Facing a head and neck cancer diagnosis
If you’re reading this, you or someone close to you has recently been diagnosed with Head, Neck or Oral cancer. This news can feel overwhelming, and you’ve likely received a lot of information. Try not to despair – there is a dedicated team working to support you through this. You’re about to begin a journey, and our goal is to help you get through treatment and back to your life.
This series of short videos will walk you through each step of the treatment pathway. The staff in the department you attend may not be the same ones on these videos but the titles will be the same – remember it’s understanding the journey that’s important.
The Clinic Reception
This is the first exposure you will have to the hospital. You will have been referred in by your Doctor or dentist and you present yourself to the reception desk where our staff will welcome you and ask you to sit in the waiting room.
Meeting the Consultant
During your first visit, you will meet the Consultant who either take the history and examine you him/ herself or your case will be presented by a junior member of staff.
Radiology
The most important examinations are the CT scan; MRI scan and Ultrasound. These four videos outline what is involved in having the scans and then gives an idea into what we are looking for:
Radiology Ultrasound
This is sometimes called the “jelly scan” and it is exactly the same one which is used when reviewing the development of babies prior to birth. A probe with the jelly is applied painlessly to the neck in order to review the tissues. This video will outline the technique and what we are looking for.
Radiology CT
A major part of the investigations are scans - CT ; MRI or you may have both. This video explains the rationale behind it all
Radiology MRI
This scan also involves lying down on a bed and being placed into a scanner so that the precise x ray images can be taken. The MRI takes longer; is noisy and a bit claustrophobic. Following this investigation, you will have a follow up clinic appointment where you will be seen again by the consultant and the Clinical nurse specialist who will discuss the findings with you
Radiology CT
This scan involves lying down on a bed and being placed into a scanner so that the precise x ray images can be taken. The CT scan is usually very quick. The video I hope will outline what you will go through. Following this investigation, you will have a follow up clinic appointment where you will be seen again by the consultant and the Clinical nurse specialist who will discuss the findings with you
Clinical Nurse Specialist
This is the link to all your treatment pathway. Any problems, then please get in touch as our CNS will sort it out or find someone who will. Remember it is no shame to ask for help.
Outpatient Pharmacy
Once you have had your consultation, you may be prescribed antibiotics, pain killers or mouth washes. You will be given a prescription and take it to the outpatient pharmacy.
Head and Neck Clinic – Reception
You will have been given an appointment to attend the Head and Neck clinic. This is located in the main outpatients department in UHW, clinic 9
Head and Neck Clinic - Senior Nurse
The diagnosis has been made but you’re still in the dark re what’s to be done! You will be informed that you will have to attend the Multidisciplinary clinic. At this clinic, the teams involved in your care will be represented and come and meet you.
Multidisciplinary Meeting
This video happens to be our team from the Royal Glamorgan outlining what happens at the MDT [Multidisciplinary team ]meeting, but it can apply to any MDT. This is where your case will be fully discussed and a treatment plan will be formulated, This may take some time so don’t worry if you feel you are just sitting around.
Head and Neck Clinic - Consultant
A Consultant will return to see the patient and family member with a member of the allied health professional team and the clinical nurse specialist to go through the plan and answer any questions. Please take as long as you want to ask anything that is of concern. It often helps to come to the clinic with any questions written down so that you don’t forget anything.
Ward Sister
Either as part of your investigations where the team may want to have a look at you whilst you’re asleep – termed panendoscopy or to put in a feeding tube – PEG which stands for percutaneous gastrostomy tube or as part of your admission for treatment, you will be admitted to a dedicated Head and Neck ward and the specially trained nurses are led by the ward sister.
Ward Housekeeper
These individuals are invaluable to the running of the ward. They make sure that the ward is kept clean and tidy as you would expect in your home. They have a difficult job but always try to be sensitive to the patients needs.
Dietician
Dietetic input is essential. Our team will review you when you first visit the Head and Neck clinic so that we get a baseline guide. Your height and weight will be recorded, and your minimal nutritional requirements noted. The dietetic team will accompany you on your journey from outpatients to the ward and follow up.
Speech and Language Therapist
In the same way that Head, Neck and Oral cancer can affect your weight, it can also affect your speech and swallowing. Therefore, at the first visit to the multidisciplinary clinic , you will be assessed by a dedicated speech and language therapist and like the dietician will follow you all the way on your journey
Nutrition Nurse
Sometimes, you will require specialist dietetic help to aid in feeding. Some patients who unfortunately cannot swallow may need to be fed by other means eg by having a tube through your tummy. This is called a percutaneous gastrostomy tube – PEG and is very welcomed by patients as it's hidden under the clothes . This nutrition team will assess you and then organise what's required
Ward Pharmacy
During your stay, you will have your own dedicated medicines, you may often bring in your own and to ensure that everything is there to meet your needs, there is a dedicated team looking after you.
Surgery - Anaethetist
If the planned treatment involves surgery, then on the night before your surgery, the anaesthetist will come to see you, examine you and explain what will happen when you go to the anaesthetic room especially concerning the events when you are being "put to sleep"
Surgery - Theatre Staff
When you are taken down to the theatre, you will be taken to theatre suite, where you will be met by a member of the theatre team and this is where you will go through a preoperative check list.
Intensive Care
It maybe decided that following your operation you will spend the initial postoperative period in the intensive care unit . You will be asleep here for one to one nursing care.
Wound Nurse
Once you have been discharged from hospital, you will return to the clinic to have your wounds dressed. This is done by the wound nurse.
Restorative Dentistry
An important part of the journey is to ensure that your mouth and teeth are in the best condition possible. We have a specialist team who are there at the initial MDT to assess your needs and then work with you during this period. The video explains their role and what the journey will entail.
Velindre
This is where you will come if your primary treatment is radiotherapy or it is decided after the operation when the pathology is reviewed that you will require additional treatment. There are many Consultants specialising in managing Head, Neck and Oral Cancer. This will give you some idea of what to expect.
Radiotherapy Preparation
It is important to realise that when you are undergoing radiotherapy, as the delivery is very precise, it is vital that there is no movement of the head. This is achieved by constructing your own personal mask which is very light and allows you to breathe easily. So every time you go for your treatment, your very own personal mask is used. This video explains the process of its construction.
Radiotherapy Planning
Once the mask has been made, the planning has to be done with enormous accuracy then its time to commence on the treatment. This is effectively another CT scan which the Oncologist will use to accurately map out where you are to have your radiation.
Radiotherapy Treatment
Once all the preparation is over, the mask made, planning done, then its down to coming for the treatment. This is obviously very strange and scary but please be reassured that all the staff are there for you.
Velindre Allied Health Professionals
Whilst you are in Velindre you will be in contact with dieticians, speech and language therapists and clinical nurse specialists who will look after all your requirements- please speak to them about your concerns.
Head and Neck Clinic
Once your treatment is completed, you will be on longterm follow up by the surgical team, even if your primary treatment was radiotherapy. Usually this is an appointment every month for the first year.
Patients Experience
Hearing the words “you have cancer” can change your world in an instant. It’s completely normal to feel uncertain or overwhelmed, but please remember - you are not alone. Our team is here to support you every step of the way, and there are others who truly understand what you’re going through because they’ve been there too. We’re restarting our patient support group - a friendly, informal space where you can meet others with shared experiences, enjoy a cup of tea, and have a chat. It’s a chance to connect, share, and remind yourself that you are part of a community that cares. If you’d like to join or find out more, please let us know. We’d love to welcome you.
Diet
The following video’s provide detailed information on the management of eating and drinking during treatment. Not all methods discussed within these videos may apply to you. Please discuss with your dietician which methods are relevant to your personal treatment modality.
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