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4% of all cancers in the United States are head and neck cancers, i.e. cancers of the head and neck area. They can be treated if detected early. But these treatments, including surgery, radiation therapy and chemotherapy, could have side effects.
Here are some of the most common side effects of head and neck cancer treatment and helpful steps you can take to manage your treatment.
Changes in appearance and self-esteem
Surgery to treat head and neck cancer can save lives but can also cause significant changes to the facial area. These changes can range from minor scarring to more serious disfigurement.
Whether the changes in appearance are major or minor, many people experience low self-esteem after treatment for head and neck cancer. And as your body image worsens, your quality of life can also worsen.
Organizations such as the Head & Neck Cancer Alliance and Support for People with Oral and Head and Neck Cancer (SPOHNC) can provide connections between people with low self-esteem and support groups, mental health providers, and other resources to help address these issues.
Difficulty eating or swallowing
Surgery, radiation, and chemotherapy to treat head and neck cancer can cause damage to nerves, muscles, bones, and other parts of the body used for chewing and swallowing. This damage could make eating challenging.
Your healthcare team can help you adjust your eating habits to manage the difficulties caused by this damage. In some cases, you may need a feeding cannula to ensure you get enough nutrition.
Respiratory changes
Surgery, radiation and chemotherapy can cause problems such as inflammation or scarring that damage the airways. Consequently, treatment for head and neck cancer can affect the 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 a tracheostomy.
Dental problems
Chemotherapy and radiation therapy for head and neck cancer can damage the salivary glands and cause a condition called dry mouth (xerostomia). The term “dry mouth” refers to exactly what it sounds like and is associated with tooth decay and other dental problems.
Drinking plenty of water, chewing sugar-free gum, and using products to treat dry mouth are steps that can help prevent tooth damage. It is advisable to keep your dentist informed of your treatment plan. It could help you deal with any dental problems you may have.
Permanently dry mouth
In some cases, salivary gland damage caused by radiation therapy is permanent, as is the dry mouth that such damage can cause.
Fortunately, the disease can be managed with the solutions mentioned above (lots of water, sugar-free chewing gum and special products to combat dry mouth). Regular visits to the dentist can help keep your teeth and gums healthy.
Jaw damage
Radiation limits the blood supply your bones need to stay strong and healthy. Because radiation therapy for head and neck cancer usually cannot prevent your jaw from becoming exposed, it can cause a condition called osteoradionecrosis (ORN), which occurs when bone dies due to exposure to radiation. This disorder most commonly affects the lower part of the jaw, but can also occur in the upper part.
One method of treating ORN is to ensure your teeth and gums are as healthy as possible before exposing them to radiation to limit damage. Therapeutic options for ORN include surgery to remove dead bone and reconstruct the jaw.
Voice changes and speech complications
Surgery and radiation therapy for head and neck cancer can damage your vocal cords and change the way you speak. Your voice may sound different or you may find it more difficult to speak.
Your healthcare team may refer you to a speech therapist, a specialist who can help you learn how to use your voice or teach you other methods of communication.
Lymphedema
Your lymphatic system carries a clear fluid (lymph) that is filtered through kidney-shaped masses of tissue called lymph nodes. Treatment for head and neck cancer can damage the lymphatic system and cause inflammation 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 many lymph nodes in the head and neck area. Lymphedema is often treated with complete decongestant therapies (CDT), which help lymph flow and be reabsorbed by the body to reduce inflammation.
Chronic pain
Head and neck cancer and its treatment can be very painful. Because living with pain can impact the effectiveness of your treatment and overall quality of life, your healthcare team will work with you to develop an individualized plan to manage your pain.
This plan may include pain medications as well as non-drug treatments such as physical therapy and acupuncture. Cognitive behavioral therapies (CBT), mindfulness techniques, and other types of mental health support may also be helpful in reducing pain associated with head and neck cancer.
Help is available
It is understandable to experience difficult emotions related to the side effects of treatment. If you have trouble coping, contact your doctor. He or she will recommend specialists, support groups, and other resources that may be helpful in dealing with all of these issues.
This educational resource was created with support from Merck.
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