Head & Neck

Overview

Facing a head and neck cancer diagnosis may feel overwhelming, but you are not alone. You will be surrounded by the support of a skilled health care team that is specially trained to help you with any physical and emotional challenges that may occur. Having a solid personal support system around you will also be healing and helpful.

Head and neck cancer describes a variety of malignant tumors that affect the mouth, pharynx (throat), larynx (voice box), sinuses, nose, thyroid and salivary glands. As a result, treating head and neck cancer is more than removing a tumor and killing cancer cells. It also includes repairing your body to enable vital functions, such as breathing, eating and speaking, to still occur. Reconstructive surgery may be necessary. If the tumor is small, a surgeon may be able to remove it without damaging too much tissue or bone. If the tumor is large, a reconstructive surgeon may be called in to help rebuild the damaged body part.

Many areas of your life may be affected by this diagnosis, including your mental and emotional health, your appearance, socializing, intimacy and returning to work. Knowing about some of the potential emotional and physical challenges you may face can help you prepare to address them. Your health care team and support groups can assist you through your healing journey.

Mental and Emotional Health

A cancer diagnosis also means taking care of your emotional health. Your feelings may range from being angry and anxious to fearful, guilty, isolated or depressed. These feelings are common, especially if you are not able to express yourself to someone who understands. Family and friends are wonderful, but they may not be able to relate. Ask your nurse navigator to recommend a support group for head and neck cancer survivors online or in your area. The people there will understand what you are going through because they have been through something similar.

Do not hesitate to ask for a referral to a patient counselor, therapist, mental health professional or other specialists who are experienced in working with people with head and neck cancer. Contact your doctor about continued feelings of hopelessness or despair. Get immediate medical attention for thoughts of suicide.

If you need speech therapy to help with your speech and swallowing and are not receiving it, contact your doctor or another health care team member.

Appearance

You may feel self-conscious if your physical appearance changes because of treatment to your face, mouth or neck. These changes can affect how you feel about yourself. Some of the best advice about your appearance may come from other head and neck cancer survivors in an online or local support group.

Facial scarring can affect your self-esteem. Your external appearance, swelling and scarring will change as you heal and may be further altered by radiation treatment. Some scars will likely fade over time. In the meantime, once you have healed from treatment you can use makeup to help conceal them and even out your skin tone. Some makeup brands are designed specifically for this purpose and may require a prescription. Ask your doctor to recommend camouflage makeup that will work best for you.

Treatment may require that some or all your teeth are removed. Talk with a dentist with experience treating patients who have cancer about your options (see Reconstructive Surgery).

Socializing

People tend to socialize over a meal and often celebrate graduations, birthdays, etc., by eating at a restaurant. Although you may have challenges with how you eat, having a nice evening out with friends in a social setting is possible by doing things a little differently than before (see Nutrition).

Intimacy

Dating and intimacy may be difficult. The physical changes in your body may make you feel less desirable or insecure about being intimate with a partner. You may be embarrassed to explain these feelings to a partner, but try to share as openly as possible about these concerns. He or she is probably as nervous and anxious as you are. Work through this together, small steps at a time. Talking with a therapist may help.

In The Workplace

Your work relationships may be a valuable source of support. How you handle the news of your cancer diagnosis at work is very personal. You may feel it is a private matter and choose to keep it to yourself, or you may share it with your employer and coworkers. Appearance changes or physical limitations may require some explanation.

For more practical ways to adapt, keep in mind that some treatment side effects may require adjustments, such as a flexible schedule, reduced hours, a redesigned work station, the ability to work from home and/or altered responsibilities, so you may want to inform your manager and human resources department. Your employer is required under the Americans with Disabilities Act (ADA) to provide reasonable accommodations. Meet with your human resources representative for details about the ADA and how it applies in your workplace.

The Healthcare Team

Meet the specialists on your health care team

People with head and neck cancer may consult with multiple doctors, specialists and other health care professionals. Most people will not need all of them.

Head and neck oncologic surgeons provide expertise in surgical procedures of the head and neck (an otolaryngologist with specialized surgical training).

Maxillofacial prosthodontists create custom dentures or other prostheses to help restore facial appearance and speech and the ability to eat normally.

Medical oncologists treat cancer with drug therapy or other medications.

Nutritionists/dietitians help meet nutritional challenges that arise during and after treatment.

Oncologic dentists or oral oncologists provide expert dental or oral care for people with head and neck cancer.

Oncology nurses provide inpatient or outpatient care in a cancer treatment facility.

Otolaryngologists treat diseases of the ear, nose and throat; also called an ENT.

Palliative care specialists work to provide physical and emotional relief for cancer symptoms and treatment-related side effects.

Patient navigators/nurse navigators serve as a guide through diagnosis, treatment and follow-up; may also be patient advocates. They identify barriers to treatment, such as the need for transportation or help with copays and deductibles, and accesses resources to resolve such barriers. They are also commonly involved with coordination throughout the continuum of care.

Radiation oncologists treat cancer using radiation therapy.

Reconstructive/plastic surgeons use reconstructive procedures and techniques to help restore function and appearance after cancer treatment.

Rehabilitation specialists/physical therapists help restore movement and build physical strength after cancer treatment.

Speech-language pathologists offer strategies and techniques for regaining or improving the ability to speak, swallow or use other oral motor skills following treatment.

 

Finding the Social Support You Need

Depending on your unique diagnosis, being treated for a head and neck cancer can affect many areas of your life. In addition to the physical challenges that may result from cancer and its treatment, you may encounter challenges with your relationships, career and confidence. Social support is available in many forms, and you are encouraged to explore it.

Many organizations offer support groups that are held in person, by telephone and online. Opening up to people who have had similar experiences can offer comfort and practical advice that are invaluable. A one-on-one buddy program, or peer-to-peer support, pairs you with another person who has the same type of cancer as you. You might also consider contacting a counselor or therapist who has expertise in working with people living with cancer.

In addition, advocacy groups, national organizations and wish-fulfillment organizations are available. Some of these organizations are specifically designed to help head and neck cancer survivors manage the unique financial challenges of treatment. Through donations, grants and volunteers, patients are able to move forward with treatment and recovery with much-needed help in a variety of areas, from access to liquid nutrition and transportation to medical appointments and dental prosthetics. Ask a member of your health care team for a referral.

 

Know the Risks

Many head and neck cancers are linked to tobacco and alcohol use. The risk is higher for people who use both tobacco and alcohol than for people who use only one or the other. Because of the increased chance of developing another primary cancer, it is important to be aware of these and other risk factors.

  • Human papillomavirus (HPV) is particularly associated with cancers of the oropharynx (back of the throat), including the tonsils and base of tongue. HPV vaccines are now available to help prevent HPV-related cancer and other conditions
  • Cigarette smoking
  • Chewing tobacco
  • Excessive amounts of alcohol
  • Poor dental hygiene
  • Prolonged exposure to the sun, which is linked to cancer of the lip

For more information about reducing your risk of head and neck cancer, talk with a member of your health care team or use the following resources.

 

 

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