Breast Cancer Awareness Race
Breast Cancer Awareness Race

Head and Neck Cancer Rehab 



     Head and neck cancers although not as common can quickly become very complex due to the small and complex anatomical area. The cancer diagnosis can vary depending on staging and tissues effected, from localized squamous cell carcinomas to adenocarcinomas, lymphomas and even melanomas. In turn, the type and order of treatment is very individualized; surgery may occur immediately or neoadjuvant chemo may be prioritized. The dissection and reconstructive surgeries are often complex, at times compromising various muscle, nerve and lymph structures. Each cancer treatment is individualized to the patient's needs, hence the need for an individualized rehabilitation plan is vital to optimize outcomes and lessen complications. I care so much about connecting with head and neck (H/N) patients as it can be such a rewarding area of care where the rehab plan can have incredible impact! 



I offer specialized rehab plans and support with:

  • pre-operative planning for all H/N surgeries (biopsies, partial/radical neck dissections)

  • comprehensive post-operative rehab planning (excisions, dissections and flap reconstructions)

  • comprehensive radiation management

  • comprehensive chemotherapy management

  • chemotoxicity management

  • peripheral and facial/shoulder neuropathies

  • cancer related fatigue, trismus, cervical stiffness, radiation fibrosis, shoulder pathologies and other symptoms.

  • H/N and shoulder lymphedema risk management 

  • safe exercise prescription/return to activity  despite functional limitations or symptoms.

  • dry needling and safe manual therapy for the H/N oncology population

  • patient self-management tools and education

  • long term screening and monitoring (bone health, cranial nerve assessments etc.); supporting patient advocacy for changing care pathways


"Nadine gave me tools to self manage the lymphedema around my neck and jaw. She also worked on me manually to help gain some movement back in my neck, and gave me a home program that I stuck with. Together we got me back to work!" -Dan W

     As the focus is often treatment due to the complexity of head and neck cancers; few tools are provided to better manage the physical symptoms that come as a consequence to treatment. Haven taken specialized H/N cancer courses, I can offer evidence based rehabilitation plans that support even better outcomes. We can work together to provide a rehab plan specific to where you are at in your cancer journey and lessen the symptom burden.







     Most H/N cancer journeys have a general treatment pathway and fall into one of three treatment phases, each in which a personalized rehabilitation can help. Often the symptom burden can be very heavy, remain untreated; and at times post treatment many complex symptoms remain. Education is power, rehab plans work and together we can find tools that help you feel better


     The prehab phase starts immediately after diagnosis prior to treatment; a rehab plan has important impact here. Diagnostics can involve blood work (cancer markers or signs of inflammation), a tissue biopsy and/or detailed imaging. Often your medical oncology team will obtain information as to whether your cancer is HPV p16 +ve, keratonitizing and provide a stage/grade. At times a genetics assessment for the TP53 gene alteration is also warranted to determine whether susceptibility genes are involved. Starting rehabilitation in prehab can lessen hospital stays, improve post-operative outcomes and simply provide patients a sense of control right from the start.


     The treatment phase varies, for most patients it starts with an excision of the tumour, a full or partial neck dissection, for others it starts immediately with induction chemotherapy. Often radiation occurs before chemotherapy for H/N patients or can be done concurrently. Depending on the tissue type, staging, grading and cell cycle a personalized treatment plan will be discussed with your medical oncology team. The need for a personalized rehab plan according to your cancer stage, type and treatment stage is vital here.










      Induction chemotherapies cause mylosuppression and may result in toxicity, pain or neuropathies. Targeted chemotherapies work more specifically on receptor blockers, enzyme inhibition or cell membrane infiltration but they too may cause symptoms. Often H/N cancer pathways involve reconstructive surgeries of varying degrees, often using muscle graphs from other areas of the body, once again creating a reoccurring need for post-op rehabilitation.


     Treatment thus often results in many burdening symptoms. A rehabilitation plan promoting manageable swelling, pain management, cardiorespiratory health, fibrosis management and energy conservation can be very effective through out this stage to get you feeling better!



     This is an exciting stage but often patients find themselves stuck here. Sometimes the focus on survivorship and treatment can mean that rehabilitation was put a side and once treatment is over, you may be left with unmanaged symptoms. Returning to work or activity may seem like a daunting task when you are feeling de-conditioned or left with complications from treatment that leave you with restrictions in your face, neck or shoulders.











     Together we can work with your insurance provider to create a manageable graded return to work providing the needed documentation. Or perhaps your goal is a personal rehab plan for return to your favourite sport. Often push crash cycling and pain can hinder progress; but together we can get you safely moving; feeling like yourself again.


     Despite any stage of treatment and any type of head and neck cancer, I care. I hope you feel that you can reach out, simply show up and I will meet you where you are at. Together we can get you feeling just a bit more like yourself again where ever you are at in your cancer journey.

Happy Old Man
Neck Massage
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