Symptom Management

Treatment of Head and Neck Cancer can cause many nutritional challenges. The mouth and throat can become sore, making eating and drinking difficult. To meet your body’s nutritional requirements it important to maintain adequate caloric intake. Juicing, protein powder, protein drinks, sauces and gravies over your food, and buttermilk, are ways to increase your daily calories. Switch to a soft diet and try using a blender. Often a G-Tube, a small tube placed in the intestines used for feeding is temporarily required.

Radiation often effects the salivary glands, making your mouth dry. Try soothing mouth rinses. Rinsing with a warm solution of salt/baking soda/water can be helpful. There are many commercial products available: xylomelts, artificial saliva, biotene products. Hyperbaric Oxygenation and acupuncture have also been helpful to restore saliva production.

The pain associated with head and neck cancer is often a result of multiple factors: the tumor itself, surgery, and the side effects of chemotherapy and radiation. The pain from head and cancer and its treatment can involve nerves, bones, muscles, ligaments, tendons and mucosa. It is important to ensure your pain is managed properly as it can cause sleeplessness, depression, limit your range of motion and slow your recovery. A variety of modalities can be used to treat and control your pain, including:

• Prescription pain medication
• Physical Therapy
• Massage Therapy
• Acupuncture
• Relaxation Techniques and guided imagery
• Nerve Blocks

It is important to manage your pain before it becomes unbearable. Be sure to discuss your pain control on a regular basis with your doctor. The sooner you treat the pain the less likely it is to get worse or cause other complications.

Numbness and tingling in the hands and feet from chemotherapy occur. Your physician can prescribe medications to help relieve this symptom. Once treatment is complete neuropathy typically slowly improves. Other remedies include: acupuncture and hand/foot massage.

Many head and neck patients experience swallowing problems that can be a result from the surgery, chemotherapy, and radiation and may be experienced as early or late effects. Patients may experience multiple problems, including:

• The need to swallow many times to clear food
• Pain and dryness when swallowing
• The need for increased lubrication to clear food
• Throat clearing while eating
• Coughing or Choking
• Gurgly, wet sounding voice after swallowing

There are multiple interventions that can help improve swallowing: hyperbaric oxygenation, specific swallowing exercises, tongue holding maneuvers, postural changes while swallowing, oral prosthesis, and diet changes.

Mucositis is inflammation of the oral mucosa, caused by radiation and chemotherapy. Good oral hygiene, avoid spicy and acidic foods, hot foods and beverages. There are many products your physician can prescribe to help manage mucositis.

Radiation can effect the salivary glands, making your mouth dry and more susceptible to dental and gum disease. Practice good oral hygiene, brush frequently, use a soft brush, and floss. Make sure you get regular check-ups with your dentist, they may also suggest fluoride rinses.

An alteration in taste or decreased in taste sensitivity is a common and distressing side effect of chemotherapy and radiation. The encouraging news is the majority of this problem resolves once treatment is complete. There are products you provider may suggest to assist with taste alteration. You may also try some of these self-care strategies: avoid metallic flatware, add more seasoning, add sugar to decrease salty or bitter taste, eat foods at cold or room temperature, good oral care, eat small meals, avoid strong smells, add fats and sauces to food.

Cancer related fatigue is one of the most common symptoms identified by patients and family. It can be quite distressing as it affects your quality of life. While cancer related fatigue is multi-factorial, there are simply lifestyle modifications you can make to help improve the level of fatigue: Plan ahead and organize your work, schedule rest periods, pace yourself, maintain good nutrition, and stay as active as possible. Regular light exercise can help a person feel energetic and improve feelings of anxiety and depression.

Radiation can cause skin damage. It is important to keep the skin well moisturized several times daily. There are many products your physician may recommend: castor oil, aquaphor, meaderm, and silvadene.