Speech therapy helps Patrick cope with side effects of cancer treatment

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Patrick Horrell practices his speech therapy every day, keeping a printout of exercises at home and in his laptop bag. That’s not something you’d expect from a cancer survivor, but he does them “religiously” to keep away the side effects of cancer treatment.

He remembers when his jaw was so tight, he could barely open his mouth wide enough to eat... When he had to use a baby toothbrush to clean his teeth... When his throat was so swollen he had to be fed through a tube... And, when his neck was so puffy with fluid, he couldn’t turn his neck.

Patrick of Norwalk, Iowa was diagnosed with squamous cell carcinoma, an HPV-related cancer in his throat, jaw and nearby lymph nodes.

To prepare for the chemotherapy and “harsh” radiation treatments ahead, Patrick began working with speech and language pathologist Sydney Brotherton in a unique program to help head and neck cancer patients maintain their ability to eat, swallow and speak.  She’s part of the team at MercyOne Richard Deming Cancer Center in Des Moines, Iowa.

Preparing for the worst

Patrick, a positive guy, liked the idea of exercises he could do to help cope with the painful symptoms ahead.  

His journey began with a sore throat in summer 2023 that wouldn’t go away despite antibiotics and steroids. An “ominous” swollen right tonsil led to surgery. Patrick awoke after surgery on Dec. 1, 2023, to learn a tumor lurking behind the swollen tonsil had also been removed. It was malignant.

“From a sore throat to cancer, I was completely shocked,” said Patrick, 52. “People in my age group were never vaccinated for HPV, and I just happened to be one of the unlucky ones to have this very specific type of cancer.” Today, an effective HPV vaccine for adolescents can help prevent HPV-related cancers.

Patrick needed chemotherapy and, the most grueling part, 35 sessions of radiation. “My MercyOne Des Moines cancer team warned me it was the harshest radiation you can have due to the location of the cancer in the head and neck.”

Before cancer treatment, Patrick had a root canal, and his wisdom teeth removed -- dental work that would be impossible once his cancer treatment began. He also had surgery to place a feeding tube, likely to be needed as swallowing became difficult.

“The goal all along was a cure, and I was told this cancer had a 90% cure rate.”

His MercyOne medical team was “incredible,” he said, from his chemotherapy oncologist Giselle Mery, MD, radiation oncologist Adam Gliniewicz, MD,  ENT Ashley Bauer, MD. and Sydney Brotherton, CCC-SLP, who provides speech therapy exclusively to head and neck cancer patients. Dr. Bauer and Sydney work together to treat these cancer patients at MercyOne Clive ENT Care.

Treatment that’s hard to swallow

Even before treatment, Patrick began meeting regularly with Sydney to learn the preventive exercises aimed at keeping him swallowing, speaking and able to open his jaw.

“This is one of the hardest treatments because it takes away your eating and sometimes your voice -- two pleasures in life that are important to social interaction,” Sydney explained. “The fact that head and neck cancer patients like Patrick receive speech therapy and ENT care throughout their treatment is unique and speaks to the elevated cancer care MercyOne offers.”

About 90% of head and neck cancer patients receiving radiation will experience internal lymphedema, or internal swelling, Sydney said. “Exercises to keep them swallowing help reduce swelling and keep the lymphedema from turning into fibrosis or hardening of the tissue.”

As Patrick progressed through his radiation treatments, his symptoms worsened as expected.  

“I couldn’t talk very well.  I could hardly get any food in my mouth or even brush my teeth. Toward the end of my radiation and for about three weeks after, I could barely sip water, and I was on a feeding tube.”

Patrick met with a nutritionist regularly.  Sydney helped him to begin eating regularly again – from liquid protein to a spoonful of applesauce to more solid foods.

A good place now

“I’m in a very good place now,” reflected Patrick in November 2024 with his cancer treatments behind him. “Thanks to the exercises and the help of everyone at MercyOne. I’ve received the tools to fight my cancer, including an OraStretch® device I use each day to help stretch my jaw and mouth.” When Patrick’s insurance company denied coverage for it, his MercyOne team successfully advocated for its coverage.

Patrick also benefited from integrative medicine at the MercyOne Richard Deming Cancer Center, including reiki, massage, acupuncture and mindfulness training.

“I don’t want to sugarcoat it,” he said.  “I had radiation 35 weekdays in a row and by the end, it got so bad I couldn’t sleep in bed because my neck hurt so bad. And with probably a week-and-a -half of radiation left, I told my wife, ‘I don’t know if I can do this anymore.’  But we just did it. My wife was amazing through this, and I had a great support system through my family and at work.”

He concluded, “Everyone at MercyOne was unbelievably fantastic! I made the decision early on that I would do everything I could to normalize my life. Making my health the No. 1 priority has made all the difference.”