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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

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