The Role of Speech-Language Pathologists and Swallow Therapists
Head and neck cancer is usually treated by a multidisciplinary team. This may include physicians in different specialties as well as nurses, speech therapists, occupational therapists, psychologists, and social workers.
Speech-language pathologists (SLPs) help prevent, evaluate, and treat problems with speech and communication, using strategies such as targeted exercises, voice therapy, and alternative voice devices (if necessary). Many are also trained in evaluating and treating swallowing disorders, using exercises and diet modifications to help patients safely eat, drink, and swallow.
“Speech pathologists can look at the big picture and provide interventions that are important to that person,” says Starmer.
The speech pathologist has become a core member of the head and neck cancer care team over the past two decades, she adds. The Head and Neck Cancer Survivorship Consensus Statement from the American Head and Neck Society states that evaluation and treatment from SLPs should be incorporated for adults with head and neck cancer who are at risk for speech and swallowing issues.
It’s important to begin working with an SLP before beginning treatment for head and neck cancer, as well as during treatment and afterward, says Megan Clark, MD, an associate professor in physical medicine and rehabilitation at West Virginia University in Morgantown, West Virginia.
“Getting a baseline assessment before surgery is helpful as it can help identify any subtle deficits that may already be present. Early engagement is very useful and important for speech and language.”
But even though speech and swallow therapy and rehabilitation are increasingly being integrated into standard care practices, they’re still not offered to every patient. “The hard part is the patients who don’t have these therapies as part of the treatment,” says Dr. Clark. “Patients need to know that it’s okay to ask for it, and to advocate and be proactive about getting this care.”
Some people live in areas where SLPs may be in short supply or are located far away. While not fully integrated yet, telehealth may be a possibility for some of these patients, Clark notes.
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