Doctors, nurses, physician assistants, social workers, and rehabilitation specialists at NYU Langone’s Perlmutter Cancer Center collaborate to provide support for people with hypopharyngeal cancer. They offer a variety of services throughout diagnosis and treatment and during follow-up appointments.
The schedule for follow-up appointments tends to vary from person to person. You may see the doctor every 1 to 3 months during the first year after treatment, then every 4 to 6 months during the second and third years, and every 6 to 12 months in the fourth and fifth years.
During these appointments, your doctor may perform a physical exam or an endoscopy to check that the cancer has not returned. Imaging tests, such as CT or PET scans, may be performed occasionally if your doctor suspects the cancer has come back in a distant part of the body.
If you’ve had radiation therapy, the doctor may use a blood test to check the function of your thyroid gland, which helps regulate metabolism. He or she may also examine your mouth and teeth.
Speech and Swallowing Therapy
NYU Langone speech and swallowing therapists meet with you before treatment to discuss how various therapies can affect your ability to speak and swallow. Surgery and radiation therapy may sometimes damage the hypopharynx and surrounding structures, including the larynx. The larynx contains the vocal cords, which create the sounds needed for speech. The tumor itself may also affect speech and swallowing.
Speech and swallowing therapy is used throughout treatment to help you maintain as much function as possible. It is also used after treatment to help you regain or compensate for any lost ability.
Therapists can teach you exercises to strengthen the muscles in the tongue, mouth, throat, and vocal cords to help improve your ability to speak and swallow.
They can also help people who have their entire larynx removed adapt to a variety of voice restoration options.
Doctors may recommend that you see an NYU Langone dentist regularly before, during, and after treatment because radiation therapy for hypopharyngeal cancer can cause dry mouth, resulting in tooth decay. Regular toothbrushing and flossing, daily fluoride treatment, mouthwash use, and frequent dental check-ups can help prevent these complications.
Since hypopharyngeal cancer and its treatments often cause swallowing problems, you may need a nutritional assessment and dietary plan. Nutritionists at Perlmutter Cancer Center can help ensure you are getting the nutrients you need from easy-to-swallow foods throughout treatment and recovery. This can help prevent weight loss.
Specialists can explain which foods or ingredients might irritate your throat and how to avoid them. They also can recommend dietary changes to ease the discomfort of dry mouth.
During or after treatment, some people may not be able to eat regularly for several weeks. The hypopharyngeal tumor itself can also interfere with eating. For this reason, doctors may want to place a feeding tube directly into the stomach or intestine to ensure that you receive adequate liquid nutrition.
This tube, which is placed through a small incision in the abdomen, is used in the hospital and at home as you recover. It stays in place until you are at a stable weight and are eating normally. Doctors and nurses can show you how to use and care for the feeding tube.
Rehabilitation for Muscle Stiffness
Sometimes, radiation therapy and open surgery for hypopharyngeal cancer cause stiffness in the jaw, neck, and shoulder muscles. After you are evaluated by a physiatrist—a doctor who specializes in rehabilitation medicine—he or she can prescribe physical therapy at Rusk Rehabilitation that includes range-of-motion exercises, stretches, and relaxation techniques to help provide relief.
Radiation therapy may also thicken the skin and soft tissues. This condition, called fibrosis, can cause stiffness in the neck. Myofascial release, a hands-on technique of manipulating and applying pressure to tissues, can loosen a stiff jaw and neck and improve range of motion.
If stiffness and fibrosis are interfering with your daily activities, occupational therapy can be prescribed to help you regain your independence in performing everyday tasks at home, at work, and in the community.
During surgery for hypopharyngeal cancer, doctors may remove lymph nodes, which may affect lymph vessels in the neck. These vessels carry lymph fluid, which contains bacteria and waste products, away from organs and tissues. Changes to these vessels can cause lymph fluid to build up, leading to swelling, stiffness, and reduced range of motion and discomfort in the face and neck—a condition called lymphedema.
A physiatrist can prescribe physical therapy at Rusk Rehabilitation, which often includes range-of-motion and flexibility exercises. This is usually followed by specialized massage therapy, which helps drain the fluid.
Staff at Rusk Rehabilitation can also teach you to recognize the early warning signs of the condition, such as aching, tingling, or a feeling of fullness in the neck and face. The sooner treatment starts, the better the chances of relief.
Neuropathy is a condition in which nerves are damaged, causing numbness, tingling, pain, and weakness, most often in the hands and feet. It may be a side effect of the chemotherapy drugs used to manage hypopharyngeal cancer.
Doctors at Rusk Rehabilitation may prescribe medication to ease the discomfort of neuropathy. They can also prescribe physical therapy to help ensure that neuropathy doesn’t interfere with your balance, strength, or ability to walk and perform daily activities.
If you are experiencing fatigue, either due to the cancer or its treatment, your doctor may recommend that you receive physical and occupational therapy at Rusk Rehabilitation. These therapies may include strength and aerobic exercises to increase your energy levels and strategies to help you complete routine tasks.
The goals of therapy include improving your quality of life and helping you return to your daily activities.
Social and Psychological Support
Social workers are available throughout your diagnosis, treatment, and follow-up care to help you cope with any financial matters or logistical challenges that may arise, such as traveling to your medical appointments.
Support groups and one-on-one counseling sessions with a psycho-oncologist, a healthcare provider trained to address the needs of people with cancer, are available at Perlmutter Cancer Center. Counseling may help you and your family cope with depression, anxiety, or stress.
Supportive and Integrative Care
Supportive care specialists at Perlmutter Cancer Center provide ongoing therapy for cancer-related or treatment-related symptoms, such as pain, fatigue, loss of appetite, or stress, helping to improve quality of life.
Integrative therapies, such as acupuncture, may lessen discomfort and relieve dry mouth, a side effect of radiation treatment. Yoga and massage therapy can help reduce stress and enhance wellbeing.
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