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Head and neck cancer, including cancers of the oral cavity and larynx, is the eighth most common cancer in the UK. These cancers are chiefly caused through cigarette smoking and drinking alcohol to excess, with the highest incidence and mortality rates in areas of high deprivation.
How effectively a surgeon or oncologist can treat these types of cancer depends on the stage of disease when the patient is first seen in a specialist setting. Cancers in the mouth and throat could be identified during dental examinations, but despite efforts to detect symptoms early, the survival rate from the disease has failed to improve over several decades.
Patients are often reluctant to seek medical or dental intervention — for a variety of reasons — and research suggests that they frequently present late with advanced stages of the disease, with many having not seen their dentist in the two years before diagnosis. Uncertainty over costs and dental anxiety are often cited as the main reasons for this. And, since these cancers are associated with social deprivation, their incidence has worsened in parts of the UK where inequalities have grown.
However, community pharmacists are already providing an increasing range of healthcare services, routinely offering advice to patients seeking over-the-counter treatments for common symptoms, including those that may be related to head and neck cancers.
We should embrace any innovations that could allow us to treat this disease more effectively. And we are exploring this area: we have recently received funding from the National Institute for Health Research Applied Research Collaboration for the North East and North Cumbria to explore whether community pharmacies could offer a pathway for people with symptoms of head and neck cancer to seek further medical help and advice. We plan to take qualitative interviews with community pharmacists and a wide range of patients at different stages of the treatment pathways.
This exciting multidisciplinary research collaboration shows how determined researchers in the North East are to improve outcomes for our population. We hope that this study will provide the foundations to develop and integrate pharmacists into existing referral pathways, with the aim of identifying more head and neck cancer early and, ultimately, improving survival rates.
James O’Hara, head and neck surgeon, Newcastle-upon-Tyne Hospitals and Newcastle University