Cancer, affecting the head and neck is on the decline, and according to the National Institutes of Health only affects about three percent of the population. The most common risk factors include tobacco and alcohol use. For some, the effects of cancer treatment can cause both short and long term issues.  Our specialized head and neck cancer rehabilitation program is here to help alleviate symptoms, restore strength and improve your quality of life.

Human Papilloma Virus (HPV) leading to new cancer diagnoses

Researches now believe that 80% of oropharyngeal cancers that affects the tonsils and back of the tongue are related to the Human Papilloma Virus, commonly known as HPV.  According to the CDC (Centers for Disease Control), a growing body of research shows that this is a common and increasing cause of oral cancer especially with white men.

The good news is that advances in surgical techniques have been able to minimize some of the effects these procedures can have on appearance.   In some instance only chemotherapy and radiation are used to treat the cancer, which clearly preserves facial features.  However, there are still a number of side effects that can impact day-to-day activities and general overall health.

A Comprehensive Approach

Side Effects of Cancer Treatment

Biofeedback for Shoulder Weakness

Focus on  Quality of Life

Today, more emphasis is being place on these quality of life issues for cancer survivors.  Progressive Physical Therapy and Rehabilitation, under the leadership of Kim Marshall, DPT, CLT, is committed to developing personalized physical therapy programs to help head and neck cancer patients on their road to recovery.

Regardless of what treatment plan is chosen, it is important for patients to be aware of possible side effects including:

  • Lymphedema –swelling of the neck or face
  • Range of motion issues of the head, neck and/or shoulders
  • Postural changes
  • Fatigue
  • Weakness
  • Difficulty swallowing, speaking, or breathing
  • Fibrosis (scarring) of the neck and facial skin


Typically associated with breast cancer, lymphedema is swelling caused by fluid buildup in the soft tissue that can result from of surgical removal of lymph nodes from the head and neck region and/or from radiation therapy.  If possible, it is advisable to consult with a physical therapist before you start treatment in order to establish baseline measurements should swelling develop following treatment.

As a certified lymphedema therapist, Kim uses a variety of techniques to lessen the effects of the lymphedema including manual decongestive therapy, compression garments and education for home management of this condition.  Click to read more about Lymphedema treatment.

Signs of lymphedema include:

  • Swelling of the eyes, face, lips, neck, or area below the chin
  • Discomfort or tightness in any of the affected areas
  • Decreased vision because of swollen eyelids
  • Difficulty eating due to swelling inside the mouth
  • Nasal congestion or chronic middle ear pain, if swelling is severe

Range of Motion

Many surgical procedures and radiation therapies can affect the ability to move unrestricted and without pain.  Physical therapy can help if you are having trouble moving your head, neck, or shoulders.   We understand the sensitivity of these areas and work to help reduce the scar tissue and increase joint mobility to help return you to a more active lifestyle.  We will also provide you with a customized home exercise program that will allow you to continue your therapy on your time schedule.

Range of motion issues can also extend to the jaw, lips and tongue, which can effect swallowing.  It is recommended that an exercise program be started concurrently with your cancer treatment.  This will potentially keep you from developing problems in the future and aid in eating and swallowing, which can become difficult.


As a result of treatment, pain and range or motion can affect your posture.  This can have a negative effect on swallowing.  Since patients with head and neck cancers have challenges with eating, it is very important to strengthen the neck muscles and make sure that any postural problems do not interfere with nourishment.


Fatigue is the No. 1 side effect complaint from the treatment of cancer.   Research is now showing the important role exercise can play in helping to lessen this side effect.  Cancer survivors who have led very athletic lives prior to their diagnosis and maintain some level of activity during treatment have been shown to have a better quality of life and report less fatigue.

Just like stroke and cardiac patients have specific rehabilitation protocols, oncology patients now have physical therapy options to assist them during and after treatments.  Kim is one of the first physical therapists in California to have received the STAR Clinician ® certification for cancer rehabilitation.  Once you have been cleared for exercise, we can work with you to develop a customized program that you will be able to do at home.

You do not have to accept the side effects of treatment as a new normal.  We are here to help you improve your quality of life and be a part of your recovery team.  Call us today to schedule an evaluation and discuss a treatment plan.

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Orange Office:  714.547.1140

Costa Mesa Office: 949.631.0125