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Invited Commentary
June 2018

Beyond “Pharyngocise” for Patients With Head and Neck Cancer: Does One Size Fit All?

Author Affiliations
  • 1Department of Outpatient Rehabilitation, University of Washington Medical Center, Seattle
JAMA Otolaryngol Head Neck Surg. 2018;144(6):488-489. doi:10.1001/jamaoto.2018.0271

Advances in technology have improved survival rates for patients with head and neck cancer; however, the medical profession continues to pursue opportunities to improve quality of life for survivors. Advances in organ preservation therapies, such as intensity-modulated radiation therapy and proton therapy, are encouraging. However, preservation of swallowing-related quality of life remains challenging. For the past decade, speech-language pathologists (SLPs) have applied neuroplasticity principles to exercise-based swallowing treatment for patients undergoing chemoradiation therapy for head and neck cancer. This intensive daily exercise regimen, termed by some pharyngocise, also includes encouragement to eat and drink throughout radiation treatment. This treatment protocol flipped the traditional swallowing treatment paradigm by using a proactive vs a reactive (“wait and see”) approach to treatment. Since approximately 2006, a growing body of research has largely supported better outcomes for patients who either completed the proactive exercises or ate and drank during treatment compared with those who did neither.

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