Doctors, nurses, physician assistants, social workers, and rehabilitation specialists at NYU Langone’s Head and Neck Center, part of the Perlmutter Cancer Center, collaborate to provide support for people with oropharyngeal cancer. They offer a variety of services throughout diagnosis and treatment and during follow-up appointments.
The schedule for follow-up appointments varies for each person. Doctors may see you every 1 to 3 months during the first year after treatment, every 4 to 6 months during the second and third years, and every 6 to 12 months in the fourth and fifth years.
During these appointments, your doctor may perform a physical exam and imaging tests, such as CT or PET/CT scans, to ensure the cancer has not returned. They may also examine your mouth and teeth, because radiation therapy may sometimes damage these structures. They may also use blood tests to check thyroid function. Radiation therapy can sometimes damage the thyroid gland, which regulates metabolism.
Speech and Swallowing Therapy
Speech and swallowing therapists at NYU Langone may meet with you before treatment to evaluate how an oropharyngeal tumor is affecting your ability to speak and swallow.
They may also discuss how treatments for oropharyngeal cancer may affect these functions. For example, radiation therapy may damage salivary glands, causing dry mouth. It may also cause inflammation or scarring in the back portion of the tongue or the soft palate. These side effects can make 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 given after treatment to help you regain or compensate for any lost function or to address any lingering treatment effects.
Therapists can teach you exercises to strengthen the muscles in the mouth, tongue, and throat to help improve your ability to speak and swallow.
Radiation therapy for oropharyngeal cancer can cause dry mouth, leading to tooth decay. Your doctor may recommend that you see an NYU Langone dentist before, during, and after treatment. Regularly brushing and flossing your teeth, using mouthwash and daily fluoride treatments, and having frequent dental checkups can help to prevent these complications.
Since oropharyngeal cancer and its treatments can cause swallowing problems, you may need a nutritional assessment and dietary plan. Nutritionists at Perlmutter Cancer Center can help ensure that you are getting the nutrients you need in easy-to-swallow foods throughout treatment and recovery. This can help prevent weight loss and malnutrition.
Specialists can also help you avoid foods that might irritate the back of your throat and 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 after treatment. The oropharyngeal tumor itself can interfere with eating. For this reason, doctors may want to place a feeding tube directly into the stomach or intestine. This tube, which is placed through a small incision in the abdomen, helps to ensure you receive adequate liquid nutrition.
The 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 through the mouth. NYU Langone doctors and nurses can show you how to use and care for it.
Rehabilitation for Muscle Stiffness
Sometimes radiation therapy and the surgical removal of lymph nodes for oropharyngeal cancer can cause stiffness in the jaw, neck, and shoulder muscles. After you are evaluated by a physiatrist—a doctor who specializes in rehabilitation medicine—physical therapists at Rusk Rehabilitation can teach you range-of-motion exercises, stretches, and relaxation techniques to help provide relief.
Radiation therapy may also cause thickening of the skin and soft tissue, a condition called fibrosis, which can cause stiffness in the neck. Physical therapists can relieve discomfort with myofascial release, a hands-on technique of manipulating and applying pressure to tissue in the jaw and neck to loosen them and improve range of motion.
If stiffness and fibrosis are interfering with your daily activities, our occupational therapists can recommend strategies to help you regain your independence in performing everyday tasks at home, at work, and in the community.
Surgery for oropharyngeal cancer may include the removal of lymph nodes, which may damage lymph vessels in the neck. These vessels carry lymph fluid, which contains bacteria and waste products, away from the body’s organs and tissue. Damage to these vessels can cause lymph fluid to build up, leading to swelling and a reduced range of motion and discomfort in the face and neck—a condition called lymphedema.
If you’re experiencing lymphedema, a physiatrist evaluates you and prescribes physical therapy at Rusk Rehabilitation. Physical therapy often includes range-of-motion and flexibility exercises. This is usually followed by specialized massage therapy to help drain lymph fluid.
Education about the early warning signs of the condition, such as aching, tingling, or a feeling of fullness in the neck and face is also available. Early treatment is the key to relief.
Neuropathy, in which nerves are damaged, causing numbness, tingling, pain, and weakness in the hands, feet, arms, and legs and other parts of the body, may be a side effect of the chemotherapy drugs used to manage oropharyngeal cancer.
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 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. The goals of therapy include improving your quality of life and helping you return to your daily activities.
Social and Psychological Support
NYU Langone social workers are available throughout your diagnosis, treatment, and follow-up care to help you cope with any financial matters or logistical challenges that may arise, such as traveling to your medical appointments or managing insurance claims.
Support groups and one-on-one counseling sessions with a psycho-oncologist, which is 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 Care
Supportive care specialists at Perlmutter Cancer Center provide ongoing therapy for any cancer-related or treatment-related symptoms, such as pain, fatigue, loss of appetite, or stress, helping to improve quality of life.
Integrative 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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