Effects on speech and voice after treatment

Changes to your lips, teeth, tongue, mouth, nose or throat can affect your speech or the sounds you make for speech (voice). These changes may be mild and recover as tissues heal. But for some people, changes are longer-lasting or may be permanent.

If changes in your teeth or the shape of your mouth has affected your speech, a restorative dentist may be able to improve this.

Speech therapy can help you learn to communicate in the clearest and most effective way. A speech and language therapist (SLT) can show you exercises to help strengthen and control the muscles used for speech. They can also give you advice on communication aids.

Here are some tips if you have speech or voice problems:

  • Keep your throat healthy by not smoking.
  • Drink plenty of water.
  • Choose a quiet, well-lit place with no distractions or background noise.
  • Face the person you are speaking to.
  • Sit up straight or stand to help use your breath better.
  • Speak slowly in short sentences and take a rest between them.
  • Keep a pen and paper with you.

Changes in communication

Speech and voice can sometimes be affected by treatment for cancer in the head or neck. If you had a treatment that could affect these, your doctor or nurse will have talked to you about the possible changes.

Speech and voice

We use our lips, teeth, tongue, mouth, nose and throat when we speak. If you had an operation or radiotherapy to one or more of these areas, your speech may be affected. You may have difficulty making certain sounds or saying certain words. Dryness can make your mouth and throat feel uncomfortable when having longer conversations.

The sounds you make for speech (your voice) are made by the voicebox (larynx). Treatments that affect the larynx can affect your voice. Your voice may be hoarse, tire more easily or be quieter than normal. If you had your larynx removed, you will need to learn new ways to communicate.

We have more information about communicating after an operation to remove the larynx (laryngectomy). This features a video that describes ways of communicating after the operation.


Changes to speech and voice

Any change to your lips, teeth, tongue, soft palate or voicebox is likely to make your speech or voice sound different. This may mean that you have difficulty making one or two sounds or saying some words. It may sometimes be more severe, so people can’t easily understand what you are trying to say, or they can’t hear you.

For some people, a change in their speech or voice will only be a minor problem and it will return to normal, or near normal, as the tissues heal. For others, it will be more of a problem and will cause permanent changes to the way they speak.

Losing the ability to talk, even for a short time, can be frightening and frustrating. In the first few days after your operation, you could communicate by writing things down. That will allow you to let people know what you need. A speech and language therapist (SLT) will be involved in your recovery from an early stage and can give support and helpful advice.

The following things may help if you have speech or voice changes:

  • Restorative dentistry – changes in the teeth or shape of the mouth cause speech problems. You can read more about restorative dentistry in our section on eating and drinking after treatment.
  • Speech and language therapy – including exercises to help you strengthen and control muscles used for speech.
  • Keeping your throat healthy by not smoking and by drinking plenty of water.
  • Aids to help you communicate.

Speech therapy

Speech therapy can help you learn to communicate in the clearest and most effective way. Therapy usually begins as soon as possible after surgery and normally continues after you go home. It is likely to involve exercises to improve the range and strength of mouth and tongue movements, or to find new ways to produce speech sounds. If you wear dentures, they may need to be changed. Sometimes, an individually-designed prosthesis is made to improve speech.

There are also special aids that your SLT will discuss with you, if necessary.

It will take time for you, and your family and friends to adjust to your changed speech or voice. When dealing with people you don’t know, it often helps to explain that you have had an operation that has made it difficult for you to talk.


Tips for communicating

If people cannot understand you, it is easy to feel frustrated. But there are things you, and the people you communicate with, can do to help you express yourself.

Ask your family and friends to give you time to speak and to let you finish what you want to say. Encourage them to tell you if they do not understand anything. If they need to check what you mean, suggest they ask you questions with a yes or no answer.

Here are some general tips:

  • Choose a quiet place with no distractions or background noise.
  • Find a well-lit place to have your meeting.
  • Face the person you are speaking to.
  • Tell them you have difficulty with your speech.
  • Sit up straight or stand up when speaking. This will help you to use your breath better.
  • Speak slowly and carefully. Try to use short sentences and take a rest between them.
  • Keep a pen and paper with you so that you can get your message across by writing it down, if the other person cannot understand what you are saying.

Other ways of communicating

Sometimes, you may need to use other ways to communicate. New technologies can help.

If you are making a phone call, you can increase the volume on some phones so that your voice can be heard without straining.

There are also helpful apps that convert the text you type into speech. You might find the Talking Mats® app useful. It uses images to help you communicate quickly. It is free to download and works on some mobile devices. Ask your SLT for more information.

My consultant recommended reading aloud to help improve my speech post-treatments. It really does help.

Joyce