Head and Neck Cancer

Roles and Responsibilities of the Speech-Language Pathologist

Speech-language pathologists (SLPs) play a central role in the screening, assessment, diagnosis, and treatment of persons with HNC. The professional roles and activities in speech-language pathology include clinical/educational services (diagnosis, assessment, planning, and treatment); prevention and advocacy; and education, administration, and research. See ASHA's Scope of Practice in Speech-Language Pathology (ASHA, 2016b).

Appropriate roles for SLPs include the following:

  • Providing prevention information to individuals and groups known to be at risk for HNC as well as to individuals working with those at risk
  • Educating other professionals about the needs of persons with HNC and the role of SLPs in diagnosing and managing associated impairments
  • Conducting a comprehensive, culturally and linguistically appropriate assessment of speech, language, resonance, voice, cognition, and/or feeding/swallowing deficits associated with HNC, and diagnosing these deficits as indicated
  • Referring to other professionals to rule out related conditions and facilitate access to comprehensive services
  • Making decisions about the functional management of communication and swallowing in HNC
  • Developing treatment plans, providing treatment (including palliative care), documenting progress, and determining appropriate discharge criteria
  • Evaluating the impact of deficits on quality of life and directing treatments to improve these areas when possible
  • Counseling before and after medical management (surgery, radiation therapy, chemotherapy) to address needs of persons with HNC and their families specific to communication- and swallowing-related issues and providing education aimed at preventing further complications related to these conditions
  • Remaining informed of research in the area of HNC and helping advance the knowledge base related to the nature and treatment of these conditions
  • Advocating for individuals with HNC and their families at the local, state, and national levels, and providing expert testimony when appropriate
  • Serving as an integral member of an interprofessional team working with individuals with HNC and their families/caregivers (see ASHA's resources on interprofessional education/interprofessional practice [IPE/IPP] and person- and family-centered care)

As indicated in the Code of Ethics (ASHA, 2016a), SLPs who serve this population should be specifically educated and appropriately trained to do so.

Roles and Responsibilities of the Audiologist

Audiologists play a central role in the assessment, diagnosis, and rehabilitation of hearing and vestibular deficits in individuals with HNC. See ASHA's Scope of Practice in Audiology (ASHA, 2004).

Appropriate roles for audiologists include the following:

  • Educating other professionals about the needs of adults with hearing and vestibular deficits pre- and post-medical/surgical management of HNC and the role of audiologists in diagnosing and managing these deficits
  • Screening for and early detection of hearing loss due to ototoxicity, tinnitus, and vestibular disturbances
  • Conducting a comprehensive and culturally and linguistically sensitive assessment using behavioral, electroacoustic, and/or electrophysiological methods to evaluate hearing, auditory function, vestibular and balance function, and related systems
  • Determining candidacy for amplification, assistive technology, and vestibular rehabilitation, and fitting and maintaining amplification and other sensory devices
  • Developing and implementing an audiologic and/or vestibular rehabilitation management plan, including maintenance of appropriate data and documentation
  • Counseling the individual with HNC and his or her family regarding the psychosocial aspects of hearing loss and other auditory processing dysfunction, modes of communication, and processes to enhance communication competence
  • Performing neurophysiologic intraoperative monitoring to help surgeons minimize or avoid injury to neural structures that are at risk due to the pathology and the proximity of neural structures to the surgical field (see ASHA's resource on neurophysiologic intraoperative monitoring)
  • Advocating for the communication needs of all individuals, including advocating for the rights to and funding of services for those with hearing loss, auditory, and/or vestibular disorders, and providing expert testimony when appropriate
  • Serving as an integral member of an interprofessional team working with individuals with HNC and their families/caregivers (see ASHA's resources on interprofessional education/interprofessional practice [IPE/IPP] and person- and family-centered care)

As indicated in the Code of Ethics (ASHA, 2016a), audiologists who serve this population should be specifically educated and appropriately trained to do so.

Interprofessional Collaboration

SLPs and audiologists collaborate with many other disciplines in caring for individuals with HNC. Referral to, and collaboration with, members of the team are important for ensuring quality service for individuals—particularly during the assessment process and during treatment planning.

The focus of collaboration is on the use of information from a variety of professionals to affect functional outcomes that benefit the patient.

(See the ASHA resources on collaboration and teaming and interprofessional education/interprofessional practice [IPE/IPP].)

Content Disclaimer: The Practice Portal, ASHA policy documents, and guidelines contain information for use in all settings; however, members must consider all applicable local, state and federal requirements when applying the information in their specific work setting.