Medical and Life Sciences supporting Macmillan Therapist in head and neck cancer therapy

Patients who have a cancer in the head and neck will either need to have surgery to remove the cancer, chemo-radiotherapy, or a combination of both. The long term side effects of having surgery or radiation to the head and neck area have a significant impact on the quality of life of a patient even after their treatment has finished. One of the most debilitating and often distressing symptoms is swelling of the head and neck caused by damage to the lymph nodes in this area caused by surgery or radiation. This is known as lymphoedema and two thirds of all patients who receive treatment will have some form of lymphoedema. Lymphoedema is a collection of fluid that sits underneath the skin that cannot drain properly due to damage to the lymph nodes caused by surgery or radiation. If left untreated, this backlog of fluid sitting underneath the skin will turn hard and develops into scar tissue. At this point, it is irreversible, but if treated early enough, it can be resolved. The impact of this swelling on patients is very distressing. It can cause swelling in the lips, tongue, face, neck and internally in the throat. This causes facial disfigurement and difficulty eating and drinking.

The therapy will give patients a combination of manual lymphatic drainage, skincare advice, neck exercises and a compression garment to wear over the swelling to help drain the backlog and soften the swelling. This is known as Complete Decongestive Therapy. This specially designed programme by Macmillan Speech & Language Therapist Alison Smith, who is also trained as a Lymphoedema Therapist will combine the knowledge of how to treat the swelling and how to specifically improve swallowing to improve confidence, eating and drinking ability and quality of life. Results from this study will be used to decide if the plan can be used for a larger study in the future.