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Speech-Language Pathology
Role of the Speech-Language Pathologist (SLP) in Oncology
Swallowing Function
People who have been treated with oral or laryngeal cancer often experience changes or impairment in swallowing (dysphagia). Swallowing function can be impaired depending on the location and size of the tumour, type of treatment, and the nature of any reconstruction. Dry mouth or oral infection often results in discomfort or pain when swallowing. Having a tracheostomy tube also can impact on swallowing function.
A SLP can help by providing a swallowing assessment to determine ways to swallow safely. This assessment starts with a bedside assessment to listen to the person’s swallowing history and to assess the nature of the swallowing impairment. Dysphagia management may involve diet texture modification and using swallowing strategies during mealtime to reduce risk of aspiration and choking. A videofluroscopic swallowing study (VFSS) is often suggested for further assessment to determine if intensive swallowing treatment is required.
Swallowing treatment can help to improve swallowing function by incorporating muscle exercises, compensatory strategies, and head postures. Part of treatment is enhancing oral hygiene so that swallowing is more comfortable and safer by reducing risk of aspiration of oral bacteria.
Speech and Communication
Speech and voice function can be affected by oral or laryngeal cancer, making it difficult to communicate with family, friends, and the medical team. An SLP can help by providing alternate means of communication during recovery and determine if speech and voice rehabilitation is beneficial.
When to make a referral to a SLP?
A person’s speech and swallowing function can fluctuate and worsen during treatment due to the side effects of surgery, chemotherapy and radiation treatment. In acute care, an SLP can provide education and counselling during the early stage of medical treatment to develop realistic goals for speech and swallowing. A swallowing assessment should be considered when most of the cancer treatment is completed to address goals of returning to oral feeding or eating small amounts for pleasure when swallowing is significantly. Swallowing treatment is introduced in acute care over several sessions before discharge. A CCAC SLP referral is often suggested to help the person continue swallowing treatment at home.