Master of Science
Health and Rehabilitation Sciences
This study investigated the natural history of speech and swallowing function of patients treated for oral cavity cancers (OCC) of the oral tongue and/or floor of mouth (FOM), and explored relationships among clinico-demographic and treatment-related variables and speech and swallowing performance. Patient-, disease- and treatment-related data were collected along with clinical outcomes data from medical charts of 72 individuals. Repeated measures analyses revealed changes in speech and swallowing function post-treatment with a general pattern of worse function at hospital discharge and improved function long-term post-treatment, although function did not return to baseline levels. Correlation and regression analyses identified that, in combination, an individual’s comorbidity status, tumour staging, and adjuvant treatment can predict variance in the normalcy of one’s diet and the social aspects of eating post-treatment. These results have the potential to inform patient education and counselling regarding anticipated outcomes and enhance future treatment decisions.
Summary for Lay Audience
Head and neck cancers (HNC) are diseases that occur within the oral cavity (mouth), pharynx (throat) and larynx (voice box). Cancers of the oral cavity, specifically those affecting the tongue and floor of mouth (FOM), impact speech and swallowing function, and quality of life (QOL), or one’s overall state of well-being. Given the high risk of functional impairment following oral cavity cancer (OCC) surgery, this investigation looked at the speech and swallowing function of patients treated for OCCs of the tongue and/or FOM. Further, this study examined relationships among patient-, disease-, and treatment-related variables (e.g., age at diagnosis, sex, co-existing conditions, etc.) and speech and swallowing performance, in order to identify potential predictors of function.
From the medical charts of 72 patients with OCC, we collected information related to the patient, their cancer, and the treatment they received. In general, changes in speech and swallowing function occur immediately after surgery, and while these functions improve in the long-term (6- to 12-months post-treatment), function often does not return to normal. Interestingly, patients rated their swallowing-related QOL the same at one-year after treatment when compared to before treatment. Age was found to be related to swallowing-related QOL, suggesting that older individuals report their swallowing difficulty has less of an impact on their daily activities than younger individuals. Also, treatment-related characteristics such as the use of adjuvant treatment (additional treatment given after primary surgery) was related to poorer speech and swallowing function.
These preliminary results have the potential to help the clinical team counsel patients regarding anticipated speech and swallowing outcomes. However, to better understand why some patients experience better speech and swallowing outcomes than other patients, the search for other meaningful predictors of outcome in this patient population should continue.
Lebedeva, Victoria N., "Speech and Swallowing Outcomes in Patients Treated for Oral Cavity Cancer" (2023). Electronic Thesis and Dissertation Repository. 9175.