Before treatment for head and neck cancer

Preparing for head and neck cancer treatment can involve having dental checks, eating well, or doing certain exercises to help reduce side effects. Improving your general health and getting ready mentally can also help with your recovery.

You will usually see other health professionals in your multidisciplinary team (MDT), including a:

  • dentist
  • dietitian
  • speech and language therapist (SLT)
  • physiotherapist.

They may recommend some dental treatment, or give you advice on your diet. You may need to be fed through a tube to gain weight or keep your weight stable. A dietitian will talk to you about this.

An SLT may talk to you about any effects that treatment may have on your speech or swallowing. If you smoke or drink alcohol, your head and neck team can give you advice on stopping.

Dental care

It is important to have a check-up and any dental care you need before treatment. This avoids problems later. You may be referred to a specialist dentist with experience in treating people with head and neck cancers. Or you may see your own dentist.

If any of your teeth are unhealthy, you usually have these removed. You may see an oral hygienist for advice on looking after your teeth and gums.

It is important to know how to look after your mouth and prevent problems. Cancer treatments, especially radiotherapy, may mean you are more likely to get mouth infections. After radiotherapy to the mouth area and salivary glands. you are more likely to get tooth decay. You need to continue looking after your mouth and teeth after treatment. You also need to visit the dentist regularly.

Eating, speech and voice problems

Before treatment you may see a dietitian and an SLT. They assess your weight and diet, and any problems with swallowing and speaking. They also explain how treatments may affect these things and what can help. You may have tests to assess your swallowing, speech and voice, Your SLT will continue to assess you during and after treatment. You may be given exercises to do.

Exercises to reduce side effects

Your SLT may give you exercises before radiotherapy for your tongue, jaw, throat and larynx. These help you to swallow and open your mouth, which helps keep your weight up during treatment. Jaw exercises help reduce the risk of problems opening your mouth (trismus) after radiotherapy or surgery. You need to start these exercises early and continue to do them long term.

If you are having surgery to remove the lymph nodes in your neck, you usually see a physiotherapist. They will give you exercises to reduce side effects, such as a stiff neck.

Maintaining your weight

Before your treatment starts, it is important to eat as well as possible. Your dietitian may advise using food supplements and following a building-up diet to increase your weight. Radiotherapy, especially with chemotherapy (chemoradiation), causes difficulty swallowing and leads to weight loss. Putting on weight before treatment can slow this down and help you cope better with treatment.

Feeding through a tube

Your treatment may make it difficult for you to eat enough by mouth. To make sure you get enough calories to keep up or gain weight, your doctor may suggest being fed through a tube for a while. You can be fed by a tube in different ways:

  • Nasogastric (NG) feeding

    A thin tube is passed up your nose and down into your stomach. It is usually only used for a few weeks.

  • Gastrostomy feeding

    A tube is passed directly into your stomach. This is called a percutaneous endoscopic gastrostomy (PEG) or radiologically inserted gastrostomy (RIG) tube. You usually have this if tube feeding is needed for a longer time. It can be kept in place for several months if necessary.

When your swallowing improves and you can eat more through your mouth, the tube can be removed. You are taught how to use it and look after the tube safely. Family or friends can also be shown how to do this. Sometimes district nurses may set up the feeds for you at home. We have more information about nutritional support and artificial feeding.

Exercise to get fitter

Being as fit as possible before treatment may help you cope better with the side effects of treatment. It may also help reduce the risk of complications after surgery. You can improve your fitness in a few weeks by doing regular exercise. You may be asked to do exercises that improve your heart health and make your muscles stronger.


If you smoke, stopping will:

  • increase the chances of your treatment being effective
  • mean you are likely to get fewer side effects, and that they are less severe
  • reduce the risk of cancer coming back after treatment
  • reduce the risk of getting another head or neck cancer or other smoking related cancer.

Stopping smoking before surgery

It is best to try and stop smoking as soon as you can. If possible you should stop several weeks before surgery. Even stopping 2 to 3 weeks before surgery, and not smoking afterwards, reduces your risk of complications. Stopping smoking before surgery makes it more likely that:

  • your wounds heal more quickly
  • you have a shorter stay in hospital
  • you recover more quickly.

Stopping smoking before radiotherapy

Stopping smoking increases the chances of radiotherapy and chemoradiation working better. It also means side effects, such as sore mouth or difficulty swallowing, are likely to be less severe.

Support with stopping smoking

It can be difficult to stop smoking, especially when you are stressed. Your hospital will usually have a service to support you. Using the NHS Stop Smoking Services improves your chances of success. Your GP can also give you support and advice. They can provide nicotine replacement therapies on prescription. We have more information about stopping smoking.


If you drink alcohol, stopping drinking will help reduce the risk of side effects. It also reduces the risk of developing another head and neck cancer.

If you want support to reduce how much alcohol you drink, your nurse or doctor can arrange this for you. We also have information about reducing the amount of alcohol you drink.

Questions to ask about your treatment

Knowing more about what to expect can help you prepare for treatment. It might help to make a list of the questions you want to ask your doctor, nurse, SLT or dietitian. For example, you might want to ask about these things.

  • Eating and drinking
    • Will the treatment make it hard for me to swallow?
    • If my mouth is sore, how will I eat and drink?
  • Mouth care
    • How can I look after my mouth during treatment?
    • If my mouth is sore, what will help?
  • Controlling pain
    • Am I likely to have pain?
    • What can help reduce any pain?
    • Who can help me manage my pain?
  • Communicating
    • How might treatment affect my speech and hearing?
    • Who will help me with any changes to my voice or speech?
  • My appearance
    • Will the treatment affect how I look?
    • Who can help me cope with any difficult feelings?
    • Are there any support groups that may help?
  • After treatment
    • How long will the side effects last and what might help?
    • Who do I contact if I have problems after my treatment has finished?

About our information

  • References

    Below is a sample of the sources used in our head and neck cancer information. If you would like more information about the sources we use, please contact us at

    Machiels J.-P, Leemans C. R. et al. Squamous cell carcinoma of the oral cavity, larynx, oropharynx and hypopharynx. EHNS- ESMO-ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology, 2020. Volume 31, Issue 11, Pages 1462-1475.

    National Institute for Health and Care Excellence (NICE). Cancer of the upper aerodigestive tract: assessment and management in people aged 16 and over. NICE guideline NG36 2016 (updated 2018). 

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Chris Alcock, Consultant Clinical Oncologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

Date reviewed

Reviewed: 01 March 2022
Next review: 01 March 2025
Trusted Information Creator - Patient Information Forum
Trusted Information Creator - Patient Information Forum

Our cancer information meets the PIF TICK quality mark.

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