Head and neck cancer service

Our rapid access head and neck service addresses the urgency of diagnosis and timely referral to a full admissions pathway. We provide a comprehensive and integrated care pathway that delivers a seamless experience and the best possible outcome for every patient.

• Rapid access head and neck service
• Advanced diagnostics
• Radiotherapy – VMAT, SGRT, SABR
• Systemic anti-cancer therapy
• Surgical referral
• Speech and language therapy
• Dietitians
• Exercise medicine
• Penny Brohn UK wellbeing programme

• Appointments from 24 hours to our rapid access head and neck service for assessment and diagnosis in Oxford
• Fast access to a fully integrated treatment pathway within 2 weeks
• VMAT radiotherapy plan to treatment – 7 to 10 days
• Palliative VMAT radiotherapy plan to treatment – 1 to 2 days

We help with insurance approvals and funding queries to ensure patients have fast access and continuity of care.

We operate 14 specialist outpatient oncology centres and provide a multidisciplinary and multi-modality service, collaborating with health professionals who share our vision to provide fast access to world-class cancer care. Our strategy is to invest early in new evidence-based modalities that hold the potential for improved life outcomes.

Head and neck cancers are the sixth most common group of cancers in the UK. They are typically complex and challenging to treat, with patients frequently presenting at an advanced stage, requiring sensitivity and compassion yet a swift and comprehensive response.

Our multidisciplinary and multi-modality service encompasses diagnostic clinics with access to all imaging modalities and treatment that includes volumetric modulated arc therapy (VMAT) and systemic anti-cancer therapy (SACT). Palliative patients are offered a fast-track VMAT or onward referral to our specialist stereotactic ablative radiotherapy (SABR) pathway.

Radiotherapy is also a management option for patients with benign head and neck tumours. This end-to-end service is delivered across 13 of our outpatient oncology centres and through our partner hospitals, in collaboration with more than 40 oncologists, ear, nose and throat (ENT) surgeons and healthcare specialists. Quality is assured through a robust governance process and implemented via a multidisciplinary team framework, guided by experienced head and neck oncologists and ENT surgeons.

By placing the patient at the heart of our service and anticipating their needs in advance, we can remove much of the stress and improve outcomes.

- GenesisCare    

The head and neck multidisciplinary team (MDT) at GenesisCare is central to our ability to make swift treatment actions and ensure each patient receives the right care at the right time. It is based around a core team at each centre and comprises:

• A consultant clinical oncologist
• A consultant head and neck surgeon
• Radiographer
• Clinical nurse specialist – with additional training in head and neck cancers
• Dietitian – with specific expertise in the assessment and treatment of cancer-related nutritional and dietary concerns
• Specialist speech and language therapist

As part of each patient’s assessment, the MDT will discuss the case and plan radiotherapy treatment based on the site and type of tumour. The aim is to prepare the patient for treatment and support them through the challenges of their head and neck cancer, with attention to minimising side effects and optimising treatment effectiveness.

We review patients radiotherapy side effects weekly, for up to 3 months. After curative radiotherapy, patients will be discharged to their surgeon for longer-term follow-ups up to 5 years.

We operate a rapid access head and neck service with easy GP referral. We aim to support our referring clinicians by providing reassurance, early detection of a more serious condition and easy access to an optimum treatment pathway. This consultant-led service provides diagnostic appointments within 24 hours of a referral with same day scope and biopsy if needed. Additional appointments for patients who need further investigations are scheduled within just a few days and include:

• 3T MRI
• Biopsy
• Blood tests
• CT
• PET/CT
• Ultrasound
• Ultrasound-guided biopsy (core biopsy or fine-needle aspiration)

Treatment is reviewed at an MDT and can start within 10 days of a confirmed diagnosis.

Radiotherapy is rapidly evolving. New modalities offer reduced acute and long-term impacts along with significantly improved life outcomes for curative and palliative patients. GenesisCare is at the forefront of the introduction of innovative and advanced techniques. Our centres are equipped with the latest-generation linear accelerators and new modalities as standard.

Volumetric modulated arc therapy (VMAT) is the gold standard of care for head and neck cancers, and we offer it across all our centres. VMAT delivers a highly conformal radiotherapy dose by changing intensity as it moves around the tumour site. This reduces treatment time as well as the overall toxicity of treatment.

We also use VMAT for palliative treatment because it preserves the opportunity for subsequent radiotherapy if needed. We have extensive expertise in VMAT treatment planning and use machine learning systems and physics QA automation (Mobius) to create highly accurate conformal plans for dosimetry – within hours if necessary.

We use the latest surface-guided radiotherapy (SGRT) techniques in combination with VMAT to enable 3D and 4D set-up and superior motion management during radiotherapy delivery.

Examples are:

• Gating and beam hold facilitating
• Intrafraction variation minimisation by capturing surface data in real time during each treatment session
• Surface data captured at each attendance to manage interfraction variation between treatment sessions and dosimetric changes

Our systems use three camera units to monitor thousands of points on the skin surface. This technology does not rely on radiation exposure, unlike other commonly used forms of image guidance such as CT. This powerful quality assurance technique ensures sub-millimetre accuracy which enables:

• Optimum patient safety
• Reduced treatment toxicity
• The possibility of open-face treatment shells (where applicable)
• Tattoo-free treatments
• Dedicated medical oncology

We offer stereotactic ablative radiotherapy (SABR). Also known as stereotactic body radiation therapy (SBRT), SABR is one of the most important advanced radiotherapy techniques currently available for the treatment of oligometastatic disease. It is becoming the gold standard therapy for many metastatic cancers, including head and neck cancers, often replacing surgery. SABR focuses beams of high-dose radiation at tumour sites with submillimetre accuracy – with the aim of achieving local control in just a few short treatments. There is a large body of evidence that SABR treatment given at the right time, to the right patient, can make a difference to their outcome.

Our medical oncology centres offer a complete systemic anti-cancer therapy (SACT) service that includes:

• Accreditation with the Macmillan Quality Environment Mark
• Comfortable and private chemotherapy suites
• Highly experienced chemotherapy specialist nurses
• An emergency on-call triage service
• Our patients have access to a full range of systemic anti-cancer therapies, including some of the most novel cancer drugs. We work closely with insurance companies to ensure patients are treated without delay.

Integrative cancer care (ICC) is embedded into our head and neck pathway, and each patient is offered an evidence-based programme of exercise medicine and psychological and complementary support therapies with Penny Brohn UK.

Our exercise medicine specialists work with consultants to create safe and effective exercise programmes that are specific to patient diagnosis and treatment plans.

We also provide wellbeing therapists and treatments in a unique partnership with the charity Penny Brohn UK. Our patients highly value this service, with more than 95% of them choosing to access our ICC services. We record and publish PROMs data to evaluate and adapt our service to deliver a positive and lasting life experience, helping each person live as active and healthy a life as possible.

We invite consultants to contact us to refer to one of our VMAT specialists or find out how we can help you and your patients.

At our specialist outpatient centres we provide the latest technology and treatments that are proven to make a difference.