Complications of treatment
Complications of treatment have to do with how chemotherapy and/or radiation affect the tissues and structures of the head and neck region.
- Oral complications: cancer treatments slow or stop the growth of fast growing cells, and cancer cells as well as normal cells in the lining of the mouth grow quickly, so anti-cancer treatment can stop them from growing. This slows down the ability of oral tissue to repair itself and fight infections. Radiation therapy may break down the tissues, including bone, and both chemotherapy and radiation may upset the balance of good bacteria in the mouth, which may lead to infections and tooth decay. That is why it is so important to have medical and dental checkups before starting treatment.
- Fatigue or lack of energy can be caused by both the cancer and its treatment, and it is characterized by a feeling of heaviness that won’t be alleviated with regular sleep and rest.
- Malnutrition is very common among patients with head and neck cancers. Complications from surgery, chemotherapy and radiotherapy may all lead to poor nutrition and the need for supplemental forms of food intake. Most patients receiving these treatments will need a feeding tube in the first three to four weeks after treatment. Sometimes the tube is placed into the stomach or small intestine through an incision (cut) made on the outside of the abdomen.
- Mouth and jaw stiffness can also contribute to malnutrition, oral infections and tooth decay as well as emotional problems, such as depression resulting from problems speaking and eating.
- Swallowing problems are very common in patients with head and neck cancers. In addition to poor nutrition, other complications include pneumonia and other respiratory problems, side effects from pain medication, such as constipation, and moderate to severe emotional problems.
- Tissue and bone loss can result from radiation therapy that can destroy blood vessels within the bone, making it fragile and prone to infection or fractures.
Management of symptoms
Cancer Care Ontario offers a symptom and side effect management guide that allows the patient to control their symptoms by answering a series of questions. Called “Your Symptoms Matter,” this tool is based on the Edmonton Symptom Assessment System-r (ESASr) that asks nine questions related to the most common symptoms to be rated from 0 to 10, 0 the least and 10 the most frequent, depending on how intense or painful a symptom is. This guide also provides an outline of the body so that the exact location of the symptom can be identified.