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Originally published February 23, 2026
Last updated February 23, 2026
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Preparing patients for what to expect after head and neck cancer surgery is critical. In the weeks after surgery and/or chemoradiation, patients can experience everything from swelling, facial numbness and sore throat to trouble swallowing and speaking.
鈥淎 lot of head and neck surgery is life-changing, and postoperative rehabilitation can be long,鈥� says Liyang Tang, MD, a head and neck surgeon with the 喵咪社区 Head and Neck Center, part of 喵咪社区 and the 喵咪社区 Caruso Department of Otolaryngology 鈥� Head and Neck Surgery.
Ahead, Tang explains why thoroughly educating patients about the potential challenges that lie ahead is important 鈥� especially before the patient makes a final treatment decision.
Not all patients understand how daily activities can be affected after head and neck surgery. 鈥淚f it鈥檚 tongue cancer, we鈥檙e removing a part of the tongue,鈥� Tang explains. 鈥淚f it鈥檚 laryngeal cancer, we鈥檙e removing a part of the larynx. So, eating can be affected. Speaking can be affected. It鈥檚 incredibly important to counsel patients and set their expectations before surgery, not only so they are mentally prepared but also so they can make all their postoperative care preparations at home,鈥� Tang says.
Patients should know the range of possible complications. 鈥淔or the simpler surgeries, we go through the possibilities of what recovery can look like if it goes perfectly 鈥� and what it can look like if it doesn鈥檛,鈥� Tang says. 鈥淔or example, with thyroid and parathyroid surgeries, even though it rarely happens, we always talk about possible damage to the recurrent laryngeal nerve, which can lead to vocal cord paralysis, voice changes or difficulty swallowing. We also talk about the possibility of temporary low calcium levels, which can lead to numbness and tingling.鈥�
Certain risk factors such as previous history of radiation, smoking and diabetes can make surgical recovery more challenging, so additional counseling needs to be provided. 鈥淔or instance, if anyone was previously radiated, we warn them that they鈥檙e very likely to have wound-healing issues. They may need wound care afterward.鈥�
Tang also advises patients about what to expect from more complex procedures. One example is if a patient is to undergo reconstructive flap surgery 鈥� for instance, reconstructing a significant portion of the tongue that was removed using tissue from the arm, leg or another part of the body.
鈥淚t鈥檚 a complicated surgery that takes about eight hours and requires connecting blood vessels from two different areas of the body,鈥� Tang explains. 鈥淎t least for the first couple of weeks, and especially during the first five days, recovery relies on the vessels you connected. If a clot happens in one of the connected vessels and we catch it early on, we can still save the flap 鈥� but if not, part or all of the flap can die. Even though this rarely happens, we always talk about the possibility so that patients can be mentally prepared should they need to return to the OR.鈥�
Preparing patients for these scenarios isn鈥檛 just important for setting expectations but also for giving patients all the information they need to make the right treatment decisions for their situation.
Patients have the right to weigh the possible outcomes against their own goals and preferences. For instance, says Tang, 鈥淪ometimes after hearing about what recovery might entail and about the possible risks of treatment, some patients instead opt for palliative treatment to live out the rest of their lives in comfort.鈥�
鈥淪etting expectations is incredibly important because it all goes back to patient autonomy 鈥� what they want for themselves and the life they choose,鈥� she adds. 鈥淚f we don鈥檛 give them the correct information they need to choose, we鈥檝e failed.鈥�
Some patients do have difficulty accepting the changes that surgery can bring, and as a result the patient may be resistant to a treatment plan at first.
鈥淵ounger patients, especially 20- or 30-year-olds, often have cancers that are more aggressive,鈥� she says. 鈥淚n the case of small tongue cancers, our treatment expectations are usually pretty aligned. Once we get to bigger tongue cancers, however, a lot of times our expectations are not aligned. Most recently, I had a conversation with a 20-year-old patient and his family. The tumor was affecting most of his tongue, and I told the family I had to remove his entire tongue, but they kept asking if I could only remove a small part of his tongue.鈥�
She continues: 鈥淲hen we鈥檙e talking about surgery that removes function like the ability to talk or eat normally, patients and their families have a hard time accepting it. That being said, being really honest and trying to be clear and consistent is the key that usually gets the message across.鈥�
Among the 喵咪社区 Head and Neck Center鈥檚 strengths for treating complex head and neck cancer cases is the fact that treatment plans are the result of the consensus of multidisciplinary experts who are all part of the academic health system of 喵咪社区. Being able to convey to patients that a treatment plan has been shaped and vetted by numerous advanced specialists helps build credence.
鈥淥ur tumor boards are attended by five otolaryngologists, two medical oncologists specializing in head and neck cancers, two radiation oncologists, a radiologist and a pathologist,鈥� Tang says. 鈥淪o, when I present a plan to a patient, I can tell them, 鈥榃e went through a tumor board with these experts. This is our consensus and expectations for treating you the best way we can and to get you the best outcome possible.鈥欌��
There are, of course, instances when patients hamper their own healing post-surgery. One example is a patient who, after a larynx reconstruction, continues smoking or not following postoperative recommendations.
鈥淭he patient may decide to eat when we tell them they shouldn鈥檛 yet. This can stress the incision site and can sometimes cause the incision to break open, resulting in a leakage of saliva. Other times, the reason a patient isn鈥檛 healing well is because they do not stop smoking, even during the immediate postoperative recovery period. In these two cases, patients tend to understand that they鈥檙e inhibiting their own recovery.鈥�
Ultimately, being as thorough and honest as possible in conveying information about potential risks and outcomes sets appropriate patient expectations, which benefits physicians, too. 鈥淛ust be honest and consistent about your own numbers, your own complications and expectations for recovery,鈥� Tang advises. 鈥淚n general, patients are incredibly understanding. With good counseling, your expectations should be pretty aligned.鈥�
And if patients aren鈥檛 healing as well as they鈥檇 hoped, Tang says, 鈥淚 first tell them, 鈥業鈥檓 really sorry. I understand that you鈥檙e frustrated and that you鈥檙e going through a really difficult process right now. You underwent a hugely complicated surgery, and you鈥檙e doing okay, but it will take a little bit of time for you to heal. Eventually, you will heal.鈥� Then we talk about what might be a new normal for them, and we also discuss if there are any other solutions we can try.鈥�
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