lining of the mouth, dry mouth, and tightening of the jaw muscles, which interfere with the ability to chew and swallow food.
Speech and swallowing therapy may be used throughout treatment to help you maintain as much function as possible. These therapies may also be used during recovery to help you regain or compensate for any lost function or to address any late treatment effects.
Our therapists can teach you exercises to strengthen the muscles in the tongue, mouth, throat, and vocal cords 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. Radiation therapy can cause dry mouth and tooth decay.
Regularly brushing and flossing your teeth, using mouthwash and daily fluoride treatments, and having frequent dental check-ups can help prevent these complications. Maintaining these good habits can also help you care for any dental implants you might need as a result of treatment for oral cancer.
Oral cancer and treatment can interfere with eating. Both the condition and therapy often cause swallowing problems. For this reason, your doctor may recommend a nutritional evaluation 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.
NYU Langone specialists can help you avoid foods that might irritate the lining of the mouth. They can also recommend dietary changes to help ease the discomfort of dry mouth.
Some people may not be able to eat a regular diet for several weeks during or after treatment. For these people, doctors may recommend placing a feeding tube directly into the stomach or intestine. This tube, which is inserted into the abdomen through an incision, helps to ensure you receive adequate liquid nutrition.
This tube is used in the hospital and at home as you recover. It stays in place until you are at a stable weight and eating normally by mouth. Doctors and nurses can show you how to use and care for the feeding tube.
Rehabilitation for Muscle Stiffness
Sometimes radiation therapy for oral cancer can cause stiffness in the face and jaw muscles, as well as in nearby neck and shoulder muscles. Surgery to remove lymph nodes may also contribute to muscle stiffness in these areas.
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 includes range-of-motion exercises, stretches, and relaxation techniques to help provide relief.
Radiation therapy may also cause fibrosis, a thickening of the skin and soft tissue, which can lead to stiffness in the face and jaw. 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 be prescribed to help you regain your independence in performing everyday tasks, such as dressing, cooking, shopping, and working.
Surgery for oral cancer often involves the removal of lymph nodes in the neck, which may affect nearby lymph vessels. As a result, lymph fluid can build up, leading to swelling and reduced range of motion and discomfort in the face and neck—a condition called lymphedema.
A physiatrist evaluates you and can prescribe physical therapy at Rusk Rehabilitation. This includes education 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.
Physical therapy often includes range-of-motion and flexibility exercises. This is usually followed by specialized massage therapy, which helps the fluid to drain.
Neuropathy—in which nerves are damaged, causing numbness, tingling, pain, and weakness, most often in the hands and feet—may be a side effect of chemotherapy.
Doctors at Rusk Rehabilitation may prescribe medication to ease the discomfort of neuropathy. They can also provide 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 due to oral cancer or its treatment, our doctors may recommend 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 include improving your quality of life and helping you return to your daily activities.
Social and Psychological Support
Social workers at NYU Langone are available at the time of diagnosis, throughout treatment, and during follow-up care to help you cope with any financial matters or logistical challenges—for example, when traveling to your medical appointments.
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 stress or anxiety.
Supportive and Integrative Care
Supportive care specialists at Perlmutter Cancer Center provide ongoing therapy for any cancer- or treatment-related discomfort. You may need pain medication during recovery from surgery, for instance, or to help ease any discomfort if cancer spreads. Our doctors can help you find the medications and treatments that work for you.
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.
NYU Langone also offers clinical trials involving new ways to assess and manage pain associated with oral cancer. You and your doctor can discuss whether a clinical trial is right for you.
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