Supportive care for oral cancer

Supportive care helps with the physical, practical, emotional and spiritual challenges of cancer. This important part of cancer care focuses on improving the quality of life of people with cancer and their loved ones, especially after treatment has ended.

Adjusting to life after treatment is different for everyone. Your recovery will depend on many different factors, such as where the cancer was in your body, the stage of the cancer, the organs and tissues removed during surgery, the type of treatment and side effects.

If you have been treated for oral cancer, you may have the following concerns.

Self-esteem is how you feel about yourself. Body image is how you see your own body. They are often closely linked. Oral cancer and its treatments can affect your self-esteem and body image. Often this is because cancer or cancer treatments change your body in different ways, such as:

• scars
• skin changes
• changes to the shape of the face
• having to use a prosthesis
• difficulty speaking or eating
• weight loss

Some of these changes can be temporary. Others will last for a long time or be permanent.

Find out more about coping with body image and self-esteem worries.

Dry mouth is common during and after treatment for oral cancer. Radiation therapy and surgery can damage the salivary glands and cause them to not make enough saliva. Not enough saliva can make the mouth dry. Chemotherapy may also cause a dry mouth temporarily during treatment.

Find out ways to manage dry mouth.

Surgery in the mouth that removes certain structures such as the tongue and jawbones can cause difficulty chewing and swallowing. Radiation therapy can stiffen the muscles in the mouth, making it hard to swallow. Surgery or radiation therapy treatment may make it hard to chew because of pain or numbness in the mouth.

Eating soft foods can help make chewing and swallowing easier. But some people may need reconstruction or a prosthetic facial part to make it easier to chew and swallow.

If you have part of your tongue removed, a speech-language pathologist (also called a speech therapist) can help you learn how to use the rest of your tongue when swallowing. Other ways to improve swallowing include changing your head posture, doing swallowing exercises for the throat and range-of-motion exercises for the jaw and tongue.

Find out more about swallowing problems.

Surgery that removes large parts of the tongue, jawbones or palate may cause speech problems. Dental implants or dentures can replace the structures removed and help improve speaking.

A speech-language pathologist can assess and help manage speech problems. They can teach you exercises to strengthen the muscles used for speech. Speech-language pathologists can also teach you other ways to speak and communicate using adaptive communication devices.

Radiation therapy to the head, neck or mouth may damage the salivary glands and taste buds in the tongue, which can then affect the way some foods taste. Chemotherapy drugs can also affect taste. Surgery to remove parts of the mouth or tongue can cause a reduced or lost sense of taste.

Find out more about taste changes.

Radiation therapy to the head or neck can cause dental problems. Radiation therapy can damage the salivary glands so they do not make as much saliva. Saliva helps keep the teeth and gums clean. When less saliva is made, there is a higher risk of developing cavities and gum disease. Radiation therapy can also affect tooth enamel, which increases the risk of tooth decay.

A checkup with a dentist or dental oncologist is done before treatment starts. You may have fluoride treatments to help protect teeth from developing cavities. Regular visits to the dentist or dental oncologist after treatment are often recommended.

Having difficulty chewing and swallowing, as well as a loss of appetite, may lead to your body not getting the nutrition it needs and to weight loss. A dietitian can help manage your nutrition needs and loss of appetite. They may recommend nutritional supplements and suggest ways you can try to increase your appetite and eat more to maintain good nutrition.

Find out more about nutrition and weight loss.

Radiation to the neck may cause decreased thyroid function (hypothyroidism). Between 40% and 50% of people receiving radiation therapy for head and neck cancers, including oral cancer, will develop hypothyroidism. Some symptoms of hypothyroidism include extreme fatigue, dry skin, weight gain and feeling cold.

If you have hypothyroidism after treatment for oral cancer, you may need to take medicine every day to manage it.

To make decisions that are right for you, ask your healthcare team questions about supportive care.