Head and neck cancer, which is cancer in the head or neck region, accounts for about 4% of all cancers in the United States. When it’s caught early, it’s treatable. But these treatments — including surgery, radiation and chemotherapy — may come with side effects.
Here are some of the most common side effects of treatment for head and neck cancer — and what you can do to help manage your care.
Appearance changes and self-esteem
Surgery to treat head and neck cancer can be life-saving, but it can also cause major changes to the facial region. These changes can range from minor scarring to more serious disfigurement.
Whether the changes to their appearance are major or minor, many people struggle with low self-esteem after going through treatment for head and neck cancer — and as their body image gets worse, so can 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 care providers and other resources to help them cope.Trouble eating or swallowing
Surgery, radiation and chemotherapy used to treat head and neck cancer can cause damage to nerves, muscles, bones and other body parts that help you chew and swallow. This damage may make eating a challenge.
Your healthcare team can help you adjust your eating habits to work around the damage. In some cases, you may need a feeding tube to make sure you’re getting enough nutrition.
Breathing changes
Surgery, radiation and chemotherapy can all cause issues like swelling or scarring that damage the airway. So, treatment for head and neck cancer can affect a person’s ability to breathe.
Depending on how serious the damage is, your healthcare provider (HCP) may need to create an alternative airway in the front of your neck so that you can breathe easily. This is called a tracheostomy.Dental problems
Chemotherapy and radiation treatments for head and neck cancer can damage the saliva glands and cause a condition called dry mouth (xerostomia). Dry mouth is exactly what it sounds like, and it’s linked to tooth decay and other dental problems.
Drinking plenty of plain water, chewing sugar-free gum and using products designed to treat dry mouth can help prevent damage to your teeth. It’s a good idea to keep your dentist in the loop regarding your treatment plan. They can help you deal with any tooth problems if they do happen.
Permanent dry mouth
In some cases, the damage to the salivary glands caused by radiation treatment is permanent — and so is the dry mouth it can cause.
Fortunately, the condition can be managed with the solutions mentioned above (lots of water, sugar-free gum and special products for dry mouth). Seeing a dentist regularly can help you keep your teeth and gums healthy.
Jawbone damage
Radiation limits the supply of blood that your bones need to be strong and healthy. Since it’s usually unavoidable that your jaw will be exposed during radiation treatment for head and neck cancer, you may experience a condition called osteoradionecrosis (ORN), where bone dies because of the exposure to radiation. This condition most often affects the lower jaw but can happen in the upper jaw as well.
One way to handle ORN is to make sure your teeth and gums are as healthy as possible before going through radiation to limit the damage. Treatment options for ORN include surgeries to remove dead bone and reconstruct the jaws.
Voice changes and complications with talking
Surgery and radiation treatments for head and neck cancer can damage the vocal cords, which may change the way you talk. Your voice might sound different, or it could get harder for you to talk.
Your healthcare team may refer you to a speech language pathologist, 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 by small, kidney-shaped clumps of tissue called lymph nodes. Treatment for head and neck cancer can damage the lymphatic system, causing swelling when lymph fluid gathers under the skin.
This swelling is called lymphedema, and it’s particularly common among 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 get lymph flowing and reabsorbed by the body to bring down swelling.
Chronic pain
Head and neck cancer can be very painful — and so can the treatments. Because living with pain can affect how well your treatment works and your overall quality of life, your healthcare team will work with you to figure out a personalized pain management plan.
This plan may include pain-relief medication as well as drug-free treatments like physical therapy and acupuncture. Cognitive behavioral therapy (CBT), mindfulness techniques and other mental health supports may also help to ease pain related to head and neck cancer.
Help is out there
It's completely understandable to experience difficult emotions around the side effects of treatment. If you are having difficulty coping, speak to your HCP. They can connect you with specialists, support groups and other resources to help you make it through.
This educational resource was created with support from Merck.
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