Speech and voice after head and neck cancer treatment

Treatment for head and neck cancer may cause changes to speech and voice or ability to communicate.

Changes to speech and voice

We use our lips, teeth, tongue, mouth, nose and throat when we speak. If you have had surgery or radiotherapy to your head and neck area, your speech or voice may sound different. You may have difficulty making certain sounds or saying some words. Sometimes changes to your speech or voice may be more severe. This can mean people may not be able to easily understand you.

Thick, sticky saliva may make it difficult for you to speak. Reduced saliva causes a dry mouth. This can also make your mouth and throat feel uncomfortable when having longer conversations.

For some people, these changes are only a minor problem. Their speech or voice returns to normal, or near normal, as the area heals. For others, it may involve permanent changes to the way they speak or to their voice.

If you have speech or voice changes the following things may help:

  • Do the exercises the SLT suggests. These can help you to strengthen and control the muscles used for speech and voice.
  • Keep your throat healthy by not smoking and by drinking plenty of water.
  • If speech problems are caused by changes in your teeth or shape of your mouth, a restorative dentist can help.

Your voice is the sound of your speech made at the level of your voicebox (larynx). Treatments that affect the larynx can affect your voice. The quality of your voice may become rougher (hoarse) more breathy, strained or quiet and may tire more easily.

Sometimes surgery to the vocal cords may be possible to improve your speech or any voice changes. Your SLT and specialist doctor will explain any treatments that may be helpful.

Speech therapy

Speech therapists can advise you how to communicate in the clearest and most effective way possible.

Your SLT assesses changes in your speech and voice. They can give you advice and speech therapy exercises on how to use your voice in the best way and take care of your throat. They may give you exercises to:

  • help you make your voice heard without straining
  • increase how long you can easily talk for.

The exercises may feel like hard work at times, but it is important to follow the advice of your SLT and do the exercises they gave you. It can be helpful to make them part of your daily routine. You may find it helpful to make a chart of the exercises you need to do and the times you do them.

Your SLT can usually recommend useful apps that are free and suited to your needs. They can help you to download them onto your phone, if you have one. Always talk to your SLT before using any apps.

It can take time for you, and your family and friends, to adjust to changes in your speech or voice. The reactions of people you do not know may be harder to get used to. It can be helpful to explain that you have had treatment that has made it difficult for you to talk. This can help put yourself and other people at ease.

Tips for communicating

If people cannot understand you, it is normal to feel frustrated. But there are things you and the people you talk with can do to help.

Ask your family and friends to give you time to speak and to let you finish what you have 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 tips:

  • Choose a quiet place without distractions or background noise.
  • Find a well-lit place.
  • Face the person.
  • Tell them you have difficulty with your speech.
  • Sit up straight or stand up when speaking. This helps you breathe better.
  • Speak slowly and carefully. Try to use short sentences and take a rest between them.
  • Have a pen and paper with you so you can communicate by writing things down if you need to.

Other ways of communicating

Sometimes, you may need to communicate in other ways. New technologies can help with this. 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. Your SLT or occupational therapist can advise you about this.

You can also visit our head and neck cancer forum to communicate with people who have been affected by head and neck cancer, share your experience, and ask an expert your questions.

About our information

  • References

    Below is a sample of the sources used in our late effects of head and neck cancer treatment information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

    Nilsen M L, Belsky MA et al. Late and long term treatment-related effects and survivorship for head and neck cancer patients. Current treatment options in oncology. 2020. Volume 21. Issue 12.

    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.

  • 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 April 2022
Next review: 01 April 2025
Trusted Information Creator - Patient Information Forum
Trusted Information Creator - Patient Information Forum

Our cancer information meets the PIF TICK quality mark.

This means it is easy to use, up-to-date and based on the latest evidence. Learn more about how we produce our information.