Parc Taulí creates the multidisciplinary Functional Unit for a better approach to head and neck cancer

• March 13, 2019
• No Comments

The creation of this unit enhances care focused on patients affected by these pathologies, who were already treated in a multidisciplinary manner. Parc Taulí annually treats an average of 105 cases of head and neck cancer, which is the sixth most common malignancy in the world.

The Head and Neck Functional Unit of Parc Taulí is in the process of transformation to enhance patient-centered care in these complex processes that require, more and more, more integrated professionals, as well as the involvement of the patient himself . The Unit is made up of different specialists who support the patient from the different healthcare areas of Parc Taulí. These professionals have been working together for years as an interdisciplinary committee in order to arrive at a quick and accurate diagnosis to start the most appropriate treatment, as soon as possible and supporting the patient during all phases of their treatment.

The Unit currently consists of specialists in otolaryngology, maxillofacial surgery, medical and radiotherapy oncology, pathological anatomy, dentistry, nutrition, speech therapy, anesthesia, geriatrics, palliative care, a secretary and a case manager nurse. Occasionally, they also support social workers and rehabilitative physicians.

Head and neck cancer encompasses a variety of tumors originating in the lip, oral cavity, hypopharynx, oropharynx, nasopharynx, and larynx. It is the sixth most common malignancy worldwide, accounting for approximately 6% of all cancer cases, and is responsible for 1-2% of cancer death cases. During 2018, Parc Taulí treated a total of 103 new cases diagnosed with head and neck neoplasms.

It is the sixth most common malignant tumor in the world

Oral cavity and laryngeal cancer are the most common locations within head and neck cancers. The coordinator of the Unit, Teresa Bonfill, emphasizes that "Head and neck cancer incidence trends have been strongly influenced by patterns of tobacco and alcohol use over time and in different countries.". Another risk factor detected in recent decades is the role of the papilloma virus which is especially relevant with the increasing incidence of oropharyngeal cases. Survival varies depending on the anatomical location - a laryngeal tumor has a better prognosis than a hypopharyngeal tumor -, the stage of the tumor (volume, location and extent of the tumor) - the initial (early) stages have a better prognosis than the advanced ones. or disseminated- and the status of the papilloma virus.

Survival at five years for all stages of the disease is approximately 65%. "The highest cure rates are for localized tumors with locoregional extension, ie in more early (early) stages, and the prognosis is much worse in cases of recurrent or disseminated disease." highlights Bonfill.

Head and neck cancer treatments

Treatments for localized disease generally include surgery or radiotherapy and locally advanced ones, multimodal treatments (combination of surgery, radiotherapy, and chemotherapy) and disseminated tumors, systemic treatments such as chemotherapy or immunotherapy. Treatments for this type of tumor are complex, often with a physical-emotional impact (tracheotomies, mutilating surgeries in an area visible to everyone, placement of feeding devices either temporarily or permanently), and also functional because these tumors affect the areas of swallowing and speech.

The toxicity of treatments in locally advanced tumors is very significant. "For all this are patients who need to be treated in multidisciplinary teams with expertise and extensive collaboration among professionals," says Bonfill. Hence the need to reformulate the old consensus committee for diagnosis and treatment into a Functional Head and Neck Cancer Unit for our patients. A space where the different professionals work in a coordinated way putting the patient as the center of attention.

What does the case manager do?

The case manager nurse monitors and coordinates the correct compliance with the care plans agreed by the multidisciplinary team, promoting patient-centered care, through shared decisions and continuity of care. "It is the backbone of the care processes in which it intervenes from the clinical, organizational and management point of view of the particular case of each patient", highlights the case manager nurse, Antonia Martínez.

This professional figure plays an essential role in the reception of highly complex patients. The manager is the link between the different professionals involved in the care process. Its main responsibility is to monitor the correct performance of the care plans agreed by the team.

The case manager works to ensure the fulfillment of the individualized care plan, accompanies the patient in his care process based on knowledge of the patient's situation and the available resources in his environment, among other functions.

Press release in pdf