OncoLog, Volume 61, Number 2, February 2016 Page: 5
8 p. : col. ill.View a full description of this periodical.
Extracted Text
The following text was automatically extracted from the image on this page using optical character recognition software:
Swallowing Therapy Improves
Function and Quality of Life for
Patients with Head and Neck CancerBy Bryan Tutt
In patients with head and neck cancer, loss
of swallowing function may result from radia-
tion therapy, surgery, or the cancer itself and
lead to poor health and reduced quality of life.
At The University of Texas MD Anderson Cancer
Center, individualized swallowing therapy pro-
grams directed by speech pathologists are
helping patients maintain or recover their swal-lowing function during
Recent studies support the use of
thorough evaluation of swallowing
function and tailored exercise regimens
to maintain or recover swallowing func-
tion in patients with dysphagia related
to head and neck cancer treatments.
Some of these studies assessed the ef-
fects of radiation therapy. "A common
misconception about radiation-associ-
ated dysphagia is that it is primarily an
issue of stricture of the esophagus," said
Kate Hutcheson, Ph.D., an associate
professor in the Department of Head
and Neck Surgery and the associate
director of research for the Section of
Speech Pathology and Audiology. "But
meta-analyses with thousands of pa-
tients have shown that stricture occurs
in less than 10% of patients treated
with radiation therapy for head and
neck cancer. So esophageal dilation
is not always the answer, and nine pa-
tients out of 10 need a more complete
workup to establish the source of their
swallowing difficulty."
Another study of swallowing func-
tion in head and neck cancer patients
raised questions about the widespread
application of electrical stimulation
therapy. In fact, recently published re-
suIts from a multisite randomized clini-
cal trial showed no benefit from adding
neuromuscular electrical stimulation
therapy to swallowing exercises in headand after treatment.
and neck cancer patients with post-
treatment dysphagia.
At MD Anderson, individualized
swallowing therapy programs are rapidly
evolving to improve swallowing func-
tion and quality of life for patients with
head and neck cancer. These programs
typically begin soon after treatment for
patients whose tumors are treated with
surgery or before treatment, as a pre-
ventive measure, for patients who un-
dergo radiation therapy.
Preventive therapy
"A large body of evidence suggests
that preventive swallowing therapy isthe best practice for patients who are
going to receive radiation therapy to
the head and neck," Dr. Hutcheson
said. "After their multidisciplinary
workup here at MD Anderson, patients
who are scheduled to receive radiation
therapy to the head or neck are en-
rolled in a proactive, preventive swal-
lowing therapy program even if they
have no problem swallowing at the
time they are diagnosed."
The preventive swallowing therapy
program begins with a pretreatment
evaluation that typically includes video-
fluoroscopy (also called a modified bar-
ium swallow study). "Videofluoroscopy
gives us the physical and functional pa-
rameters of the swallow: how safely and
efficiently the patient can move food
and liquid through the mouth and
throat," Dr. Hutcheson said. "Baseline
evaluations uncover subclinical swal-
lowing difficulties fairly often. Knowing
this helps us provide patients with spe-
cific instructions on how and what they
should eat during radiation therapy to
avoid swallowing things that will be
aspirated-drawn into the lungs-and
cause pneumonia."
Patients in the preventive swallow-
ing therapy program also attend an
exercise training session before the
beginning of radiation therapy. TheStill images from videofluoroscopy performed during the baseline assessment of a patient
with newly diagnosed locally advanced cancer at the base of the tongue show adequate
airway protection with complete laryngeal closure at peak swallow (left) but tumor-associ-
ated swallow inefficiency with post-swallow pharyngeal residue (right, circle).www.mdanderson.org/publications/oncolog 5
Upcoming Pages
Here’s what’s next.
Search Inside
This issue can be searched. Note: Results may vary based on the legibility of text within the document.
Tools / Downloads
Get a copy of this page or view the extracted text.
Citing and Sharing
Basic information for referencing this web page. We also provide extended guidance on usage rights, references, copying or embedding.
Reference the current page of this Periodical.
University of Texas M.D. Anderson Cancer Center. OncoLog, Volume 61, Number 2, February 2016, periodical, February 2016; Houston, Texas. (https://texashistory.unt.edu/ark:/67531/metapth839415/m1/5/: accessed July 17, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu.; crediting UNT Libraries Government Documents Department.