Background: The incidence of head and neck cancer (HNC) is increasing worldwide (Gormley 2022). With advances in care, patients are surviving longer, but with persisting and late toxicities from their treatment(s). They require ongoing support with the resulting quality of life (QoL) issues. Research has commenced into looking at developing new models of follow up care and cancer surveillance for HNC (PETNECK2 2003). This service evaluation sought to explore the potential unmet survivorship needs of patients undergoing HNC surveillance at a single tertiary referral centre.
Methods: Data were collected retrospectively over a 3-month period from July-September 2023 via case note review. The sample included patients > 1 year post treatment and under active HNC oncological surveillance in the outpatient clinic. Data included patient, tumour and treatment demographics and any recorded information regarding swallowing disorders (dysphagia).
Results: The sample included 52 patients (32 male and 20 female) with a median age of 63 (37-82 years). Tumour sites (excluding parotid and nasal cavity) were oropharynx 60% (n=31), oral 25% (n=13), laryngeal 13% (n=7) and nasopharynx 2% (n=1). The majority, 77% (n=40) were 1-5 years post-treatment, 13% (n=7) 6-10 years post treatment and 12% (n=6) were >10 years post treatment. Documented evidence of questions relating to eating and drinking were noted in 37% (n=7). Of the 7 patients questioned, 6 reported difficulties with only one patient referred for formal dysphagia assessment.
Conclusion: Despite the known long term and late effects of HNC treatment on swallowing, this data showed that just over 1/3 of our sample were asked about it during oncology surveillance clinics. As work continues to explore optimal patterns of HNC surveillance, appropriate methods to identify and address unmet need and the challenges of treatment toxicity are critical. Ongoing work continues at our centre exploring the expansion of Allied Health Professional roles in longer-term cancer surveillance and wider survivorship care.
Sinead Rothrie1, Grainne Brady1,2, Justin Roe1,2,
1 Department of Speech, Voice & Swallowing, The Royal Marsden NHS Foundation Trust, UK
2 Department of Surgery & Cancer Imperial College London, United Kingdom