The head and neck region consists of various body parts that are important for breathing, voice production, swallowing, taste, smell, and hearing - amongst other functions. Head and neck cancer includes cancers of the mouth and throat, and less common cancers involving areas such as the ear, nose, sinuses, salivary and thyroid glands. Squamous cell carcinoma accounts for over 90% of head and neck cancers and originates from the lining of the mouth, tongue, and throat. The throat is subdivided into the oropharynx (tonsil and base of tongue region), larynx (voice box), trachea (windpipe) and upper oesophagus (gullet or food pipe).
Kingston Hospital NHS Foundation Trust offers a comprehensive diagnostic Head and Neck Cancer Service including:
We form part of the South West London Cancer Network which provides treatments for patients diagnosed with head and neck cancer. The lead clinicians at Kingston Hospital are core members of the South West London Head and Neck Cancer Multidisciplinary Team (MDT), which holds a weekly meeting at St George’s Hospital NHS Foundation Trust.
Depending on the extent of disease and the involved head and neck subsite, squamous cell carcinoma of the head and neck is treated with a combination of either initial surgery followed by radiotherapy +/- chemotherapy if required or initial radiotherapy +/- chemotherapy, with surgery reserved for use at a later stage to treat, where appropriate, for patients who do not respond to radiotherapy. Given the complex treatment options, and the treatment related side effects on important bodily functions such as speech and swallowing, all patients with Head and Neck cancer are discussed at the St George’s Hospital Head and Neck Cancer MDT meeting, with oncologists from the Royal Marsden Hospital, to ensure that they receive appropriate treatment with the best chance of cure, whilst minimising exposure to therapy related side effects.
Treatment for thyroid cancer is different to squamous cell carcinoma, and usually involves initial surgery to remove the affected half, or all of the thyroid (with or without any involved lymph nodes in the neck), followed by radioactive iodine therapy a few weeks after surgery, if required. As with squamous cell carcinoma of the mouth and throat, all patients with a diagnosis of thyroid cancer or other less common head and neck cancers are discussed at the weekly St George’s Hospital Head and Neck Cancer MDT meeting prior to commencing treatment.
Following a diagnosis of head and neck cancer, surgical treatment is performed at St George’s Hospital NHS Foundation Trust. Patients requiring radiotherapy +/- chemotherapy are referred to our oncology partners at the Royal Marsden Hospital, who have treatment sites at either clinic sites in South Kensington or Sutton.
For more information on the different types of Head and Neck cancer please visit:
Holistic Needs Assessment (HNA)
People with cancer often require care, support and information in addition to the medical management of their cancer or condition.
A holistic needs assessment is a discussion with a doctor or nurse to talk about physical, emotional and social needs. The focus is on the patient as a whole – not just their illness. A doctor or nurse will gather information from the patient, however much they would like to share about their current situation. This is an opportunity for them to talk about any worries or concerns they may have. It will help to clarify their needs and ensure that they are referred to the relevant services.
In order to prepare for this discussion, patients may be asked to complete a questionnaire to bring to their next consultation. This is not compulsory and not having this assessment will not affect their care. However, many patients find having an assessment helpful as it can help to identify what help is available.
It may be offered at certain times during care, including:
It may be carried out over the phone.
With the patient's agreement, the doctor or nurse carrying out the assessment may refer them to other services that may be of help. Alternatively, if preferred, written information can be given about these services.
A multidisciplinary team work collaboratively in the care of Head and Neck cancer patients. These include Consultant Surgeons, Oncologists, Radiologists, Pathologists, surgical Registrars, Clinical Nurse Specialists, Dieticians, Speech Therapists, Psychologists, Palliative care clinicians, Restorative Dentists and Occupational Therapists.
Core members of the South West London Head and Neck Cancer Multidisciplinary team based at Kingston Hospital include:
Consultant ENT Surgeon, Lead for Head and Neck, Thyroid and Parathyroid Surgery
Consultant Oral and Maxillofacial Surgeon