Cough, Expiratory Training, and Chronic Aspiration After Head and Neck Radiotherapy

The goal of this clinical research study is to learn if exercising the muscles that help you cough and swallow, called expiratory muscle strength training (EMST), can help reduce the risk of pneumonia due to aspiration (inhaling saliva instead of swallowing it) in patients who have had radiation for head and neck cancer.

Inclusion Criteria: 1. Age \>/= 18 years 2. History of curative-intent radiotherapy at MDACC for a new primary H\&N cancer in past 15 years 3. Referred to Section of Speech Pathology and Audiology for swallowing evaluation 4. Ability to understand and willingness to sign written informed consent Exclusion Criteria: 1. History of recurrent or second primary H\&N, central nervous system, or thoracic cancer at time of modified barium swallow (MBS) study 2. Prior H\&N surgery excluding diagnostic procedures, transoral surgery, or non-radical neck dissection 3. History of functionally limiting chronic or acute cardiac, pulmonary, or neuromuscular disease 4. Tracheotomy or oxygen dependence at time of MBS 5. Patients with Mini-Mental State Examination (MMSE) \