Invitational Round Table
“Evidence-based Voice and Speech Rehabilitation in Head and Neck Cancer”

Amsterdam, The Netherlands
May 15-16, 2008

Early Rehabilitation of Head and Neck Cancer Patients at Karolinska University Hospital

Therese Engström (1), Alexander Ahlberg (2), Polymnia Nikolaidis (3), Karin Lundgren Gunnarsson (4), Lena Sharp (4), Göran Laurell (5)

(1) Dept. of Speech Pathology; (2) Dept. of ENT; (3) Dept. of Physiotherapy, (4) Dept. of Oncology; Karolinska University Hospital, Stockholm, Sweden
(5) Dept. of Clinical Sciences, Umeå University, Umeå, Sweden

Objectives: To describe a clinical pathway for early rehabilitation of head and neck cancer patients.

Method: A clinical pathway has been developed at Karolinska University Hospital to improve rehabilitation for patients with head and neck cancer receiving radiotherapy (RT) or a combination of RT and surgery. For many years the clinical pathway for these patients has included consultations with dentists, dental hygienists, dieticians, social workers, nurses and physicians before, during and after RT. Since three years, the patients are also seen by a speech language pathologist and physiotherapist for assessment and information before and after RT. The aim is to start the rehabilitation process early, before the initiation of RT and with that to reduce the risk of complications such as dysphagia, trismus and voice and speech impairment. Emphasis is put on giving patients information about treatment side-effects, improving patient involvement and self-care. The patients receive a physical training program with exercises aiming to maintain tongue and laryngeal motility, jaw opening, swallowing and shoulder function. These exercises should be performed on a daily basis during and after the RTperiod. Altogether 257 patients have been included in the intervention group. In an on-going study data is collected from medical hospital files, individual assessments and patient questionnaires (EORTC QLQ-C 30, EORTC QLQ-H&N 35, HADS and a study specific questionnaire) at baseline and at six-month follow-up. Data from the intervention group will be compared with data from a control group.

Keywords: rehabilitation

Full Paper

Bibliographic reference.  Engström, Therese / Ahlberg, Alexander / Nikolaidis, Polymnia / Gunnarsson, Karin Lundgren / Sharp, Lena / Laurell, Göran (2008): "Early rehabilitation of head and neck cancer patients at Karolinska university hospital", In EVSR-2008, 123-125.