That’s why patients have to be made aware of the potential risks, she said. Sometimes there is a choice between surgery versus chemoradiation. It is wonderful that chemoradiation offers organ preservation, but we have to make them aware that this may come at a price: that you may have the organ preserved, but it may not be functional.
Explore This IssueJanuary 2007
Ms. Zahora, who has specialized in QOL issues for head and neck cancer patients at Cancer Care, said that patients often express feelings of isolation once they have completed treatment. The physician was very involved in their care during the active treatment phase and may no longer be as accessible as before. However, patients often have need for psychosocial services to help them deal with depression, and for monetary support services to deal with long-term side effects from radiation, such as tooth deterioration.
Benefits of Dedicated Centers
It is sometimes tempting for patients to opt for the convenience of undergoing chemoradiation in the community, but patients can often benefit by traveling to larger cancer centers for treatment. The most important thing about coming to a bigger center like this is that our radiation people only do head and neck radiation, said Dr. Yao. The nasopharynx is close to the brain, eyes, and many important structures, so planning and execution of radiation are very critical.
Another benefit is that patients have access to the multidisciplinary team, including speech-language pathologists and oncology social workers. In tertiary centers, it’s easier to have collaborations because everyone is present and they’re already part of a tumor board, noted Dr. Mirza.
At the Milton J. Dance Head and Neck Rehabilitation Center, housed at the Greater Baltimore Medical Center, oncology social worker Dorothy Gold, LCSW-C, OSW-C, is part of the multidisciplinary team who care only for head and neck cancer patients. In an endowed program, the team follows patients from time of diagnosis throughout treatment and beyond. Ms. Gold and her colleagues have designed an early interventional approach so that patients and their families get help throughout the diagnosis, treatment, and survivorship continuum. Originally established as a preoperative education and counseling program, the services have now expanded to include patients undergoing chemoradiation. Meeting patients prior to treatment, says Ms. Gold, allows social workers to assess other stressors in the patients’ lives, as well as their existing support systems. In that way, they do not have to wait for a crisis to try to help with coping strategies. Anxiety levels of patients and family members have been reduced by employing this method.