Head and neck cancer accounts for approximately 4% of all cancers in the United States. If caught early, it is treatable. However, these treatments – including surgery, radiation and chemotherapy – can have side effects.
Here are some of the most common side effects of head and neck cancer treatment—and what you can do to manage your treatment.
Changes in appearance and self-esteem
Surgery to treat head and neck cancer can be life-saving, but it can also cause significant changes to the facial area. These changes can range from minor scarring to more serious disfigurement.
Whether major or minor changes to their appearance, many people struggle with low self-esteem after treatment for head and neck cancer—and as their body image worsens, so does their quality of life.
Organizations like the Head & Neck Cancer Alliance and Support for People with Oral and Head and Neck Cancer (SPOHNC) can connect people struggling with low self-esteem to support groups, mental health providers, and other resources to help them cope.
Problems eating or swallowing
Surgery, radiation, and chemotherapy to treat head and neck cancer can cause damage to nerves, muscles, bones, and other parts of your body that help you chew and swallow. This damage can make eating challenging.
Your healthcare team can help you adjust your eating habits to repair the damage. In some cases, you may need a feeding tube to ensure you get enough nutrients.
Breathing changes
Surgery, radiation, and chemotherapy can cause problems such as swelling or scarring that damage the airway. Therefore, treatment for head and neck cancer can affect a person’s ability to breathe.
Depending on how severe the damage is, your doctor may need to create an alternate airway in the front of your neck so you can breathe easily. This is called a tracheostomy.
Dental problems
Chemotherapy and radiation for head and neck cancer can damage the salivary glands and cause a condition called dry mouth (xerostomia). Dry mouth is exactly what it sounds like, and it’s been linked to tooth decay and other dental problems.
Drinking plenty of plain water, chewing sugar-free gum, and using products to treat dry mouth can help prevent tooth damage. It’s a good idea to keep your dentist updated on your treatment plan. They can help you deal with any dental problems if they arise.
Permanently dry mouth
In some cases, the damage to the salivary glands caused by radiation treatment is permanent—as is the dry mouth it can cause.
Fortunately, the condition can be managed with the solutions mentioned above (lots of water, sugar-free chewing gum and special dry mouth products). Visiting the dentist regularly can help you keep your teeth and gums healthy.
Jawbone damage
Radiation limits the blood supply your bones need to be strong and healthy. Because it is usually unavoidable that your jaw will be exposed during radiation treatment for head and neck cancer, you may develop a condition called osteoradionecrosis (ORN), in which bones die due to radiation exposure. This condition most commonly affects the lower jaw, but can also occur in the upper jaw.
One way to deal with ORN is to make sure your teeth and gums are as healthy as possible before undergoing radiation to limit the damage. Treatment options for ORN include surgery to remove dead bone and reconstruct the jaw.
Voice changes and complications when speaking
Surgery and radiation treatments for head and neck cancer can damage the vocal cords, which can change the way you speak. Your voice may sound different or it may become more difficult for you to speak.
Your healthcare team may refer you to a speech therapist, a specialist who can help you figure out how to use your voice or teach you different ways to communicate.
Lymphedema
Your lymphatic system carries a clear fluid (lymph) that is filtered through small, kidney-shaped clumps of tissue called lymph nodes. Treatment for head and neck cancer can damage the lymphatic system and cause swelling when lymph fluid builds up under the skin.
This swelling is called lymphedema and is particularly common in people with head and neck cancer because there are so many lymph nodes in the head and neck. Lymphedema is often treated with complete decongestive therapy (CDT), which helps lymph flow and be reabsorbed by the body to reduce swelling.
Chronic pain
Head and neck cancer can be very painful – as can treatment. Because living with pain can impact the success of your treatment and your overall quality of life, your medical team will work with you to develop an individual pain management plan.
This plan may include pain-relieving medications as well as drug-free treatments such as physical therapy and acupuncture. Cognitive behavioral therapy (CBT), mindfulness techniques, and other mental health supports can also help reduce pain associated with head and neck cancer.
Help is out there
It is completely understandable to have difficult feelings related to the side effects of treatment. If you are having difficulty coping, talk to your HCP. They can connect you with specialists, support groups, and other resources to help you cope.
This educational resource was created with support from Merck.
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