After treatment, patients with oral cavity or oropharyngeal cancer need to be monitored closely for signs of cancer returning or new cancers developing in the head and neck area. Your cancer care team will discuss the necessary tests and their frequency based on your cancer type, stage, treatment and risk of recurrence.
It's important to attend all follow-up visits with your doctor, possibly for many years. During these visits, your doctor will check for any problems and may perform exams, endoscopies, lab tests or imaging tests to detect signs of cancer returning, new cancers or treatment side effects. Some side effects might appear weeks, months or even years after treatment, so these visits are a good time to discuss any concerns you have.
Doctor Visits and Tests
If there are no signs of cancer, doctors often recommend regular physical exams and tests every few months for the first couple of years after treatment, then less frequently in subsequent years. Early-stage cancer patients might have fewer visits.
Quitting Smoking
If you smoked before treatment, quitting is crucial to reduce the risk of new smoking-related cancers. Your doctor can offer counseling and medication to help you stop smoking. It's important to quit, even if you had early-stage cancer.
Find out more about the Smoking Cessation Program at The Lung Center at Brigham and Women’s Hospital.
Managing Speech and Eating Challenges After Oral or Oropharyngeal Cancer Treatment
- Speech Changes After Cancer Treatment: Cancer and its treatments can impact speech, especially if the cancer is in the tongue, soft palate, lips or voice box. These changes might make your voice sound huskier, quieter or like you have a cold. Some people may temporarily or permanently lose their voice or find it hard to pronounce certain words, making communication difficult. Speech therapy can help improve speech over time and doctors can suggest ways to keep your mouth moist if radiation therapy causes dryness.
- Coping with Speech Changes: Losing your ability to speak clearly can be very frustrating. It takes time to adjust and find new ways to communicate. Writing notes on a notebook or using an electronic device can be very helpful during this period.
- Eating and Drinking Challenges: Cancer in the mouth or throat and its treatments can make eating and drinking difficult. You might have trouble swallowing, notice changes in taste, lose weight or have a dry mouth. Fortunately, there are ways to manage these issues and healthcare providers can refer you to a dietitian for additional support.
- Difficulty Swallowing: If your treatment affects swallowing, a speech and language therapist and a dietitian will be part of your care team. They will help you manage swallowing difficulties during and after treatment.
- Radiation Therapy Effects: Radiation therapy can make your throat sore and swallowing painful. Your doctor can provide strong painkillers and a protective gel for your mouth to help with the discomfort.
- Oral Hygiene: Maintaining good oral hygiene is important, even if you're not eating much. Keeping your mouth and teeth clean helps prevent infections and can improve your overall comfort.
- Soft Diet or Liquid Nutrition: A dietitian may evaluate whether you need a feeding tube before starting treatment. This could be a nasogastric tube (from nose to stomach), a gastrostomy or PEG tube (directly into the stomach) or a stoma (through the throat). Liquid nutrition through these tubes can help prevent weight loss during treatment.
- Taste Changes: Cancer treatments can change your sense of taste, making food taste metallic, bitter, salty or bland. These changes are usually temporary with chemotherapy but can be permanent with radiation therapy. Surgery on the tongue can also affect taste.
- Dry Mouth: Radiation therapy can cause dry mouth, making eating and talking uncomfortable. This condition might last for months or be permanent. Doctors can prescribe artificial saliva or stimulants for the salivary glands. Drinking water frequently, using ice cubes, moistening food with sauces and chewing sugarless gum can help. Regular dental check-ups are important to prevent infections and tooth decay.
- Loss of Appetite and Weight Loss: Cancer treatment can reduce appetite and cause weight loss. Pain or difficulty swallowing might make you reluctant to eat. Painkillers and high-calorie supplements can help. If weight loss continues, inform your healthcare team for further support. Eating small, frequent meals and high-calorie foods can also help.
- Difficulty Chewing: Surgery in the mouth or jaw can cause numbness or pain, making chewing difficult. Soft foods may be needed while your mouth heals. Chewing difficulties might last longer if nerve damage occurs. Reconstructive surgery or a dental prosthesis might be necessary to help with chewing and swallowing.
- Loss of Smell: Cancer treatment can affect your sense of smell, reducing appetite and enjoyment of food. Trying different textures and spicy foods can make eating more enjoyable. Ask your doctor about options for keeping your sense of smell intact.
- Stiff Jaw: Radiation therapy or surgery can cause a stiff jaw, known as trismus, making it hard to open your mouth, eat or chew. Gentle jaw exercises, recommended by your doctor or dentist, can help prevent permanent stiffness. Speech and language therapists can provide additional support if needed.
