Speech Therapy

Cancer of the voice box (larynx), throat (pharynx), mouth, tongue or brain can affect a person's ability to speak or swallow. Some cancer treatments can also cause problems. Surgery for head or neck cancer may result in permanent changes that cause difficulties in communication or swallowing. Radiation can cause problems ranging from short-term swelling of tissue (edema) and pain to long-term scarring and stiffening of tissue. Even some chemotherapy treatments may have effects on communication and swallowing.

Speech therapists (speech-language pathologists) work closely with surgeons and oncologists and can provide assessment and treatment suggestions for:

• speech or language problems
• difficulty swallowing (dysphagia)
• mental (cognitive) communication problems

When necessary, speech pathologists also help cancer patients learn how to use other ways to speak or communicate. These may include using:

• an augmentative or alternative communication device
  • Examples of augmentative or alternative communication device include a voice amplifier, which uses a microphone to pick up a weak voice and makes it louder or amplifies it, and writing pads, erasable writing boards or electronic notebooks.
• a prosthetic voice box (artificial larynx)
  • An electrolarynx is an example of an artificial larynx. It is a small, battery-powered, hand-held device that is used to mimic the vocal cords and produces a mechanical voice. It is often placed against the skin of the neck or along the cheek. Pressing a button on the device causes it to make a vibrating sound. The person moves their mouth and tongue to form this sound into words.
• esophageal speech
  • When the windpipe (trachea) is separated from the mouth and esophagus during surgery, a person can no longer expel air from the lungs through the mouth to speak. People are trained to swallow air and force it out through their mouth. As the air passes through the throat it causes vibrations that the person turns into speech.
• transesophageal speech
  • Some cancer patients who need to have their larynx surgically removed (laryngectomy) may have a tracheoesophageal (TE) valve placed into a small opening or puncture made between the trachea and the esophagus (tracheoesophageal puncture or TEP). This allows them to speak using air from the lung that is channelled into the esophagus by the valve.

Speech pathologists may be found at hospitals throughout Canada or by contacting the Canadian Association of Speech-Language Pathologists and Audiologists.