Helping Patients Swallow: The Role of the Speech-Language Pathologist in Head and Neck Cancer Recovery

For head and neck cancer patients, the ability to chew and swallow foods and/or liquids can be disrupted. The ability to enjoy a meal, sip water without coughing, or swallow pills safely can become a daily struggle – things which impact nutrition, hydration, social life and emotional well-being.

That’s where Speech-Language Pathologists (SLPs) come in. Often seen as experts in speech production, language or voice, SLPs also play a critical role in swallowing rehabilitation. At ECHN, our Speech-Language Pathologists work collaboratively with your Physicians, Nurses, Registered Dietitians and Social Workers to ensure your safety is a priority throughout your Oncology treatments.

Swallowing: More Than a Reflex

The act of swallowing is a coordinated effort of voluntary and involuntary (reflexive) actions of many muscle groups and nerves that work together for safe and efficient swallowing.  Cancer treatments like surgery, radiation, or chemotherapy can damage or weaken these structures, resulting in dysphagia—difficulty swallowing. For the head and neck cancer population, radiation therapy can result in short-term and long-term changes to the muscles of swallowing, which can result in impaired safety or ability to eat by mouth.

Swallowing can become uncomfortable or painful during cancer treatments. If left untreated, it can lead to serious medical complications like aspiration pneumonia, malnutrition, dehydration, and a profound drop in quality of life.

SLPs are trained to assess, treat, and support swallowing function across the entire cancer journey.

Before Treatment: Building a Strong Foundation

Pre-treatment swallow evaluations are crucial. At this stage, the SLP:

• Assesses current swallow function (baseline)
• Identifies potential risk factors
• Educates patients on what to expect
• Introduces prophylactic exercises to preserve strength
• Establishes a connection that will persist throughout cancer treatments

This proactive approach—sometimes referred to as "prehabilitation"—has been shown to improve long-term outcomes and reduce the severity of dysphagia post-treatment.

During Treatment: Preserving What Matters

During radiation and chemotherapy, patients often experience:

• Painful swallowing (odynophagia)
• Dry mouth (xerostomia)
• Thick secretions
• Fatigue
• Weakening of the muscles used for swallowing
• Altered taste
• Reduced appetite/desire to eat, which can lead to weight loss

SLPs help patients maintain swallow muscle function through specific exercises and compensatory strategies with eating. Even if a patient is no longer eating by mouth, these targeted exercises will help them maintain strength in their swallowing muscles and prevent further decline in function.

They also offer strategies for safer swallowing, guidance on safe food textures, and techniques to manage discomfort or secretions.

After Treatment & Into Survivorship

For many, the post-treatment phase is the most challenging. Structural changes from surgery or fibrosis from radiation can dramatically impact swallow safety and efficiency.

At ECHN, our SLPs help with:

• Conducting instrumental assessments (like Modified Barium Swallow Studies or Fiberoptic Endoscopic Evaluation of Swallowing) to evaluate the problem
• Developing individualized treatment plans to retrain swallowing and resume oral intake
• Providing manual therapy techniques to reduce fibrotic changes, reduce swelling/fluid retention and improve range of motion with swallowing
• Teaching compensatory techniques to prevent aspiration
• Coordinating with dietitians to ensure adequate nutrition
• Following your care into survivorship until you have met your personal swallowing goals

It’s Not Just About the Swallow. It’s About the Whole Person.

Swallow therapy isn't just about preventing pneumonia or getting off a feeding tube – it's about giving people their lives back. The ability to eat a holiday meal, enjoy coffee with friends, or taste favorite foods again is deeply meaningful.

Speech-Language Pathologists are there for every step, from assessing swallow safety to celebrating that first successful bite.

If you or a loved one is facing treatment for head and neck cancer, don’t wait to talk to an SLP. Swallowing therapy can make the difference between surviving and thriving.  Referral to an SLP at the time of diagnosis is critical to your recovery.

A referral is needed to schedule an appointment with ECHN’s SLP’s.
To schedule an appointment, please call 860.872.5150.