Head & Neck Cancer
Reconstruction & Rehabilitation
Your medical team will do everything possible to help you begin to feel more like yourself. Multiple options are available and certain organizations are dedicated to contributing financially to help head and neck cancer survivors afford procedures that will help them live fully during and after treatment.
This type of surgery can help you perform vital functions that may have been altered by your cancer or its treatment. It may also help restore your appearance, if needed or desired. Reconstruction may require more than one procedure, and it may not produce results right away. Before treatment begins, consult with a skilled surgeon who is experienced in head and neck reconstruction. Ask about your options; the timing of any surgeries you will have; where surgery will occur; who will perform it; and what to expect afterward.
Sometimes treatment involves surgery to remove a large amount of soft tissue or bone. Your surgeon may use a “flap” procedure in which healthy skin or tissue is rotated or moved to fill the wound.
With local flap surgery, the surgeon rotates or moves nearby tissue that has an attached blood supply. The tissue goes onto the surgical site from this nearby site. This might include muscle and skin from your chest (pectoralis major flap) or skin from your shoulder (supraclavicular flap).
With free flap surgery, a specially trained surgeon removes a “flap” of tissue plus its feeding artery and vein from another part of the body. The surgeon uses this tissue to reconstruct areas in the head and neck. This involves creating a new blood supply by sewing the flap’s artery and vein into an artery and vein near the wound (called microvascular reconstruction). Free flaps are most often taken from the forearm, thigh, lower leg or back/shoulder blade.
After surgery to remove your upper or lower jaw and teeth, your doctor may suggest dentures or dental implants. These can improve your appearance and help you eat more normally.
Gastrostomy tube (G-tube)
An inability to swallow may prevent you from getting the right nutrition. A tube inserted into your stomach through a small incision in your belly (called a gastronomy tube) or through your nose (called a nasogastric tube) allows you to receive liquid nutrition (see Nutrition). Swallow therapy may also be prescribed.
This is an artificial replacement for your ear, eye, nose, hard palate or teeth. A specialist (a maxillofacial prosthodontist or anaplastologist) can design a custom prosthesis.
A surgeon creates a hole called a tracheostoma – or stoma – in the front of the neck and connects it to the windpipe. Then the surgeon inserts a hollow plastic device (tracheostomy tube) into the stoma. You can breathe through this new airway.
In some cases, the surgeon must remove your voice box (called a laryngectomy). This requires placing a soft, plastic or silicone tube (laryngectomy tube) – or lary tube – to help with the healing process. Once healing is complete, you no longer need the laryngectomy tube, but the stoma is permanent. You then breathe through this hole.
Getting Comfortable with you Self-image
If you struggle with your self-esteem, do not ignore your feelings or become isolated. Ask for referrals to therapists and other specialists. Some of the best advice may come from other head and neck cancer survivors.
- Swelling and scarring changes. These occur with treatment and over time. Once you heal from treatment, try concealing makeup to even out your skin tone. Ask your doctor about prescription makeup.
- Trouble speaking. This may make you feel self-conscious. Speech therapy can help you improve your communication skills and regain confidence. A speech-language pathologist can teach you exercises or new ways of speaking.
- Your stoma. Over time, you may think less and less about your stoma. To disguise it, try wearing turtlenecks, scarves, crew neck cotton undershirts or jewelry.
These suggestions may help you adapt to your stoma. Seek out the advice of your medical team and other cancer survivors with stomas.
- Add humidity. Breathing through your nose or mouth moistens, warms and filters air, but breathing dry, cool air through a stoma can cause a buildup of thick, crusty mucus. It can also lead to coughing and trouble breathing. Using saline squirts and humidifiers when sleeping can help ease these symptoms. Ask your health care team about heated humidifiers and heat and moisture exchange systems (HMEs).
- Clean your stoma daily. Your body may produce more mucus, which can plug the stoma. Keep tissues handy throughout the day to remove any extra mucus. Your health care team will provide detailed guidelines about how to clean and suction out your stoma.
- Cover your stoma when you cough. Covering your stoma with a tissue allows you to catch any mucus your cough produces. It may feel strange to cough through your stoma at first, but most people adjust fairly quickly.
- Dress comfortably. Choose soft, cotton garments to avoid irritating the stoma.
- Maintain personal hygiene. When you bathe or shower, use a shower shield, collar, stoma cover or washcloth. This helps avoid getting water and soap in your stoma. Even the smallest amounts can cause severe coughing and irritation.
- Use a stoma cover. This helps keep pollen, dust, pet hair and aerosol sprays from going into your lungs.
- Wear a medical ID that alerts others you have a stoma.