Even as medical professionals continue to develop more targeted, sophisticated approaches to cancer treatment, new troubles have arisen for individuals who undergo radiation therapy. Namely, fibrosis, otherwise known as the hardening of tissues in the neck and mouth, can make simple, everyday tasks, such as swallowing, more difficult.
As part of a clinical trials group with the Medical College of Wisconsin, associate professor in the Department of Communication Sciences and Disorders, Barbara Pauloski, PhD, CCC-SLP, has been developing preventative swallowing protocols to help patients with head and neck cancer maintain muscle strength as they undergo radiation treatments.
Pauloski’s work in helping cancer patients
Pauloski first became aware of head and neck cancer patients when studying voice restoration during her graduate work. At the time, patients who had head and neck cancers often underwent total laryngectomies, or removal of the larynx, which left them entirely without voice functions. As she worked with these patients, she learned that those who underwent these surgeries not only had problems with voice and speech, but also swallowing.
“At that time, the field of swallowing was relatively new in our discipline,” Pauloski said. “As I worked with these patients, who had undergone such invasive procedures, I developed an appreciation for their recovery process. Working with them as they actively participated in their own healing inspired my continued commitment to swallowing research into the present day.”
Since then, advancements in cancer treatments have moved away from total laryngectomies. Most physicians now opt for less invasive surgical options and radiation therapy. However, Pauloski noted the unintended consequences of less invasive procedures. “Trends in head and neck cancer treatment have evolved to preserve the larynx and other structures, which is a good thing because it keeps the digestive and respiratory tracts intact. But, these advancements have made swallowing protocols increasingly relevant as patients have to relearn basic functions post-treatment.”
The therapies that Pauloski and her collaborators are developing not only aim to minimize the negative side effects of radiation cancer treatments, but to prevent swallowing problems altogether. “Radiation treatment remains an important tool in the fight against cancer, but it can lead to devastating side effects as well, even with targeted approaches. The best treatment for fibrosis is prevention,” Pauloski said.
Using ultrasound for documenting swallowing rehabilitation
Pauloski hopes to expand her research to developing more ultrasound imaging techniques with the goal of documenting the results of swallowing rehabilitation techniques, rather than relying on fluoroscopy (moving X-ray), the standard for imaging the swallow. Contrary to fluoroscopy, which relies on radiation, ultrasound technology is non-invasive, and has no negative side effects. Ultrasound may be a more valuable tool in tracking the building of muscle mass
“Our ultrasound research is still very much in its infancy, but it is important work. We have to keep pace with the ever-evolving landscape of cancer treatment if we want to make a difference in these patients’ lives.”