Head and neck cancer and its treatment can also affect your ability to breathe normally.
This can be due to a number of factors. The location and size of the tumor, as well as swelling related to surgery, radiation, infection, or other treatments, can affect both breathing and swallowing. If you have a tumor in your throat, for example, it may block your airway or put pressure on the structures around it.
If cancer develops in your vocal cords or larynx, that can also affect breathing. The larynx allows you to speak and helps with breathing and swallowing, so cancer can affect those functions.
Treatment can also affect breathing. Surgery is one of the main interventions for head and neck cancer, but it can cause swelling afterward in your mouth and throat. This can make breathing more difficult. Radiation therapy can also cause inflammation and swelling in the neck area, leading to breathing problems.
“Tumors may narrow the airway in the throat or voice box, while surgery or radiation can cause swelling, thick secretions, or scarring that makes breathing more difficult,” says Kyle Hatten, MD, a head and neck surgeon at the University of Maryland Greenebaum Comprehensive Cancer Center and an associate professor of otorhinolaryngology at the University of Maryland School of Medicine in Baltimore. “New noisy breathing, rapidly worsening shortness of breath, difficulty speaking, or the sensation that the airway is closing should be treated as an emergency.”
Airway management is an important consideration from the time a head and neck cancer is diagnosed, explains Rajasekaran. “Airway function should be assessed proactively as part of the patient’s overall cancer evaluation and treatment plan,” he says. “It’s important for patients to be aware of [potential breathing difficulties] and communicate clearly with their medical professionals about any significant problems, as these may require urgent treatment.”
If there’s a chance that a tumor or treatment could compromise the airway, it’s safer to establish a plan before breathing becomes an emergency, adds Dr. Hatten. “Patients and families should understand which symptoms require an immediate call to the treatment team and which require calling 911,” he says.
Strategies to safeguard your airway include:
- Change Positions “Interventions may begin with positioning techniques that help patients breathe more comfortably, such as elevating the head,” says Hatten. You can try sitting upright and leaning forward slightly or using pillows to prop up your head and upper body while sleeping.
- Use Controlled Breathing Techniques These techniques, such as pursed-lip breathing, can help make each breath you take more effective. Pursed-lip breathing is done as follows: Breathe in through your nose and hold your breath for two counts, and then breath out slowly with your lips puckered. This will feel like you are whistling. Exhale for four counts. Always breathe out for a longer period of time than you breathe in.
- Plan Activities Wisely Schedule your daily activities in a way that ensures you have time to do the things that are most important. Go at a pace that doesn’t tire you out and that works for you.
- Try Oxygen Therapy If your oxygen levels are low, your doctor may suggest oxygen therapy. Oxygen levels can be measured by placing a small sensor on your finger. If levels are low, oxygen can be delivered through a mask or nasal prongs.
- Run a Humidifier The lining of your mouth, nose, and throat may be more sensitive to dry air if you’ve undergone radiation or had certain surgical procedures, so using a humidifier can be helpful to ease breathing, says Hatten. Alternatively, you can run a hot shower for about 10 minutes to steam up the bathroom and then breathe in the warm mist for 30 minutes.
- Address Underlying Causes An underlying cause, such as asthma or heart failure, may also contribute to breathing problems. “Patients with head and neck cancer may also experience medical problems that cause breathing difficulties that are not due to airway problems, and medical professionals can help make these diagnoses as well,” says Shuman.
- Find Ways to Relax Research suggests that certain relaxation and techniques, such as meditation, may ease stress and anxiety. In turn, feeling more relaxed may help you breathe better.
- Manage Secretions Radiation therapy can cause changes to your saliva. It can make your mouth dry, with saliva becoming thicker and more “sticky.” Or it can also cause you to produce too much saliva. It can also affect your ability to swallow normally, so you may be unable to clear the saliva in your mouth and throat, which can put you at risk of respiratory issues. Portable suction equipment allows you to clear your mouth of excess mucus or saliva, prevent airway blockages, and make breathing easier. “For patients who have difficulty clearing saliva or other secretions, suction devices can provide temporary symptomatic relief and help patients manage secretions at home,” says Rajasekaran.
- Seek Medical Interventions In some circumstances, more definitive interventions may be necessary, such as medications to relieve swelling related to the cancer and its treatment, or surgeries to bypass or open the blocked airway, says Shuman. It’s important for patients to be aware of these possibilities and communicate clearly with their care team about any significant breathing problems, as these may require urgent care, he adds.
- Tracheostomy If the airway becomes significantly compromised or is expected to become compromised because of the tumor or treatment-related swelling, a tracheostomy may be necessary to establish a secure airway, says Rajasekaran.
A tracheostomy is an alternative airway that allows you to breathe through a hole in the front of your neck. However, a tracheostomy doesn’t necessarily have to be permanent. “In some patients, once the tumor has been treated and the airway is no longer compromised, the tracheostomy can be removed,” says Rajasekaran.
Read the full article here
