People with cancer may experience a range of communication difficulties, which may be due to the cancer or their treatments.

Surgery for head and neck cancer may affect the mouth, throat or the vocal cords, impacting on speech and making it sound slurred (dysarthria) or hoarse (dysphonia).

A brain tumour can lead to aphasia or dysphasia (difficulties with understanding and talking as well as, reading and writing). It can also result in cognitive changes, such as planning and memory issues. Communication can also be impacted by consequences of treatment on hearing and eyesight.

Identification of communication problems includes the following:

• Difficulty understanding the spoken word
• Difficulty with reading and writing
• Difficulty finding the right word (word finding difficulties)
• Inability to make clear speech sounds (dysarthria)
• Hoarse voice (dysphonia)

Multi-disciplinary management strategies include:

• Consider impact of treatment, infection and /or medication on communication impairment
• Ensure glasses and hearing aids are present
• Use of clear, simple language
• Offering the person choices if they cannot find the correct word such as ‘Would you like tea or coffee’?
• Reducing background distractions such as TV and radio when speaking with the person
• Recognising the need to refer to specialists such as speech and language therapy or to occupational therapy for cognitive issues
• Referring to Ear, Nose and Throat (ENT) doctors if concerned about hoarseness
• Speech and language therapy involvement at either a registered, enhanced and advanced level depending on the complexity of the patient may include:
• A comprehensive case history establishing the person’s current functioning, with regards to understanding, speech, reading and writing
• Family involvement as needed to aid with case history
• Carry out assessment of cognition and its impact on communication including insight and awareness, liaising with Occupational Therapy
• Educate people with cancer, communication partners, appropriate health and social care professionals on patient specific communication difficulties
• Provide interventions for communication problems, personalised to each person and their diagnosis
• Continue education, support and advocacy throughout the pathway
• Provide specialist support for professional colleagues

Rehabilitation Assessment for Identifying Communication Problems

Assessment of individual communication needs and strengths/assets