Clinical Care And Rehabilitation In Head And Neck Cancer

Malignancies involving structures of the head and neck frequently impact the most fundamental aspects of human existence, namely, those functions related to voice and speech production, eating, and swallowing. Abnormalities in voice production, and in some instances its complete loss, are common following treatment for laryngeal (voice box) cancer. Similarly, speech, eating, and swallowing may be dramatically disrupted in those where oral structures (e.g., the tongue, jaw, hard palate, pharynx, etc.) are surgically ablated to eliminate the cancer. Consequently, the range and degree of deficits that may be experienced secondary to the treatment of head and neck cancer (HNCa) are often substantial. This need is further reinforced by the Centers for Disease Control and Prevention who have estimated that the number of individuals who will be newly diagnosed with HNCa will now double every 10 years. This estimate becomes even more critical given that an increasing number of those who are newly diagnosed will be younger and will experience the possibility of long-term survival post-treatment. Contemporary rehabilitation efforts for those treated for HNCa increasingly demand that clinicians actively consider and address multiple issues. Beyond the obvious concerns specific to any type of cancer (i.e., the desire for curative treatment), clinical efforts that address physical, psychological, communicative, and social consequences secondary to HNCa treatment are essential components of all effective rehabilitation programs. Comprehensive HNCa rehabilitation ultimately seeks to restore multiple areas of functioning in the context of the disabling effects of treatment. In this regard, rehabilitation often focuses on restoration of function while reducing the impact of residual treatment-related deficits on the individual’s overall functioning, well-being, quality of life (QOL), and ultimately, optimize survivorship. Regardless of the treatment method(s) pursued for HNCa (e.g., surgery, radiotherapy, chemoradiation, or combined methods), additional problems beyond those associated with voice, speech, eating and swallowing frequently exist. For example, post-treatment changes in areas such as breathing, maintaining nutrition, limitations in physical capacity because surgical reconstruction such as deficits in shoulder functioning, concerns specific to cosmetic alterations and associated disfigurement, and deficits in body image are common. Those treated for HNCa also may experience significant pain, depression, stigma and subsequent social isolation. Concerns of this type have led clinicians and researchers to describe HNCa as the most emotionally traumatic form of cancer. It is, therefore, essential that clinicians charged with the care and rehabilitation of those treated for HNCa actively seek to identify, acknowledge, and systematically address a range of physical, psychological, social, and communication problems. Efforts that systematically consider this range of post-treatment sequelae are seen as critical to any effort directed toward enhanced rehabilitation outcomes. Actively and purposefully addressing post-treatment challenges may increase the likelihood of both short- and long-term rehabilitation success in this challenging clinical population. Current information suggests that successful clinical outcomes for those with HNCa are more likely to be realized when highly structured, yet flexible interdisciplinary programs of care are pursued. Yet contemporary educational resources that focus not only on management of voice, speech, eating, and swallowing disorders, but also address issues such as shoulder dysfunction due to neck dissection, the significant potential for cosmetic alterations can offer a much broader perspective on rehabilitation. Contemporary surgical treatment frequently involves reconstruction with extensive procedures that require donor sites that include both soft tissue from a variety of locations (e.g., forearm, thigh, etc.), as well as bone (e.g., the scapula). Collectively, resources that address these issues and many other concerns and the resultant social implications of HNCa and its treatment can serve to establish a comprehensive framework for clinical care. Consequently, providing a highly specialized and comprehensive educational resource specific to HNCa rehabilitation is currently needed. The proposed edited book is designed to address this void in a single authoritative resource that is also accessible to the clinical readership. Integral to this proposed book is information that guides clinical approaches to HNCa rehabilitation, in addition to offering emphasis on the direct impact of changes in voice, speech, and swallowing and the impact of such losses on outcomes. Finally, while several other published sources currently exist (see attached list), the emphasis of these books is directed either toward the identification and diagnosis of malignant disease, clinical and surgical pathology, associated efforts directed toward biomedical aspects of cancer and its treatment, or those with a focus on a single clinical problem or approach to rehabilitation. Therefore, the content of the proposed multi-chapter text centers on delivering a systematically structured, comprehensive, and clinically-oriented presentation on a range of topics that will provide readers at a variety of levels with a strong, well-integrated, and empirically driven foundation to optimize the clinical care of those with HNCa. The primary audience for this textbook is undergraduate and graduate-level students in Speech-Language Pathology, as well as practitioners, especially hospital-based practitioners, in Speech-Language Pathology; other key audiences include junior and senior level otolaryngology residents and fellows, translational researchers in head and neck cancer, related medical specialists (e.g., radiation oncology), oncology nurses, and potentially other rehabilitation professionals such as occupational therapists, counseling psychologists, social workers, and rehabilitation counselors.

This text provides a comprehensive grounding in the contemporary rehabilitation, management, and clinical care of patients following treatment of head and neck cancer (HNCa). It provides the diagnostic and clinical information necessary to successfully manage patients with HNCa, and aids clinical health trainees and professionals in identifying, acknowledging, and addressing a wide range of problems that may occur post treatment, such as abnormalities in voice and speech production, eating, and swallowing. In addition, the book explores the physical, psychological, communicative, and social aspects that form essential components of cancer rehabilitation programs that seek to restore multiple areas of functioning which are disrupted secondary to treatment. Post-treatment changes in breathing, nutrition, physical capabilities, disfigurement, mood, and body image are also covered.

Edited by cancer rehabilitation specialist Dr. Adrian Cristian, Head and Neck Cancer Rehabilitation provides clinicians with a concise and accessible resource covering the holistic rehabilitation of head and neck cancer patients. This book begins with the epidemiology, genetics and pathophysiology of cancer in this region and moves into clinical assessment and treatment options before providing comprehensive coverage of rehabilitation. Featuring practical information, best practices, and the latest advances and research, this book provides a valuable reference for physical medicine and rehabilitation physicians and residents, as well as occupational therapists, physical therapists, and ENT specialists. Provides a clear understanding of the current medical, surgical and radiation treatments for head and neck cancer. Covers the whole spectrum of head and neck cancer rehabilitation, including the role of physical and occupational therapy, the treatment of anxiety and depression, integrative care, nutritional rehabilitation, and more. Offers a timely and convenient resource written by leading experts in both head and neck cancer and rehabilitation. N/A

This book identifies key treatment challenges and unique care considerations in patients with head and neck cancers, providing a comprehensive guide to patient management that illustrates the critical importance of a multidisciplinary approach in achieving optimal oncological, functional, and survival outcomes. It covers all relevant specialties, including dental and oral medicine, medical oncology, radiation oncology, surgical oncology, and reconstructive surgery. It highlights the vital role played by ancillary head and neck cancer services, such as speech and swallowing therapy, occupational and physical therapy, and nutritional therapy in offering essential physical and psychological support from the time of diagnosis onward. The closing chapters address post-treatment issues, including those relating to survivorship, surveillance, and end-of-life care. Multidisciplinary care is perhaps even more important for patients with head and neck cancers than for other cancer patients, and in addressing all its aspects this book is invaluable for a wide range of practitioners.

The emphasis on cancer management in the past was based primarily on control rates from multidisciplinary input in management. There has always been a recognition that one would like to achieve the best result with the least complication, but never has there been any major emphasis on evidence-based outcome studies, nor on functional preservation and quality of life. The authors of this book have dealt very effectively with the various tumor types in head and neck cancer with the experts in the ? eld of management. The contents range from epidemiology and treatment outcome, treatment techniques with the potential impact on the quality of life such as dysphagia, to the various options relative to high technology radiation therapy programs for mana- ment. The potential for improving form and function through surgical care as an integrated part of the program is dealt with very effectively as well as the potentials for chemotherapy and the use of targeted agents have on quality of life issues. The volume also addresses toxicity, quality of life, and techniques for prevention of adverse effects, as well as the potentials for rehabilitation and supportive care. The authors have clearly done an extraordinarily good job in addressing the mul- plicity of problems that impact upon the functional preservation and quality of life in head and neck radiation therapy. Philadelphia Luther W.

Rehabilitation in Cancer Care is an essential clinical resource forall Allied Health Professionals working within or entering thisspecialist area. It provides practical guidance for therehabilitation of people with cancer or those receiving palliativecare. As well as explaining the key skills required at every stageof the cancer journey, the book specifically offers advice ondiagnosis, treatment, management and effective interventions.Furthermore the role of each member of the interdisciplinary teamis clearly explained at each stage, as is the importance of teamwork and holistic care. Section 1 introduces the reader to the rationale for therehabilitation of people with cancer or those receiving palliativecare, Section 2 looks at the multi-professional management ofcommon cancers and Section 3 looks at symptom management.

Finally, a concise pocket guide designed as a quick reference for busy clinicians who seek to improve the care they provide to cancer patients and cancer survivors. It is a comprehensive text formatted for fast access to a wide range of clinical information. This compact compendium is conveniently organized by cancer type for rapid review. It describes the many issues that cancer patients may face throughout the chronologic spectrum of care, starting from cancer diagnosis, to treatment, and survivorship. Each chapter helpfully highlights common impairments and treatment options using succinct tables, helpful illustrations and clinical peals from experts in the field. In addition, each chapter contains a clinical case and questions on the material to enhance understanding. Evidence for exercise treatment, including pertinent exercise precautions, is included, as are innovative research topics and emerging treatments. This includes dedicated chapters covering cancers of the breast; digestive organs; brain, eye, and central nervous system; urinary tract and genital organs; lip, oral cavity, and pharynx; lymphoid, hematopoietic, and related tissues; bone, articular cartilage, and soft tissues; respiratory and intrathoracic organs; skin. Thankfully, advances in cancer care such as chemotherapy, radiation, and surgery mean that more people than ever before are surviving long after their cancer diagnosis. Unfortunately, a large fraction of them live with at least one serious impairment as a consequence of their treatments that seriously impacts their ability to function and quality of life. This concise and essential guide to cancer rehabilitation will help the clinician navigate the care of this often complex population.