Helping a Head and Neck Cancer Patient Recover the Ability to Eat

Sherri Hughes has worked as a speech-language pathologist in VNSNY Home Care’s Nassau region since 2011. Prior to that, she worked in a variety of clinical settings, including helping to run a cleft palate clinic for children at a Long Island hospital.

“Head and neck cancer surgeries are as individual as a fingerprint,” says Sherri. “You never know exactly how much of the mouth or tongue the surgeon is going to take out, or how the patient is going to heal, because the scar tissue is different with each person.” Such surgeries, coupled with follow-up radiation therapy, typically leave patients with troubling side effects, including facial pain, sores in the mouth, dry mouth from lack of saliva, loss of taste, and difficulty opening the mouth—a condition known as trismus.

Referring to the head-and-neck cancer patient who recently wrote a letter praising Sherri for her therapy services, Sherri notes, “He was fortunate to have had a type of surgery he was able to recover fairly quickly from, and he was able and willing to put in the work—so he did very well. When we first began therapy, my patient couldn’t get a spoon into his mouth, and he was receiving all of his nutrition through a feeding tube.”

Sherri’s first step with head-and-neck cancer patients is always to thoroughly explain the after-effects of the surgery and the exercises she would be prescribing to help the patient recover. “It’s important that patients understand that what they’re experiencing is not unusual, and that it will get better,” she says. “This surgery is life-changing and it can hit patients very hard—so part of my job is to help them stay hopeful and positive.”

Sherri took her patient through a number of different oral motor and swallowing exercises in each session, to help him regain the use of his mouth and tongue. The fact that he is a recreational athlete helped, she notes, since he was used to pushing through barriers. The patient worked diligently at the exercises, but he balked when it came to eating applesauce—an important part of his recovery, since learning to swallow the pureed food would help wean him off the eating tube. “He really didn’t want to do it, but I finally got him to take about ten spoonfuls,” smiles Sherri. “Later that night, he texted me a photo of the empty applesauce jar. It was an incredible feeling to see that photo!”

A speech therapist with VNSNY since 2011, Sherri has also worked extensively with patients in hospital settings, and appreciates the advantages of doing therapy in the patient’s home. “Besides being able to work with their own kitchen and food supplies, it’s more personal,” she says. “If we’re going in three times a week, we might see patients more often than some of their family members. Being able to develop a relationship with your patients and motivate them is everything. You need to convince them that they’re better than they think they are.”

Once he began eating pureed foods, Sherri’s patient progressed rapidly. Within several weeks of starting treatment, he realized his dream of eating a corned beef sandwich. His feeding tube was removed a short time after that. While the patient’s 8-week home care episode has ended, he still checks in with Sherri occasionally by phone to get tips on nutrition and respiration as he trains for his next triathlon.

“With this type of cancer, while you’re never completely the same after treatment, some degree of taste and saliva flow typically does return,” says Sherri. “In this case, other than some residual pain due to scarring tissue pressing his trigeminal nerve, the patient has largely recovered all his functioning. It’s a real success story!”