Optimal Care Pathway for People With Head and Neck Cancers
Cancer Council Australia. (2021).
New South Wales (Australia): Head and Neck Cancer Australia, 1-75.
This consensus-based guideline provides recommendations on the optimal care pathways for individuals with head and neck cancer. This summary highlights recommendations for service delivery within the scope of speech-language pathology.
Cancer Council Australia
Cancer Council Australia; Australian Government Cancer Australia
<p class="MsoNormal">This guideline is included within an umbrella systematic review of guidelines investigating available recommendations for head and neck cancer survivorship care. See the Associated Article(s) section below to access the umbrella systematic review.</p>
<div>Individuals with head and neck cancer should receive care from a multidisciplinary team of healthcare providers who all "have an important role in promoting rehabilitation" (p. 37). Speech-language pathologists are one of the core members of the multidisciplinary team who should be present for the majority of multidisciplinary team meetings.</div>
<div>Individuals with head and neck cancer should have access to care from allied health professionals, in particular speech-language pathologists, for managing side effects resulting from cancer treatment. Speech-language pathologists should have current training and experience in providing safe, quality care to individuals with head and neck cancer who receive radiation therapy. Individuals with head and neck cancer should be referred to a speech-language pathologist for:</div>
<ul>
<li><span style="color: #333333;">aspiration symptoms (e.g., coughing when eating or drinking);</span></li>
<li><span style="color: #333333;">swallowing difficulties including trismus;</span></li>
<li><span style="color: #333333;">laryngectomy management;</span></li>
<li><span style="color: #333333;">long-term tracheostomy support for breathing, swallowing, and/or communication needs; and/or</span></li>
<li><span style="color: #333333;">communication impairment(s).</span></li>
</ul>
<div>For head and neck cancer patients, the first multidisciplinary team meeting should occur within two weeks of diagnosis and cancer staging. Cancer prehabilitation should include exercise, nutrition, and psychological strategies to prepare for cancer treatment.</div>
<div>Individuals with head and neck cancer should undergo a speech-language pathology assessment for communication impairment(s). The evaluation should assess whether the individual may benefit from a communication device.</div>
<div>Individuals with head and neck cancer should undergo speech-language pathology evaluation of swallowing difficulties, especially for individuals at-risk for aspiration.</div>
<div>Individuals with head and neck cancer should receive speech-language pathology management for communication impairment. For individuals who have undergone a laryngectomy, or for those who have a permanent tracheostomy, communication access should be maximized.</div>
<div>Individuals with head and neck cancer should receive speech-language pathology management for dysphagia symptoms, particularly for individuals who have undergone a laryngectomy or who have a permanent tracheostomy. Managing swallowing problems may include humidification/airway management, monitoring swallowing outcomes, and quality of life outcomes and considerations (e.g., weighing oral feeding benefits and aspiration risk).</div>
<div>Total laryngectomy candidates should undergo a comprehensive speech-language pathology assessment, should receive education about laryngectomy, and should be offered the opportunity to access support from other individuals who have undergone laryngectomy.</div>
