There are few diseases that impact a patient’s sense of self as acutely as head and neck cancer. Affecting the vital structures governing speech, swallowing, and breathing, these tumours compromise the most visible and functional aspects of the body. As incidence rates across Australia demonstrate a concerning upward trajectory, there is an urgent need for the medical profession to evolve; the focus must shift from survival alone to a holistic program of surgical and rehabilitative support.
Surgical Interventions
Surgery plays a pivotal role in the management of head and neck cancer. The primary goals of surgical treatment are to remove cancerous tumours and surrounding tissues, restore function, and improve quality of life. Depending on the stage of the cancer and its specific location, the following surgical options may be considered:
1. Tumour Resection
Tumour resection involves the surgical removal of the cancerous tumour along with a margin of healthy tissue. This is often the first line of treatment and may involve highly specialised techniques. For example, in cases where the cancer affects the larynx, partial or total laryngectomy may be necessary, resulting in changes to the patient’s ability to speak.
2. Neck Dissection
In cases where cancer has spread to the lymph nodes, a neck dissection is performed. This procedure involves the removal of lymph nodes in the neck to prevent further metastasis. The type of neck dissection performed whether selective or radical will depend on the extent of the cancer.
3. Reconstructive Surgery
After tumour removal, reconstructive surgery may be required to restore appearance and function. Techniques such as free flap reconstruction involve using tissue from other parts of the body to rebuild structures that may have been removed during surgery. This is particularly important for maintaining functions like speaking and swallowing.
Rehabilitation
Following surgery, rehabilitation is crucial in helping patients regain their strength and adapt to any changes in function. In Australia, a multidisciplinary approach is often adopted, involving medical professionals, speech therapists, dietitians, and physiotherapists to optimise recovery.
1. Speech Therapy
For patients who have undergone laryngectomy or other surgeries affecting the vocal cords, speech therapy is essential. Speech therapists use a variety of techniques, including alternative communication methods and vocal rehabilitation, to help patients regain their ability to communicate effectively.
2. Swallowing Therapy
Changes in swallowing function are common after head and neck surgery. Dietitians and swallowing specialists work together to create tailored dietary plans, assistive devices, and swallowing therapies to ensure patients can eat safely and maintain nutrition during their recovery.
3. Physical Rehabilitation
Physical rehabilitation is important for restoring strength and mobility. This may include exercises to increase range of motion in the neck and shoulders as well as general fitness programs to help patients regain their overall health post-surgery.
4. Psychosocial Support
The emotional and psychological impacts of head and neck cancer can be significant. Access to psychological support services, including counselling and support groups, is vital to help patients cope with the challenges of their diagnosis and recovery.
Conclusion
In Australia, the transition from surgery to rehabilitation for head and neck cancer patients is a multifaceted journey that demands commitment and a robust support system. By gaining insights into the available surgical options and recognising the significance of rehabilitation, patients and their families are better equipped to navigate the challenges posed by head and neck cancer. We encourage you to join our support group HERE for connection and shared experiences.