Head and neck cancer part 2: the patient journey Stephanie Hackett Oliver Jones Despoina Chatzistavrianou David Newsum Dental Update 2024 46:9, 707-709.
Specialist in Prosthodontics, Specialty Registrar in Restorative Dentistry, Birmingham Dental Hospital and University of Birmingham School of Dentistry, Birmingham Community Healthcare NHS Trust, Birmingham, UK
Consultant in Restorative Dentistry, BDS, MFD RCS, MSc, MRCPS, MRD RCSEd, FDS(Rest Dent) RCSEd, Birmingham Dental Hospital and School of Dentistry, Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK
This is the second paper in a three-part series to discuss head and neck cancer diagnosis, treatment and rehabilitation. Following a confirmed diagnosis of head and neck cancer, patients will begin a long and often challenging pathway that will involve clinicians from a multidisciplinary team (MDT). This paper will summarize the role of individual MDT members involved in patient care, diagnostic and treatment phases for head and neck cancer and common side-effects encountered. By gaining an insight into this part of the patient's journey, dental practitioners should feel more comfortable and confident engaging in the care and support for head and neck cancer patients.
CPD/Clinical Relevance: This paper aims to provide readers with an insight into the journey that patients will undertake after being diagnosed with head and neck cancer.
Article
Care for head and neck cancer patients in England and Wales was reformed in 1995 following the Calman Hine Report.1 In this report, a patient-centred framework for the commissioning and provision of cancer services was proposed to ensure that treatment received was of a uniformly high standard.1 The quality and availability of care has improved immeasurably over the past decades with improved training, multidisciplinary working and treatment modalities,2 leading to improved survival rates.
The Cancer Reform Strategy (2007)3 set out the 62-day patient pathway for treatment of cancers in the UK (Figure 1). Following a suspected cancer referral, the patient is seen within 14 days by the accepting unit. Specifically for head and neck cancers, arrangements will be made to see the patient on a ‘fast track’ head and neck clinic by a consultant in head and neck surgery from the fields of Oral and Maxillofacial Surgery, Plastic Surgery and Ear, Nose and Throat Surgery. Diagnostic tests, including biopsies and imaging, are implemented within the next phase and a decision to treat must be made by MDTs within 31 days. The patient's first exposure to treatment of the cancer will be made within the following 31 days, concluding that the first treatment for the patient pathway should be started within 62 days of the referral being received.
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