Optimising Care for Patients with Head and Neck Cancer Forum - 16 October 2009

The Patient Perspective
Noelene Hunt

In April 2007, Noelene Hunt was diagnosed with a nasopharyngeal carcinoma and was treated with chemotherapy and radiotherapy at the Sydney Head and Neck Cancer Clinic. As the first speaker of the forum, Noelene presented her personal journey as a head and neck cancer patient to set the scene of ‘patient focussed care’. Noelene’s session was rated as the most enjoyed aspect of the day.

Click here for audio (requires Quicktime player) [MP4 | 12.07 MB]
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Signs, Symptoms and Referral Pathways
Dr Kerwin Shannon, Director, Sydney Head and Neck Cancer Institute; Head
and Neck Surgeon, Chair NSWOG Head and Neck

This introductory session explained the epidemiology, risk factors and head and neck tumour characteristics as well as referral pathways and data on referral delays.

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Surgical Techniques
Dr Carsten Palme, Head and Neck Surgeon, Westmead Hospital

Using video presentations, Dr Carsten Palme demonstrated the use of laser microsurgery for early laryngeal cancer. The presentation included background information to the procedure, a description the requirements when setting up Endoscopic Laser Service and the clinical results and experience of using the technique at Westmead Hospital.

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Patterns of Patient Information Needs and Affective Distress for people with Head and Neck Cancer and their family members
Luci Dall’Armi, Head and Neck Cancer Nurse Co-ordinator, Liverpool Hospital

This presentation outlined results of the Cancer Institute NSW funded project designed to address the information needs of head and neck cancer patients. The study found limited appropriate resources in the Australian context and that patients and families were most interested in information regarding disease and survivorship.

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Role of Chemotherapy in Head and Neck Cancer
Professor Michael Boyer, Medical Oncologist Sydney Cancer Centre

Professor Michael Boyer described the Role of Systemic Therapy in Head and Neck Cancer, outlining systemic agents used, toxicity relating to each and incorporating chemotherapy with loco-regional therapy. There was a brief outline of research and trials combining different chemotherapy agents with radiation therapy and overall survival outcomes.

Click here for audio (requires Quicktime player) [MP4 | 31.8 MB]
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Radiotherapy Techniques
Dr Allan Fowler, Radiation Oncologist, SSWAHS

The role of radiotherapy for head and neck patients was explored in this session, specifically the process of delivering radiotherapy, the dose, planning and defining gross tumour volumes. This session briefly provided an overview of the common side effects of radiation therapy.

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Oral Complications of Head and Neck Cancer Treatment
Dr Sue-Ching Yeoh, Specialist, Oral Medicine & Oral Pathology, SSWAHS
Dr Claire Scott, Senior Dental Officer, RPA Dental Clinic

Oral and dental complications of head and neck cancer treatments were described in detail, particularly those resulting from radiation therapy. These side effects include mucositis, xerostomia, loss of taste and radiation caries. The presentation also detailed the effect of trismus, fibrosis and irradiated bone as well as practical strategies to combat these side effects.

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Speech and Swallowing Issues
Julia Maclean, Speech Pathologist, St George Hospital

Using video case studies, Julie Maclean demonstrated how swallowing assessment is conducted and swallowing therapy and strategies to maintain function. The session also provided an overview of communication and voice disorders related to alteration of head and neck anatomy.

Click here for audio (requires Quicktime player) [MP4 | 19.10 MB]
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Nutritional Challenges for Patients with Head and Neck Cancer
Merran Findlay, Senior Oncology Dietitian, RPA

This session highlighted the importance of nutrition intervention before, during and after treatment with continued access to services. Using case studies to demonstrate the evidence of benefit, the presentation also included an overview of nutrition assessment and post-treatment monitoring.

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Caring for Tracheostomy and PEG at home
Justine Oates, Head and Neck Cancer Care Coordinator, RPA

This detailed session provided a comprehensive overview of the functional aspects of tracheostomy and PEG tubes; their design and function, challenges and complications and appropriate care requirements.

Click here for audio (requires Quicktime player) [MP4 | 23.32 MB]
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Palliative Care Perspectives
Joan Ryan, Palliative Care Clinical Nurse Consultant, RPA

With emphasis on providing dignity and autonomy in end of life care, this session described the complexities and unique factors impacting on patients with head and neck cancer, a highly symptomatic population with an alienating disease.

Click here for audio (requires Quicktime player) [MP4 | 27.43 MB]
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The day closed with a question and answer session with an expert panel, which included speakers from the afternoon sessions.