Head and neck service: My information folder

Introduction

This folder contains information about your treatment.

It also contains space for you and others involved in your care to make notes, write down questions or to record other aspects of your care.

There is further specific information about your cancer available through

Macmillan Cancer support (opens in a new tab) in their booklets and factsheets.

Further support can be found at our Macmillan POD, Oncology Department or from Maggie’s (opens in a new tab).

The head and neck cancer multidisciplinary team (MDT) at Cambridge University Hospitals NHS Foundation Trust

What is the MDT?

Following your recent diagnosis of head and neck cancer, you will receive support and treatment from different clinicians who form the MDT.

The MDT consists of doctors, nurses and other professionals who meet together to assess your condition, plan and provide treatment and/or care appropriate for you. In order to do this, the members of the MDT meet each Wednesday to discuss people with a new diagnosis and to review those who have previously been diagnosed with cancer. Due to patient confidentiality, patients are unable to attend these meetings.

Due to the nature of the disease, there may be a number of investigations and treatment options available and more than one specialist is likely to be involved in your care. It is essential that everyone involved can share their expertise and understanding about your case, even though you may not personally meet all the members of this team.

Multidisciplinary clinic

You will attend the head and neck clinic where the MDT will discuss any findings from tests taken and meet with you and your family. They will answer any questions you have on the benefits and risks of your treatment options. Following your appointment, your GP will also be sent a summary of your agreed treatment plan.

This is a very busy clinic and will involve some waiting time, and we do apologise for this delay. You are encouraged to bring a friend or relative to these appointments to give you support or help you ask questions.

Following your treatment you will continue to be seen by the head and neck team regularly for follow-up appointments. This may be a mixture of telephone and face to face consultations. This is to check your progress and allow you to discuss any concerns you may have or symptoms you may be worried about.

A member of the MDT will be designated as your key worker/clinical nurse specialist (CNS). They are your point of contact during your illness.

Should you have concerns between appointments, you can contact your key worker/CNS.

Who does what?

Ear, Nose and Throat (ENT) surgeons

The ENT surgeons (also known as otolaryngologists) specialises in the diagnosis and treatment of head and neck disorders involving the face, ear, nose, throat, sinuses, skull base and neck. They are responsible for performing surgery to remove cancer in these areas.

You will be reviewed by the surgeon regularly after your surgery with the frequency of these reviews reducing over time. Most patients are reviewed by the ENT surgeon for approximately five years after initial diagnosis.

Head and Neck maxillofacial surgeon (OMFS)

The OMFS specialise in the diagnosis and treatment of head and neck tumours affecting the mouth (for example, tongue, cheek, floor of mouth, and palate), bones of the face and skin of the face.

They are responsible for performing surgery to remove cancers in these areas. They often work with the head and neck plastic surgeons as necessary in the reconstruction of the face and mouth.

You will be reviewed by one of the OMFS regularly following your surgery. The frequency of these outpatient visits will be for a period of five years, reducing in frequency over time from six weeks to six months depending on the original tumour.

In some situations, it may be necessary to provide a facial prosthesis – this is a false part such as a nose or ear. These may be implant retained. The OMFS works with maxillofacial prosthetic technicians to provide these prostheses which help restore facial form and function where possible.

Maxillofacial nurse practitioner (MNP) and surgical care practitioner (SCP)

The role of the MNP and SCP is to provide care and support, emotionally and psychologically, from diagnosis, during treatment and follow-up.

Your MNP is your key worker for the MDT and contact details will be given to you during your clinic appointment.

The MNP works closely with the OMFS in theatre and outpatient clinics.

Your MNP/SCP will be able to answer any questions you may have, explain your surgery and provide advice on symptom control.

Plastic surgeons

The plastic and reconstructive surgeons specialise in reconstruction and cosmetic surgery for patients with cancer of the head and neck. They work closely with the ENT and OMFS and are responsible for closing surgical defects once the tumour is removed. This can be done using skin grafts or bone and tissue flaps from other parts of the body. The plastic and reconstructive surgeon will monitor you closely following surgery to ensure the flap or tissue used for reconstruction has healed well. They will also monitor the area where the flap or tissue was taken from.

Clinical oncologists

The clinical oncologists specialise in the treatment of head and neck cancer using radiation and chemotherapy treatment. They advise whether the cancer is best treated with radiotherapy alone, chemotherapy, or a combination of both.

They also advise on the timing of this treatment (eg before surgery, after surgery or as a stand-alone treatment).

The clinical oncologists will monitor you regularly during your treatment and for some time after you finish treatment.

Advanced practice radiographer – Head and Neck (H&N Rad)

The H&NRad works alongside the clinical oncologists and specialises in radiotherapy and chemo-radiotherapy to the head and neck. The H&NRad is your main point of contact for queries regarding radiotherapy/chemo-radiotherapy treatment and appointments.

The H&NRad is your key worker for any concerns and, alongside the medical team, will assess and manage your treatment side effects. The H&NRad works closely with the MDT specialties to support you through your treatment.

Macmillan clinical nurse specialists (CNS)

There are four CNSs. You will meet one or all of them during the course of your treatment. They are involved in the care of people who are having surgery, radiotherapy and/or chemotherapy and immunotherapy.

Your CNS will explain your treatment, give information and answer your questions. They will provide emotional support and advice about the best way to manage pain and other symptoms.

The CNSs work closely with the MDT and will link you with other healthcare professionals if necessary.

The role of the MNP and SCP is to provide care and support, emotionally and psychologically, from diagnosis, during treatment and follow-up.

Macmillan navigator

The role of the Head and Neck navigator is to assist patients and their families by offering support, information and highlighting how the holistic needs assessments (HNA) can help us to help you during your cancer treatment and beyond. The HNA is a simple set of questions, which cover all areas of your life, including physical and general wellbeing. Your answers will help us find out what is important to you and then develop a plan to support your individual needs and signpost or refer to local activities and resources.

Dietitians

The dietitian’s role is to look after your eating and drinking throughout your treatment. They will advise you on ways to enrich your diet and modify the texture of foods if needed. They will also help you to manage your feeding tube, if this is required during your treatment.

Speech and language therapists (SLT)

SLTs are specialists in speech, voice and swallowing. Some types of head and neck cancer and their treatments can lead to difficulties with communication, eating and drinking.

The speech therapist will be able to offer assessment and management for any of these difficulties, and will be able to support you before, during and after treatment.

Following assessment you may be given strategies to help you eat and drink, communicate or manage your saliva more effectively.

They are also able to advise you and supply devices to help improve your communication, secretion management and jaw opening if required.

The SLT team work closely with the dietitians to monitor your eating and drinking throughout your treatment.

Treatment options

Your treatment depends on where your cancer is and what type of cancer you have. Some patients need only one form of treatment and others need a combination of different treatments. Often we combine treatments such as radiotherapy and chemotherapy, or surgery and radiotherapy.

Questions I want to ask at my next appointment

It is important that you are involved with the decisions about your treatment and care as much as possible. If you have any queries, or need further information or support, please do not hesitate to ask.

Diagram of the head and neck

Your doctor will use this diagram to explain more about your tumour.

Contacting the departments

In a medical emergency dial 999 or 911

Head and Neck Clinical Nurse Specialist 01223 217425

Head and Neck Dietitians 01223 216655

Advanced Practice Head and Neck Radiographer 01223 596330

Secretary to Dr Benson, Dr Jadon and Dr Barnett 01223 596182

Secretary to Mr Jani and Mr Amen 01223 216486

Secretary to Miss Irune 01223 256032

Secretary to Mr Sharma 01223 250755

Secretary to Mr Fish 01223 257230

Secretary to Mr Durrani and Mr Price 01223 256080

Plastics Clinical Nurse Specialist 01223 348025

Clinic 8 (Maxillofacial) 01223 216412

Maxillofacial Nurse Specialist and SCP 01223 216638

Secretary to Mr Cameron and Mr Thompson 01223 216705

Speech and language therapy department 01223 216200

Acute Oncology service (24hrs) 01223 274224

Radiotherapy Centre 01223 216634

Addenbrooke’s Contact Centre 01223 245151

Clinic 10 (ENT) 01223 217588

M5: Surgical ward 01223 348525 0r 01223 348527

D9: Oncology ward (24hr) 01223 217708

Peterborough contacts

Head and Neck Clinical Nurse Specialist 01733 677039

Secretary to Mr Amen 01733 677001 or 01733 677003

Speech and Language Therapist 01733 678502

Dietitian 01733 673674

West Suffolk contacts

Head and Neck Clinical Nurse Specialist 01284 713000 Ext 4283

Mr Martinez secretary 01284 713820

Bedford Hospital contact

Head and Neck Clinical Nurse Specialist 01234 792209

Privacy and dignity

Same sex bays and bathrooms are offered in all wards except critical care and theatre recovery areas where the use of high-tech equipment and/or specialist one to one care is required.