Post-Cancer Treatment Care

Living with and Beyond Head & Neck Cancer:
Treatments, Side Effects, and Rehabilitation

Head and neck cancers affect areas such as the mouth, throat, and voice box. While treatments like surgery, radiation, and chemotherapy save lives, they can also leave lasting challenges—making eating, speaking, and even daily movement difficult. Rehabilitation after treatment is a team effort. Different specialists, including physical therapists, speech therapists, dietitians, and psychologists, work together to help patients recover function and improve quality of life.

1. Common Treatments for Head & Neck Cancer:

Treatment usually involves one or more of the following:

Surgery:

Removes tumors and sometimes lymph nodes, but can affect swallowing, speech, and shoulder function (National Cancer Institute [NCI], 2024).

Radiation therapy:

Targets cancer cells but may cause dry mouth, swallowing problems, and stiffness (Bensadoun et al., 2020).

Chemotherapy:

Uses drugs to destroy cancer, often with radiation. Side effects include fatigue, nausea, and neuropathy (NCI, 2024).

Targeted therapy & immunotherapy:

Newer treatments that attack cancer cells more precisely or boost immunity. They may cause fewer systemic effects but still affect thyroid function, skin, and swallowing (Mehanna et al., 2021).

2. Common Side Effects After Treatment:

Survivors often deal with side effects that persist beyond treatment:

Swallowing difficulties (dysphagia)

– due to scarring, nerve injury, or muscle weakness (Logemann, 2019).

Neck and shoulder stiffness

– common after neck dissection surgery (McGarvey et al., 2015).

Dry mouth (xerostomia)

– caused by radiation damage to salivary glands (Bensadoun et al., 2020).

Speech and voice changes

– from surgery or radiation affecting vocal cords (Merrill et al., 2020).

Fatigue and weakness

– frequent after chemotherapy and radiation (Bower, 2019).

Lymphedema

– swelling of the face or neck from lymph node removal or radiation (Ridner et al., 2021).

3. Multidisciplinary Rehabilitation Approach:

Rehabilitation after head and neck cancer is most effective when different specialists address specific needs:

Speech-Language Pathology (SLP):

Focuses on swallowing therapy, speech clarity, and safe eating strategies. Exercises and special swallowing techniques help prevent choking and aspiration (Carnaby-Mann & Crary, 2008).

Nutrition/Dietetics:

Helps patients maintain adequate calories and hydration despite swallowing challenges or taste changes. Modified diets and supplements are often needed (Ravasco, 2010).

Occupational Therapy (OT):

Supports independence in daily tasks, assists with adaptive tools, and addresses fatigue and energy conservation (Silver et al., 2015).

Psychology & Counseling:

Addresses anxiety, depression, and body image concerns that commonly arise after treatment (Reeve et al., 2014).

Physical Therapy (PT):

Plays a key role in restoring movement, reducing swelling, and rebuilding strength—covered in detail below.

4. Physical Therapy: Restoring Function and Reducing Side Effects:

Physical therapy is central to recovery after head & neck cancer treatment, addressing the physical complications that affect daily life.

a. Neck & Shoulder Rehabilitation

Surgery and radiation often lead to stiffness and weakness in the neck and shoulders.
PT uses stretching, range-of-motion, and strengthening exercises to restore mobility and reduce pain (McNeely et al., 2019).

b. Lymphedema Management

Swelling of the face or neck can cause discomfort and restrict movement.
Manual lymph drainage, soft tissue mobilization, compression garments, and posture training are core PT techniques (Ridner et al., 2021).

c. Jaw Mobility (Trismus)

Radiation may limit mouth opening, making eating and dental care difficult.
Physical therapists use stretching, manual therapy, and devices to improve jaw opening (van der Molen et al., 2011).

d. Fatigue & Strength Recovery

Exercise programs combining aerobic and resistance training improve energy, endurance, and daily functioning (Mustian et al., 2017).
PT designs safe, progressive routines tailored to each patient’s condition.

5. Living Well After Cancer Treatment:

Recovery is not just about eliminating cancer—it’s about regaining the ability to live fully. With coordinated care, patients can:

Improve speech, swallowing, and nutrition.
Restore neck, shoulder, and jaw mobility.
Manage swelling and reduce fatigue.
Return to work, social activities, and exercise with confidence.

The path may be challenging, but with a multidisciplinary team—especially with physical therapy support—patients can move forward toward a healthier, more independent life.

Scientific References:

Bensadoun, R. J., et al. (2020). Radiotherapy-induced side effects: incidence, management, and prevention. Supportive Care in Cancer, 28(10), 4751–4760.
Bower, J. E. (2019). Cancer-related fatigue—mechanisms, risk factors, and treatments. Nature Reviews Clinical Oncology, 16(3), 165–178.
Carnaby-Mann, G., & Crary, M. (2008). Examining the evidence on neuromuscular electrical stimulation for swallowing. Dysphagia, 23(4), 322–330.
Logemann, J. A. (2019). Evaluation and treatment of swallowing disorders. Austin: PRO-ED.
McGarvey, A. C., et al. (2015). Shoulder dysfunction following neck dissection: prevalence and risk factors. Head & Neck, 37(3), 375–379.
McNeely, M. L., et al. (2019). Exercise interventions for shoulder dysfunction in patients treated for head and neck cancer. Cochrane Database of Systematic Reviews, (5).
Mehanna, H., et al. (2021). Immunotherapy in head and neck cancer: current status and future directions. British Journal of Cancer, 125(7), 1023–1033.
Merrill, R. M., et al. (2020). Speech and voice outcomes in patients with head and neck cancer. Journal of Voice, 34(4), 561–568.
Mustian, K. M., et al. (2017). Exercise for the management of cancer-related fatigue in adults. Cochrane Database of Systematic Reviews, (11).
National Cancer Institute (NCI). (2024). Head and neck cancers—treatment (PDQ®)–Patient version. NIH.
Ravasco, P. (2010). Nutrition in cancer patients. Journal of Clinical Medicine, 29(2), 171–181.
Reeve, B. B., et al. (2014). Impact of cancer treatment on psychological well-being. Psycho-Oncology, 23(5), 547–556.
Ridner, S. H., et al. (2021). Lymphedema in head and neck cancer survivors: incidence, diagnosis, treatment, and outcomes. Cancer, 127(6), 748–758.
Silver, J. K., et al. (2015). The role of rehabilitation in cancer care. CA: A Cancer Journal for Clinicians, 65(2), 123–144.
van der Molen, L., et al. (2011). Trismus in head and neck cancer patients: etiology, prevention, and treatment. Oral Oncology, 47(5), 452–457.