Respiratory-Swallow Training in Head and Neck Cancer

Difficulties swallowing food and drink following cancer of the head and neck are common. Swallowing difficulties often arise due to the position of the tumour itself (which may be found in the mouth, tongue, voicebox or throat) and after treatment (surgery, chemotherapy and/or radiotherapy). Swallowing difficulties may last a long time and can lead to problems such as: fear of eating; losing weight; chest infections; and even death. Swallowing difficulties can also have a negative impact on an individual’s mental health. These difficulties can affect how people interact with others and whether they take part in enjoyable activities. Unfortunately, exercises designed to improve swallowing do not always work for a lot of patients with head and neck cancer. This means we need to look for new ways of improving swallowing.

The solution? Recently, new training, which aims to change the breathing-swallowing pattern of patients with swallowing difficulties, has been developed in America. It seems to work well and improves swallowing for people with head and neck cancer. However, this training programme requires expensive equipment and a lot of training to work. Dr Michelle Lawton and colleagues from the Liverpool Head and Neck centre thinks it is possible to train people to improve without this expensive equipment. This will benefit patients because, if it works, it will be available quickly to lots of people. It will also be easy to access from home, reducing the need to come into hospital.

Dr Lawson is running a study which aims to:

• develop a training package for speech therapists.
• train speech therapists to use the programme with patients.
• see if we can train speech therapists to give the right feedback to patients during training, without the use of expensive equipment.
• carry out a study to see how the training programme would work in practice, using equipment to train one group and no equipment in the other group.
• find out about whether the project is doable, likely to work in the NHS and worth investing in.
• ask patients and therapists about what they think of the training and whether it can be improved.
• make sure the results are available to all, including patients, healthcare professionals and researchers, using research articles, social media, newsletters and videos.

Dr Lawson told us “I will continue to work with patients and therapists to make sure that the research is meaningful to patients with head and neck cancer and the NHS. Therapists and patients will help to develop the training. Patients will help to make sure the study is designed well, and the results are important to them.“

Dr Michelle Lawson can be contacted at michelle.lawton@liverpool.ac.uk and see more at Liverpool Head & Neck Centre | World-Class Research For Patient Care | Liverpool Head & Neck Centre (livheadandneck.co.uk)