Doctors, nurses, nurse practitioners, physician assistants, social workers, and rehabilitation specialists at NYU Langone’s Perlmutter Cancer Center and Rusk Rehabilitation collaborate to provide support for people with salivary gland cancer throughout diagnosis and treatment and during follow-up appointments.
Doctors may see you every month during the first year after treatment and every two months during the second year. During the third year after treatment, you may see your doctor every three months and then every six months to a year in the fourth and fifth years after treatment.
During these appointments, your doctor may perform a physical exam, biopsies, and imaging tests, such as MRI or CT scans, to ensure the cancer has not returned.
Speech and Swallowing Therapy
Speech and swallowing therapists at Perlmutter Cancer Center can meet with you before treatment starts to explain how different therapies may affect your speech and swallowing abilities. They can also evaluate how a salivary gland tumor is currently affecting those functions.
The surgical removal of a salivary gland does not usually cause dry mouth, because the remaining glands continue to make saliva. However, radiation therapy and chemotherapy may cause dry mouth and difficulty swallowing, which resolve after treatment is complete.
Talking after surgery or radiation therapy may be difficult because of temporary tissue swelling in the mouth and throat. If any nerves are damaged during surgery, resulting muscle weakness may also affect speech and swallowing.
Speech and swallowing therapy may be used throughout treatment to preserve as much function as possible. It may also be given afterward to help you regain or compensate for any lost function. Therapy usually consists of exercises to strengthen the muscles in the tongue, mouth, vocal cords, and throat.
Rehabilitation for Facial Weakness
Sometimes surgery for parotid gland cancer may cause facial weakness and stiffness, because a facial nerve was damaged or had to be sacrificed to remove the tumor. If the nerve is only bruised, these effects are usually temporary.
If the facial nerve had to be sacrificed, all or part of the nerve can be reconstructed with nerve grafts to help restore facial muscle function. Surgeons may also reposition other muscles adjacent to the face or transfer muscles from other areas of the body. NYU Langone surgeons are experts at restoring as much function as possible.
After surgery, a Rusk Rehabilitation physiatrist—a doctor who specializes in rehabilitation medicine—evaluates you. He or she can prescribe physical therapy and speech therapy to help restore function.
If surgeons use a nerve graft to restore facial function, physical therapists and speech and swallowing therapists can teach you muscle strengthening and range-of-motion exercises to help with recovery. If the facial nerve has been cut and facial weakness or paralysis is affecting your ability to chew and swallow, speech and swallowing therapists can help you compensate for lost function.
Therapies for Stiffness and Fibrosis
Radiation therapy and surgery for salivary gland cancer may cause muscle stiffness in the face, jaw, neck, and shoulders. Physical therapists and speech and swallowing 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, called fibrosis. Physical therapists can manage this with myofascial release, a hands-on technique of manipulating and applying pressure to tissue in the jaw and neck to loosen the tissue and improve range of motion.
If stiffness and fibrosis are interfering with your daily activities, occupational therapists can help you learn how to perform routine tasks, such as cooking and shopping.
Radiation therapy for salivary gland cancer may cause dry mouth, leading to tooth decay. For this reason, your doctors may recommend visiting an NYU Langone dentist before, during, and after treatment. Regular toothbrushing and flossing, daily fluoride treatments, and using mouthwash can help prevent these complications.
Because salivary gland cancer treatment may cause difficulty with swallowing, you may need a nutritional assessment and dietary plan. Throughout your treatment and recovery, nutritionists at Perlmutter Cancer Center can help ensure you’re getting the nutrients you need in easy-to-swallow foods. They can also help you avoid foods that might irritate your mouth and throat and recommend dietary changes to help ease dry mouth.
You may not be able to eat as usual for several weeks during or after treatment, so doctors may place a feeding tube directly into the stomach or small intestine. This tube, which is inserted 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 can maintain a healthy weight. Doctors and nurses can show you how to use and care for the feeding tube.
Surgery for salivary gland cancer may involve removing 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 tissues. Damage to these vessels can cause lymph fluid to build up, which can lead to swelling, reduced range of motion, and discomfort in the face and neck—a condition called lymphedema.
A physiatrist can evaluate you and prescribe 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 the lymph fluid to drain.
Education about the early warning signs of the condition—which may include a sensation of aching, tingling, or fullness in the neck and face—is also available. Early treatment is the key to relief.
Physical Therapy for Neuropathy
Neuropathy is when damage to nerves causes numbness, tingling, pain, and weakness in the hands, feet, arms, legs or other parts of the body. In people treated for salivary gland cancer, neuropathy can be a side effect of chemotherapy.
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.
Support for Fatigue
If you are experiencing fatigue due to salivary gland cancer or its treatment, doctors may recommend physical and occupational therapy at Rusk Rehabilitation. This type of therapy may include strength and aerobic exercises to address fatigue caused by surgery, radiation therapy, or chemotherapy.
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 are available throughout diagnosis, treatment, and follow-up care to help you address any related financial matters or logistical challenges—for example, handling insurance reimbursement or traveling to doctor appointments.
Support groups and one-on-one counseling sessions with a psycho-oncologist, a healthcare provider trained in addressing the needs of people with cancer, are available at Perlmutter Cancer Center. Counseling may help you and your family cope with any stress or anxiety that arise after a diagnosis of salivary gland cancer.
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 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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