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Most People Can Speak and Swallow After Combination Treatment for Head and Neck Cancer


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Most people do not have ongoing speaking or swallowing difficulties following combined chemotherapy and radiation treatment for advanced head or neck cancer, but several factors may be associated with worse outcomes in these functions, according to a report in the Archives of Otolaryngology–Head & Neck Surgery.

“Speaking and swallowing deficits are experienced by many survivors of primary cancers of the head and neck,” the authors write as background information in the article. “Although it is often difficult to separate the individual contributions of the tumor and the treatment to these deficits, several studies have shown that, when compared with organ-removal surgery, chemoradiotherapy with or without organ preservation surgery can minimize post-treatment speech and swallowing deficits while maintaining excellent tumor control.”

It is encouraging to note that, when day-to-day activities are used as a metric, most patients experience a return to normal or near-normal function.”

In the study, factors that were associated with worse speaking ability were being female, having a history of smoking, having a tumor in the hypopharynx or in the larynx, or having a tumor that did not respond to the initial dose of chemotherapy. Factors associated with worse swallowing ability included being older, having poor performance status (a measure of disability) before treatment, and neck dissection, with a trend toward worse scores in those with tumors in the hypopharynx and larynx.

“One of the remarkable features of the data is that most of the patients experienced minimal residual speech or swallowing deficits,” the authors write. “Although differences detected by more advanced modalities may exist between these patients and healthy subjects, it is encouraging to note that, when day-to-day activities are used as a metric, most patients experience a return to normal or near-normal function.”

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This article was published in Coping® with Cancer magazine, January/February 2011.