What to Expect After Head and Neck Cancer Surgery

Two women sit around a table and one stands behind them. One is wearing a white lab coat and stethoscope. She uses a pen to point to something on paper. The other seated woman wears a pink head wrap following cancer treatment. The third woman leans over and places a hand on the second woman, supporting her.

Written by Jana Zalmanowitz M.Cl.Sc, Reg. SLP, SLP(C)

Prior to becoming a Speech-Language Pathologist (SLP), Jana worked as a research technologist, assisting in dysphagia research. This sparked her interest and she has continued to serve this population as a SLP in both hospital and private practice settings.

March 1, 2023

February 4th was World Cancer Awareness Day. At True Angle, we have those living with and surviving cancer in our thoughts beyond just the month of February. Many of our Mobili-T users have undergone treatment for head and neck cancer and experience dysphagia (swallowing problems) as a side effect to their cancer or treatment. For this reason, we continue our commitment to improving lives and ensuring people live well with dysphagia

A head and neck cancer diagnosis is life altering. Treatments for head and neck cancer can have a major impact on function, appearance and quality of life. One of the best things you can do is arm yourself with information so you can be prepared for what may lie ahead.

This article will specifically focus on what to expect when you have surgery for head and neck cancer.  

Your Team for Cancer Recovery and Treatment

Diagnosis, treatment and rehabilitation typically includes many health care professionals, each with expertise in a certain aspect of your care.

You may have consults with oncologists, reconstructive surgeons, maxillofacial prosthodontists and otolaryngologists who will plan and guide you through the medical treatment and possible reconstruction following cancer. 

There will also be professionals dedicated to different aspects of your treatment and recovery.

Nurses, respiratory therapists, psychologists, social workers, dietitians, speech-language pathologists (S-LP) and physical therapists may also contribute to your team.

It can be difficult to know who can answer your questions or provide you with guidance. Your team is there to help, so ask questions and if they cannot answer, they will point you in the right direction. 

Surgical Head and Neck Cancer Treatment

Questions to Ask

Types of surgery to remove cancer will vary based on your type and stage of cancer. You can ask the following questions to gain a better understanding of what your surgery will entail:

  • Which parts of the head and neck does your team anticipate will be affected?
  • After the cancer is removed, will there be any type of reconstruction of the structures affected?
  • If so, what kind of reconstruction? Depending on your type of cancer and the technique being used, reconstructive surgery may include use of a “flap” which is a flap of tissue either close to the site or from a different part of the body, (called a “free flap”), such as the forearm. If you have a free flap, you will also be recovering from surgery to the donor site where this flap is from. 
  • Does your team anticipate they will need to remove any lymph nodes? (this is called a neck dissection)
  • Will there be changes to how you look?
  • What can you do to prepare with regards to subjects like eating and drinking, shaving, taking time off from work and ensuring support at home?
  • How long will you need to stay in the hospital?
  • When and where will you follow up after surgery?

Recovering from Head and Neck Cancer Surgery

It can take varying lengths of time to recover. Head and neck surgery is complex and the first part of your recovery will likely take place in the hospital.

Here are some medical aspects that may be a part of your recovery: 

  • Tracheostomy – swelling or changes to your anatomy can affect your ability to breathe through your mouth. A tracheostomy is a small opening in your neck directly into your airway to ensure you can breathe. A tracheostomy may be a temporary part of your recovery. It will affect your ability to speak so you may need another way of communicating such as written words or pictures immediately following surgery.
  • Catheter – A catheter may be inserted to ensure your bladder can empty during surgery. This will likely be removed soon after. 
  • Bandages and drains – These may be in place at the surgery site(s) to assist with healing. Your team will help you know how to care for them and when they can be removed.  
  • Oxygen – You may require the help of an oxygen mask for breathing following surgery.
  • IV – This will ensure that hydration and medications can be delivered effectively.

There will be changes to the way your head and neck feel. You may experience swelling and sensation changes to your head, neck and shoulders. There could be pain, tingling, stiffness or numbness. Some of this may resolve as you continue with your recovery.

Be sure to let your healthcare team know what you are feeling and they can guide you with how to manage. 

Managing Dysphagia or Swallowing Problems

Dysphagia is a common side effect of head and neck cancer surgery. You will not be able to eat or drink immediately after surgery and will likely require a feeding tube. How long you need to use a feeding tube will depend on the type of surgery and your recovery.

There are a number of factors that can help keep you healthy in the presence of a swallowing problem. 

Saliva management

Having dysphagia means you may have difficulty managing your own saliva. You may also produce more phlegm after surgery. Your team can provide guidance on how to clear what they may refer to as “secretions.” 

Practicing good oral care

Keeping surgical sites clean helps with healing. It is also important to minimize bacteria in the mouth as it minimizes the risk that harmful bacteria will enter your lungs, causing pneumonia.

Your nurses and S-LP can provide education on the best ways to keep your mouth clean.

Movement and clearing your lungs

It is important to work with your team after surgery to get your body moving. A physical therapist can help guide you as to what exercises you can do to get your body moving. Ensuring you are up and about will help ensure you can keep your lungs clear and maintain mobility. 

Minimizing aspiration risk

Aspiration occurs when food or other material enters your lungs. When you are ready to start eating by mouth, your S-LP will assess your risk for aspiration and provide you with instructions on how to manage in your specific case.

Your ability to chew may be altered due to loss of strength, range of motion or sensation in the jaw and tongue, and changes to your teeth. This may mean avoiding certain textures of food or changing positions when you swallow. Aspiration can lead to a chest infection or aspiration pneumonia. 

Exercising and gaining better control of your swallowing muscles

Once you have reached an appropriate point in your recovery, a swallowing exercise program may be beneficial to improve your swallowing. Your S-LP can guide you in specifics. There are ways to ensure your exercise is as effective and consistent as it can be, such as the use of a biofeedback device like Mobili-T

Continuing your Recovery

As you physically heal or undergo other treatments beyond surgery, such as chemotherapy, radiation therapy, targeted therapy and immunotherapy, there will likely be bumps in the road. You may continue to experience long-term side effects of treatment.

The uncertainty of a head and neck cancer diagnosis as well as the life changes that accompany it, mean you will also benefit from social as well as mental health supports. No matter what you are experiencing, we hope you have access to the people and tools you need to enjoy the life you’re living following head and neck cancer surgery and we are striving to make these more accessible. 

About Mobili-T: Mobili-T is the innovative wireless sEMG biofeedback device that helps you live well with dysphagia. 

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