Clinical Service Line 11 - Cancer & End of Life, Clinical Oncology, Chemo

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    National Lung Cancer
    (2023-10-19) Chapman, Timothy; Bedford Site
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    Post Treatment Oncology Clinic
    Hunt, Jenny; Cullip, Sarah; Luton and Dunstable Site
    Background A marked increase in patients presenting with late treatment effects – muscle atrophy and advanced radiation induced fibrosis of swallowing musculature. Patients often leaving it very late to seek help indicating they are unclear when or how to self refer, presenting many years after treatment via A&E or through GP. Can lead to alternative feeding/functional laryngectomy. Evidence* suggests prophylactic exercise programme targeted at swallow musculature may be beneficial for prevention of late effects. Swallowing is a ‘sub maximal’ activity, it is hypothesised that improving strength and ROM optimises physiological reserve. There is however a lack of high quality definitive trials. Exercises should be commenced prior to treatment starting, performed throughout treatment and then continued life long. Anecdotal evidence of patients discontinuing exercises once RT finished or later in post treatment period and lack of awareness of rationale for continuing. Minimal contact with patients returning from RT with no significant reported dysphagia but reduced oral intake due to taste/dryness – often just a brief discussion in clinic. Not arming the patient for future changes or really unpicking current swallow status.
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    Rapid-Access Head & Neck Lump Clinic referrals presentation
    Tornari, Chrysostomos; Dar, T; Luton and Dunstable Site
    Nationwide faster diagnosis for cancer standard From referral date to diagnosis or reassurance – 28day target