Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Supporting the oral cancer patient – what is the role of the dental team? Karen Matley Catherine Waldon •Patient Involvement in Service improvement groups, ‘buddying’ and research projects. •Our own experiences and that of other patients too •Catherine – Volunteer helper in Maxillofacial clinics in Bradford Outline: • Our own cancer experiences • Our treatments • NHS and multidisciplinary team • Our fears and anxieties • Short term effects • Long term effects/ living with Cancer Our main messages: • Early diagnosis key to patients’ future Quality Of Life • Multiple and life-long side effects and impacts of surviving oral cancer, even when these are hidden from view Catherine’s Cancer “Journey” • Tonsils removed when young • History of sore throats • Branchial cyst 1984 • No history of heavy drinking or smoking • GP consultation re “something at the back of my throat” • GP referral to ENT • Biopsy and bad news • Scans, x-rays, blood tests • Squamous cell carcinoma T2 in tonsil tissue/back of tongue • Metatasized to neck lymph glands Treatment options 1 • Radical surgery to remove primary tumour, and neck glands with reconstruction with a skin flap • Chemo-radiotherapy for 4 or 7 weeks Opted for this approach. Treatment options 2 • More minor surgery to remove neck glands • Chemotherapy to shrink/eliminate tumour and course of radiotherapy Major treatment fears: • • • • • • • Loss of front tooth/teeth Damage to lip nerves Pain after surgery Facial disfigurement Talking/communication problems Eating problems/swallowing Damage to hearing, kidneys, and hair loss etc. The NHS roller coaster: • Dentist • Dental hygienist • Speech therapist • Dietician • Radiologically Inserted Gastrostomy (RIG) also (PEG) • Macmillan Specialist Nurse • Surgeons • Anaesthetist • Oncologist and Radiography team • GP • Restorative Dentists Karen’s Cancer “Journey” • Lump in the back of my mouth • Aching jaw • Non smoker • Not a heavy drinker • Face began to swell • Blocked saliva glands referral to St. Lukes’ • ‘Slow tracked’ • Routine operation to remove lump • Routine biopsy • Early recall • BAD NEWS! Karen’s Treatment: • • • • • • • Further surgery to area where lump was Full neck dissection All lymph nodes removed from neck Facial split surgery Skin graft from arm to mouth Temporary tracheotomy 6 and a half weeks of radiotherapy with chemotherapy Immediate Effects of Treatment: • Loss of mobility • Learning to eat again Long Term Effects • Xerostomia • Worse at night time – disturbed sleep • Always having to check out where the toilets are! • Saliva problems Long Term Effects FOOD! EATING! • Anxiety about eating out with friends • Having to check out menus before-hand • Choking and swallowing problems Long Term Effects • Continuing fear of losing teeth • Constant care of mouth and teeth Long Term Effects Trismus • Jaw exercises every week – with a hi-tec device of mouth spatulas Speech • Re-training the tongue to speak clearly Other Long Lasting Effects of Treatment: • Numbness in lips or hypersensitivity • Ringing in ears • Susceptibility to infection To summarise: 1.Importance of regular and careful screening and health promotion to help minimise life long side effects and prevent re-occurrence of cancer. 2.Description of our treatment options. Finally • Still grateful! • Thank you for listening! • Any questions? • And now for something completely different!!...............