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Side Effect: Trouble Speaking

What is Trouble Speaking?

Trouble with speaking is a speech disorder characterized by poor voice quality. Patients can experience changes in voice pitch, volume, or vocal effort known as dysphonia. Patients with cancer can also experience difficulty in articulating speech sounds or producing speech due to impaired movement of the lips, tongue and mouth known as dysarthria (muscles used to produce speech are weak).

Trouble Speaking

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Who has Trouble Speaking?

Cancers of the head and neck region can directly affect the speech muscles and nerves. Additionally, cancer treatments such as surgery and radiation therapy can also cause dysarthria by damaging the speech muscles and nerves.

Chemotherapy-related trouble speaking examples:

How to prevent Trouble Speaking

Preventing speaking trouble in patients with cancer receiving radiation involves careful planning and coordination of treatment. Radiation to the head and neck may be delivered with techniques that minimize the dose to the vocal cords.

Speech and language therapy can be helpful in teaching patients strategies to preserve their voice and maintain good vocal hygiene during cancer treatment. Other preventive measures, such as adequate hydration, avoidance of irritants, voice training, and amplification, may reduce the risk of developing dysphonia. Behaviors to avoid include yelling or shouting, consumption of alcoholic products, and smoking.

How to treat Trouble Speaking

Treatment for dysarthria in patients with cancer may involve a combination of medical and rehabilitative approaches. Medical treatments may include medications to reduce inflammation or surgery to remove tumors that are pressing on speech muscles or nerves.

Voice therapy rehabilitation methods such as speech therapy, physical therapy, and occupational therapy can help patients improve their speech and regain functional communication skills.


1) Stachler RJ, Francis DO, Schwartz SR, et al. Clinical Practice Guideline: Hoarseness (Dysphonia) (Update). Otolaryngol Head Neck Surg 2018;158(1_suppl):S1-S42.

2) De Lisa M, Ballatore Z, Marcantognini G, et al. Irinotecan-Induced Transient Dysarthria: Case Series and Updated Literature Review. Oncol Ther 2020;8(1):147-160.

Created: February 26, 2024 Updated: March 7, 2024