During the past 8 months LCA has launched a therapy program that is geared to meet the needs of patients diagnosed with head and neck cancer that are receiving or have received chemo-radiation treatment. The objective of the program is to reduce the side effects of this life saving treatment as it relates to swallowing. Side effects often include xerostomia (dry mouth) and stenosis (stiffness) of the swallowing mechanism resulting in complications of swallowing including aspiration. These complications have required the insertion of PEG tubes for nutritional support, however, with early intervention and ongoing intervention, the swallowing mechanism may be improved to the point that the patient may be able to resume oral intake. This program requires close cooperation between the radiation oncologists and the speech pathologists. An example of this close cooperation is the wonderful cooperation between LCA speech pathologists including Beth Farley and Amber Tincher in our Charleston locations of Thomas Memorial and St. Francis Hospitals and Kanawha Valley Radiation Oncologists.
How the Program Works:
When a patient is first seen by the radiation oncologists, a referral is made immediately to LCA for an evaluation. The evaluation is a joint evaluation with the speech pathologist and a registered dietician to determine the status of the swallowing mechanism and current nutritional needs. Often the patient is utilizing the G-tube for sole nutritional intake. Swallowing intervention is determined by clinical evaluation and possibly a modified barium swallowing study as indicated, and a program established to address any current needs and to establish preventitive exercises. The patient is either seen directly or followed indirectly by phone with direct intervention as indicated. A re-consult for evaluation is made at the end of the radiation program and possible plans are made for G-tube removal for those patients with a swallowing mechanism that is intact with input from the speech pathologist and dietician. Patients continue to be followed over time due to the delayed effect of radiation on the swallowing mechanism. Patients are encouraged to continue preventitive exercises and to get into contact with the speech pathologist at the first sign of swallowing difficulties so that re-evaluation and possible direct intervention can be made.
Currently, more than 30 patients have been seen by LinguaCare Associates speech pathologists and are being followed in this program. Patients have expressed very positive feedback with the program in that they have someone to talk with at any time regarding their swallowing or nutritional needs. It is hoped that swallowing preservation will be increased with this population of patients that previously thought there was nothing that could be done to increase their swallowing skills and that a G-tube was the only way they would ever be able to receive nutrition. This program definitely goes along with the LinguaCare Associates motto: “Communication and Swallowing….Life’s Basic Essentials” This program is available to patients in Charleston through Thomas Memorial Hospital and St. Francis Hospital and in Huntington through the LCA speech pathologists at St. Mary’s Medical Center. In the near future, it is expected to be available to patients in Beckley through Raleigh General Hospital and our LCA speech pathologists. For further information regarding our work with head and neck cancer patients receiving radiation treatment please contact us at 304-345-6313.
