Changes to speech, chewing, swallowing or your voice

Depending on what structures of the head and neck have undergone treatment you may have experienced changes to speech, chewing, swallowing or voice. The role of the Speech and Language Therapist is to help you adapt to these changes and provide appropriate therapy when the time is right.
Surgery and radiotherapy can cause the swallowing muscles to become weak, slow and uncoordinated. We can give advice on strategies to make your swallowing easier and safer, including fluid and food texture advice.
Sometimes it can be difficult to assess what is happening with the swallow so we may suggest a video swallow test which is similar to an x-ray but provides us with detailed information on how the muscles are working together and help guide our therapy.
Our main concern with swallowing is to prevent food and fluids entering the lungs which can cause frequent bouts of coughing when eating and drinking and will often result in chest infections.

Before treatment.
Prior to radiotherapy treatment you may have been given some exercises to try and prevent swallowing difficulties from arising.
These are designed to encourage a faster recovery and to help keep you swallowing as safely as possible for as long as possible.
However, everyone is individual and symptoms, as well as the severity of symptoms from radiotherapy can vary and some may last longer than others.
It is important to continue these exercises for at least 3 months following treatment as the immediate effects of radiotherapy can continue for some time after.

After treatment.
Following treatment, rehabilitation programmes for the muscles in your mouth, jaw, face and voice box are designed to help increase their flexibility and strength, which helps to improve symptoms.
These exercises take time and commitment but your confidence in communicating with others and with eating and drinking should improve as therapy continues.
It is important to remember that recovery can take months as swallowing and speech are dependent on complicated muscle movements.
The extent of recovery can also vary as everybody is individual.

Occasionally, radiotherapy changes to the speech and swallowing muscles may continue for some time after treatment unnoticed and symptoms may become apparent even years later. It is important to talk to your GP or medical team if you are concerned about any new changes so they can be addressed. 

New signs to look for may be:

  • changes to your swallow
  • recurrent chest infections
  • weight loss
  • changes to your voice quality or noisy breathing
  • reduction in mouth opening

For individual advice contact your local Speech and Language Therapy team.

For more information on speech and swallowing after surgery/treatment go to:
Macmillan Cancer Support
Cancer Research UK

Heads2gether are very grateful to the Speech and Language Therapy team at the Churchill Hospital, Oxford, for providing the above guidance.