Mouth cancer - Complications of mouth cancer

Complications of treatment for mouth cancer can include dysphagia (difficulty swallowing), speech problems and emotional disruption.

Difficulty swallowing

Dysphagia is the medical term for difficulty swallowing. It is easy to take your ability to swallow food and liquid for granted, but in reality the process relies on a complex interaction of muscles, which can be easily disrupted.

Surgery and radiotherapy can affect your tongue, mouth or throat, resulting in dysphagia. Dysphagia is a potentially serious problem because, aside from the risk of malnutrition, there is a chance that small particles of food could enter your airways and become lodged in your lungs. This can trigger a chest infection, known as aspiration pneumonia. 

If you are having problems swallowing, a speech and language therapist (SLT) will need to assess your swallowing reflex. One way an SLT can do this is to perform a test known as a videofluoroscopy, which involves adding a special dye to liquid and food that you swallow. The dye highlights your swallowing reflexes and by using X-rays your SLT can see if there is a risk of food entering your lungs.

If this is the case, it may be necessary in the short term to provide you with a feeding tube, which will be directly connected to your stomach. The SLT will teach you exercises so you can "relearn" how to swallow properly.

Read more detailed information about how dysphagia is treated.

Your ability to swallow will improve as you learn the exercises and the damaged tissue is allowed to heal. However, there is a chance your swallowing reflex will never fully recover.

In some circumstances, you may have to alter your diet to make swallowing easier. A dietitian can give you dietary advice.

Speech

Much like swallowing, your ability to speak clearly is governed by a complex interaction of muscles, bones and tissue, including your tongue, teeth, lips and soft palate (a section of tissue found at the back of the mouth).

Radiotherapy and surgery can affect this process and make it difficult to pronounce certain sounds. In severe cases, you may have problems making yourself understood.

An SLT will help you improve your verbal communication skills by teaching you a series of exercises that develop your range of vocal movements and teach you new ways of producing sounds.

Emotional impact

The emotional impact of living with mouth cancer can be significant. Many people report experiencing a roller coaster effect.

For example, you may feel down when you receive a diagnosis, but feel up when the cancer responds to treatment. Then you may feel down again as you try to come to terms with the side effects and after effects of your treatment.

This type of emotional disruption can sometimes trigger depression. Signs that you may be depressed include:

• feeling down or hopeless during the past month
• no longer taking pleasure in the things you used to enjoy

Contact your GP for advice if you think you may be depressed. There are a range of effective treatments for depression, including antidepressant medication and talking therapies, such as cognitive behavioural therapy (CBT).

Read more about depression and coping with cancer.

You may also find the Cancer Research UK website a useful resource.