Designing a survivorship program for head and neck cancer patients.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e17007-e17007
Author(s):  
Jolie Ringash ◽  
Maurene McQuestion
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Care Delivery ◽  
Care Pathway ◽  
Interdisciplinary Collaboration ◽  
Clinical Care ◽  
Treatment Team ◽  
Psychosocial Needs ◽  
Specific Patient

e17007 Background: Our institution receives approximately 700 new patients with head and neck cancer (HNC) annually. A need was identified to develop, provide and evaluate services for the unique needs of HNC patients and their families. Methods: A dual leadership model was established, involving two HNC specialists: an advanced practice nurse and a radiation oncologist. After a literature search and environmental survey, we contacted identified H&N survivorship programs. Internal participants were identified from the HNC clinical team and existing institutional survivorship program. We established interdisciplinary Steering (focused on development and oversight of clinical & education programs) and Research (tasked with assessing needs and outcomes) committees. We sought consensus on program principles, scope, a definition of survivorship, and a theoretical model of the HNC journey. A half-day retreat including community partners and patient/family representatives was held to set 5-year priorities. Results: Little published literature on survivorship initiatives specific to HNC exists. Three HNC survivorship clinical or research programs were identified; the largest (established in 2009) was visited, while telephone contact was made with investigators at the others. Principles guiding program development included interdisciplinary collaboration, grass-roots expertise, and a holistic scope. We defined survivors as all HNC patients and their families, from diagnosis through death. Program scope includes physical, emotional, social, financial, functional and psychosocial needs. A theoretical map of the cancer journey and evolving challenges was developed. The retreat included 50 participants, representing 20 different roles. We identified these top priorities: 1) Establish a post-treatment team; 2) Make survivorship a (mandatory) standard of care; 3) Optimize patient navigation; 4) Match services to specific patient groups (eg. men); 5) Expand access to allied health services; and 6) Develop a clinical care pathway. Conclusions: Survivorship is a complex and evolving area of research and care delivery. A team-based, comprehensive approach has been developed to address the needs of the highly specialized HNC population.

scholarly journals Clinical Care Pathway for Head and Neck Cancer

2002 ◽  
Vol 128 (3) ◽  
pp. 258 ◽  
Author(s):  
Kristin M. Gendron ◽  
Stephen Y. Lai ◽  
Gregory S. Weinstein ◽  
Ara A. Chalian ◽  
Julian M. Husbands ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Care Pathway ◽  
Clinical Care ◽  
Clinical Care Pathway

Understanding the impact of a clinical care pathway for major head and neck cancer resection on postdischarge healthcare utilization

Head & Neck ◽  
2015 ◽  
Vol 38 (S1) ◽  
pp. E1216-E1220 ◽  
Author(s):  
Jonathan F. Dautremont ◽  
Lucas R. Rudmik ◽  
Steven C. Nakoneshny ◽  
Shamir P. Chandarana ◽  
T. Wayne Matthews ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Healthcare Utilization ◽  
Neck Cancer ◽  
Care Pathway ◽  
Clinical Care ◽  
Cancer Resection ◽  
Clinical Care Pathway ◽  
The Impact

scholarly journals Adding exercise to a care pathway for patients undergoing surgery for head and neck cancer

2020 ◽  
Author(s):  
Julia Daun ◽  
Rosemary Twomey ◽  
Joseph C. Dort ◽  
Lauren C. Capozzi ◽  
Trafford Crump ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Care Pathway ◽  
Clinical Care ◽  
Healthcare Providers ◽  
Symptom Burden ◽  
Surgical Patients ◽  
Structured Interviews ◽  
Clinical Workflow

Head and neck cancer (HNC) surgical patients experience high symptom burden. Exercise prehabilitation has the potential to improve patient outcomes, but the perspectives of patients and healthcare providers (HCPs) must be considered to facilitate implementation. The purpose of this study was to obtain qualitative feedback from HNC surgical patients and HCPs regarding: (1) adding patient assessments across the HNC surgical timeline, and (2) the logistics and potential benefits of a future exercise prehabilitation intervention. Semi-structured interviews took place with patients and HCPs. Interview questions included satisfaction with study recruitment, measurement completion, impact on clinical workflow (HCPs), and perceptions of a future prehabilitation program. Transcripts were analyzed using a constructivist philosophy and interpretive description methodology. Ten patients and ten HCPs participated in this study. Four themes were identified: (1) the value of exercise and its importance in clinical care, (2) acceptability and necessity of assessments, (3) factors to support implementation, and (4) the components of an ideal prehabilitation program. Overall, these findings highlight the importance and value of exercise across the HNC surgical timeline from both the patient and HCPs’ perspective. These findings will inform the future implementation of a multiphasic exercise prehabilitation trial in HNC surgical patients.

Training Otolaryngologists in Palliative Care Delivery: An Underutilized Opportunity

2017 ◽  
Vol 158 (1) ◽  
pp. 24-26 ◽  
Author(s):  
Yemeng Lu-Myers
Keyword(s):  
Palliative Care ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Psychosocial Support ◽  
Care Delivery ◽  
Care Providers ◽  
Treatment Paradigm ◽  
Positive Effect

Palliative care is an underutilized and often misunderstood discipline in the treatment of patients with head and neck cancer. The key components of palliative care include symptoms management, psychosocial support, and enhanced communications. Abundant evidence has demonstrated the beneficial effect for the early incorporation of palliative care in the treatment paradigm for patients with chronic diseases and malignancies, with findings supporting its positive effect on patients’ quality of life as well their survival. Particularly for otolaryngologists, the unique morbidities of head and neck cancer make our patients especially vulnerable and even more in need of the support and benefits that can come from palliative care. While increased consultation with palliative care providers for patients with head and neck cancer is a good first step, training otolaryngologists to develop their own “primary palliative care competencies” is key for improving our patients’ outcomes.

scholarly journals Financial Toxicity in Head and Neck Cancer Patients Treated With Proton Therapy

2021 ◽  
Vol 8 (1) ◽  
pp. 366-373
Author(s):  
Grace L. Smith ◽  
Ya-Chen Tina Shih ◽  
Steven J. Frank
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Proton Therapy ◽  
Care Delivery ◽  
Treatment Options ◽  
Insurance Coverage ◽  
Financial Toxicity ◽  
Economic Implications

Abstract Cancer-related financial toxicity impacts head and neck cancer patients and survivors. With increasing use of proton therapy as a curative treatment for head and neck cancer, the multifaceted financial and economic implications of proton therapy—dimensions of “financial toxicity”—need to be addressed. Herein, we identify knowledge gaps and potential solutions related to the problem of financial toxicity. To date, while cost-effectiveness analysis has been used to assess the value of proton therapy for head and neck cancer, it may not fully incorporate empiric comparisons of patients' and survivors' lost productivity and disability after treatment. A cost-of-illness framework for evaluation could address this gap, thereby more comprehensively identifying the value of proton therapy and distinctly incorporating a measurable aspect of financial toxicity in evaluation. Overall, financial toxicity burdens remain understudied in head and neck cancer patients from a patient-centered perspective. Systematic, validated, and accurate measurement of financial toxicity in patients receiving proton therapy is needed, especially relative to conventional photon-based strategies. This will enrich the evidence base for optimal selection and rationale for payer coverage of available treatment options for head and neck cancer patients. In the setting of cancer care delivery, a combination of conducting proactive screening for financial toxicity in patients selected for proton therapy, initiating early financial navigation in vulnerable patients, engaging stakeholders, improving oncology provider team cost communication, expanding policies to promote price transparency, and expanding insurance coverage for proton therapy are critical practices to mitigate financial toxicity in head and neck cancer patients.

scholarly journals Patient and Provider Perspectives Regarding Enrollment in Head and Neck Cancer Research

2019 ◽  
Vol 162 (1) ◽  
pp. 73-78 ◽  
Author(s):  
Andrew G. Shuman ◽  
Michele C. Gornick ◽  
Collin Brummel ◽  
Madison Kent ◽  
Kayte Spector-Bagdady ◽  
...  
Keyword(s):  
Cancer Research ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Clinical Care ◽  
Cancer Center ◽  
Precision Oncology ◽  
Provider Perspectives ◽  
Key Stakeholders ◽  
Semistructured Interviews

Objective The advent of precision oncology complicates how clinicians and participants understand how clinical care and research interface. Here we examine how key stakeholders perceive the utility of, and evaluate the decision to participate in, genomic sequencing head and neck cancer research. The goal of this study was to highlight unique considerations for our community as this type of research proliferates across the country. Study Design Prospective multimethod qualitative and quantitative embedded ethics protocol. Setting Single-institution National Cancer Institute–designated academic cancer center. Subjects and Methods Multimethod study using paired surveys and semistructured interviews among patients and providers involved in a prospective precision head and neck oncology sequencing protocol (116 survey patient-participants, response rate 82%) with 18 interviewees. Results Participants were generally enthusiastic about enrollment in research, both to help future patients and as a way of giving back to the community. They described reliance on information from and trust in their cancer doctor regarding the decision to participate in research, but paradoxically there was discordance in how doctors and patients reported their respective influence in the decision-making process. Clinicians also stressed the importance in separating clinical and research-informed consent processes, although patients did not describe this tension. Conclusion As we enter an era of increasing personalized medicine and targeted therapies, the relationship between clinicians, scientists, and patients plays a larger role in how we individualize and contextualize cancer research. Our data are another step toward the ultimate goal of respecting and protecting patients as participants in head and neck translational oncology.

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