Before treatment starts

Before treatment starts, you will see your doctor or specialist nurse. If you smoke or drink alcohol, your doctor or nurse will give you advice on stopping before treatment starts. Stopping smoking can help reduce the amount and severity of side effects from treatment.

You may see a dentist. They can give you advice on how to look after your mouth during treatment.

Before treatment you may also see a SLT or dietician. They can tell you what effects treatment may have on your breathing, swallowing, diet and speech. They can also tell you what can help. If you have surgery you may need to learn to breathe and speak in a different way this will depend on the type of surgery you have.

If your specialist thinks treatment may affect your swallowing your SLT can talk to you about things that may help. Your doctor may suggest you are fed through a tube for a while. There are different ways of tube feeding.

It is important to remember you will get lots of support to help you cope with any changes.

Before treatment starts

Your specialist doctor or nurse will usually give you advice on preparing for treatment.

Smoking

If you are a smoker, stopping smoking:

  • may decrease the side effects of your treatment
  • decreases the risk of the cancer coming back
  • decreases the risk of developing a second cancer in your head and neck, and also in other parts of your body
  • decreases the risk of other conditions such as heart disease.

Continuing to smoke increases the risk of side effects and can make radiotherapy less effective. Smoking can be difficult to give up, especially at times of stress. If you would like to give up smoking, there are organisations and self-help groups that you may find useful. Your GP can also give advice and prescribe nicotine replacement therapies, such as nicotine patches, gums and inhalers.

Alcohol

Avoiding alcohol, particularly spirits, may help to reduce some of the side effects of your treatment. If you’d like support to help reduce your alcohol intake, ask your specialist nurse or doctor.

Dental care

Your doctor or nurse will advise you to visit a dentist or oral surgeon for a check-up and to have any necessary treatment. Making sure your teeth or dentures are in good condition reduces the risk of possible problems with your mouth during and after treatment.

We have more about looking after your mouth and teeth during and after radiotherapy. We also have information about mouth care during and after chemotherapy.


Changes to breathing and speaking

Before treatment for cancer of the larynx, you will see a speech and language therapist (SLT). Treatment can affect your breathing, speech and voice in different ways. Your SLT will talk to you about possible effects of treatment. They will also explain how to cope with these changes.

If you have radiotherapy, you will breathe and speak in the same way, but your voice may become hoarse.

If you have surgery, you may need to learn how to breathe and speak in a different way. Effects on your breathing and speech will depend on the type of surgery you have. Your surgeon and SLT will talk to you about what changes to expect from your surgery. Remember, you will get lots of support to help you cope with any changes.


Eating and speech problems

If your team think treatment may affect your swallowing, you may see a dietician and SLT. They can help with any swallowing and dietary problems you have before treatment. Your SLT can also tell you about any effects treatment is likely to have on your swallowing. They will talk to you about what can help.

Sometimes radiotherapy can make it very difficult to swallow. This can happen particularly if radiotherapy is combined with chemotherapy (chemoradiation). Your SLT can show you exercises to help improve swallowing after treatment. These will depend on the type of swallowing difficulties you have. Usually, swallowing improves within a few months of finishing treatment. Some people find it takes longer to improve. Rarely, some swallowing difficulties are permanent.

If your team thinks you may develop swallowing difficulties during treatment, they may suggest you are fed through a tube for a while. This is to make sure you have enough calories to maintain or gain weight.

There are different ways you can be fed by a tube:

  • Nasogastric (NG) feeding – a thin tube is passed up the nose and down into the stomach. It is used for shorter periods of time, for example less than 4 weeks.
  • Gastrostomy feeding – a tube is passed through the skin and muscle of the tummy (abdomen) into the stomach. This called a percutaneous endoscopic gastrostomy (PEG) or radiologically inserted gastrostomy (RIG) tube. This depends on how the tube is put into the stomach. You may have this if you need to be fed through a tube for a longer period of time.

If you have problems swallowing and need to be tube fed, your healthcare team will explain which type will be best for you. When your swallowing improves, and you can eat and drink more through your mouth, the tube may be removed.

You may need to go home with a feeding tube. If this happens, your dietitian or a nurse can teach you, and your family members or friends, how to use and look after it safely. You may also have home visits from community nutritional care nurses. These nurses can help with feeding tube care and setting up the feeds.

We have more information about nutritional support and artificial feeding.

Back to Coming to your decision

Finding out your treatment options

Knowing basic information about your type of cancer and different treatments options can help you to make an informed treatment decision.

Making your decision

If you’re struggling to come to a decision about treatment, try following these five steps.