Head and Neck Cancer Clinic

Head and neck cancer and its treatment, such as surgery, chemotherapy, and radiation therapy, can affect a person’s communication and swallowing. Our Speech Therapists can help in the management and rehabilitation of these changes. They are involved in a patient’s care from diagnosis, through to supporting them back at work and life after treatment is complete. Our therapists work closely with the multi-disciplinary team at the SingHealth Duke-NUS Head and Neck Centre including the surgeons, the radiation oncologists, the nurses and other allied health professionals.

Our Speech Therapists work closely with patients and their loved ones before, during and after treatment to give them the information they need to prepare for changes, manage their needs and achieve their therapy goals. They provide a variety of services to help patients overcome their speech and swallowing problems following cancer treatment. Patients are seen during their inpatient hospital stay and followed up as outpatients. The outpatient services include:

Head and Neck Allied Health Professionals (AHP) Clinic

The Allied Health Professionals (AHP) Clinic is a one-stop multidisciplinary service designed to help prepare patients before they go for head and neck surgery. This clinic is held weekly within the SingHealth Duke-NUS Head and Neck Centre.

The AHP Clinic involves a diverse group of allied health professionals, including:

Dietitians
Clinical psychologists
Medical social workers
Physiotherapists
Occupational therapists

At the Clinic, patients and their family are introduced to the rehabilitation professionals. They help patients understand the changes that they may experience during and after treatment. A pre-treatment assessment is done, and an individualized care plan is developed for the patient.

Head and Neck Speech Clinic/ Head and Neck Swallow Clinic

In patients with head and neck cancer, loss of speech function and swallowing function may result from surgery, radiation therapy or the cancer itself. This results in reduced quality of life. At the Speech Therapy Department in Singapore General Hospital, the speech therapists develop individualized speech and swallowing therapy programs to help patients maintain or recover their speech and swallowing function before, during and after treatment.

Radiation Oncology Speech Therapy Clinic

Radiation therapy to the head and neck area can cause side effects, such as dry mouth, ulcers, and pain. These side effects can make it harder to eat and drink. Our speech therapists see patients who are undergoing head and neck radiation therapy at the Department of Radiation Oncology, at Singapore General Hospital and the National Cancer Centre Singapore.

In this weekly clinic, we speak with patients who are undergoing head and neck radiation therapy about the side effects they may face, and how this may affect their eating and drinking. Our speech therapists also check on patients’ swallowing function, advise them on swallowing exercises and food texture changes they may require in the course of radiation therapy.

Post-Laryngectomy Voice Rehabilitation

A laryngectomy is the surgical removal of the larynx (voice box), including the vocal cords. After a laryngectomy, the patient loses their ability to produce a voice.

Our speech therapists have expertise in working with patients to help them regain their ability to speak after a laryngectomy. They provide comprehensive rehabilitation to patients before and after surgery, counseling them about their voicing options and working closely with them and their families throughout the recovery process. The three options of communicating after a laryngectomy are explored with the patient and include:

Artificial larynx (electrolarynx and /or pneumatic device)
Oesophageal speech
Tracheosophageal (TEP) speech

The speech therapist will help the patient decide which option of communication is best and all options will require practice and time to learn. Patients are encouraged to meet other laryngectomees as well as attending the New Voice Club, Singapore Cancer Society.

Prosthetics Speech and Swallowing Rehabilitation (PSSR) Clinic

The Prosthetics Speech and Swallowing Rehabilitation (PSSR) Clinic is a collaborative service between our speech therapists and the prosthodontists from the National Dental Centre Singapore (NDCS).

The monthly clinic held within the NDCS Centre for Maxillofacial Rehabilitation aims to provide comprehensive management of patients with motor speech and swallowing disorders. The patients commonly seen in this clinic include those diagnosed with nasopharyngeal carcinoma, head and neck cancer as well as cerebral vascular disorders. The prostheses will be constructed with special features to aid speech and swallowing. The types of prostheses include:

Palatal Augmentation Prosthesis

This is functionally designed to help swallowing by bringing the roof of the palate lower to increase tongue-to-palate contact.

Obturator

An obturator closes the gap between the oral and nasal cavity after cancer surgery.

Speech Bulb

For patients with a soft palate defect, the bulb improves closure at the back of the throat for better speech clarity.

Palatal Lift Prosthesis

For patients with weak muscle tone of the soft palate, this helps to elevate and close the back of the throat for improved speech and swallowing.

How can I obtain an appointment to see the Speech Therapist?

You will require a referral letter from a Singapore-registered medical doctor, made out to SGH Speech Therapy Department. Please call SGH Central Appointment’s Hotline at 63214377 to make an appointment.

Patient Education

Your therapist may have given you some exercises for swallowing rehabilitation. Below are the handouts for some of those rehabilitation exercises. Please only commence on these exercises as suggested by your Speech Therapist. Also, do remember to consult your therapist if you have any questions.

In English:

In Chinese:

In Malay:

Maintaining Jaw Opening