Unmet Needs in Head and Neck Cancer
Unmet Needs in Head and Neck Cancer
Head and neck cancer is a devastating
diagnosis. Treatments cause enormous damaging side effects
to everything that make us human beings. Our ability to
engage with others. To converse. To share a meal and drink
together. Not to mention the changes to facial
appearance.
Head And Neck cancer is the sixth most common
cancer worldwide – in NZ about 600 people are diagnosed
each year, but it has never achieved the recognition of,
say, breast cancer or the often closely associated cervical
cancer.
That recognition level is slowly changing,
according to the Head and Neck Cancer Survivors Network ,
helped by the introduction of voluntary HPV vaccinations for
boys and girls. (Human Papillomavirus causes cervical
cancer and currently nearly 80% of throat cancers. )
Less
progress however is being made in the standard of after
treatment care of head and neck patients by district health
boards around the country. That can especially apply to
those who have had their voice box, the larynx, removed by
surgery. This is called a laryngectomy and usually this
follows a course of failed radiotherapy and
chemotherapy.
Surgical removal of the voice box leaves
the patient with an opening onto the neck for breathing . No
longer do they breathe via the nose. Instead of breathing
in warm, moist filtered air, the Lary now breathes in cold
dry unfiltered air. This is a major irritant to the lungs
and causes the person with the Lary to produce a lot of
sputum and cough frequently.
To help improve this and
protect the lungs an HME ( heat moisture exchange ) system
was developed more than 20 years ago. Use of them, the
network says is considered the gold standard of
care.
The HME consists of sticky plate with a hole in the
middle into which an HME filter clips. This covers the hole
in the neck, mimics the function of the nose and helps to
restore some self esteem and a positive body image for the
lary. This means an improved quality of life.
The support
network has found some health boards supply these filters
free of charge, in some cases ACC pays for them , but in
many areas such as Northland and in parts of Auckland (
depending on the DHB ) the patient has to buy their own.
This is “post-code health care” and is
inequitable.
It is an anomaly that the Head and Neck
Cancer Survivors Network says has to be addressed. The
number of people living with a laryngectomy is declining as
treatments improve so Network spokespeople argue that cost
is hardly a major factor for the DHBs.
``But it can be
for the patients, who hardly need the extra financial stress
on top of everything else.’’ says network
representative, Maureen Jansen.
``Supplying HME filters
is a simple, practical and reasonable ask – the DHBs need
to listen and respond – favourably.’’
A day
after this was written, the support network heard that HME
filters will be supplied for new laryngectomees in the ADHB
and WDHB areas. No mention yet of Northland and other parts
of New Zealand.
Tammy von Keisenberg
Website: www.headandneck.org.nz