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EHNS Make Sense Campaign Newsletter (880.05 kB) 

Last  September  marked  the  successful  launch  of  the  inaugural  Make  Sense Campaign  Head  and  Neck  Cancer  Awareness  Week.  The  week-long programme, spearheaded by the European Head and Neck Society  (EHNS),  was designed  to  raise  awareness  of  head  and  neck  cancer  which,  despite  being  the 6th  most  common  cancer  globally,  remains  widely  unknown  and under-diagnosed.

The week’s  activities were aimed  at healthcare  professionals and policy  makers involved in the  diagnosis,  treatment and  management  of head and neck  cancer across  Europe,  as  well  as  the  media  and  general  public.  The  theme underpinning  the  week’s  activities  was  ‘early  diagnosis’  –  a  key  factor  in improving survival outcomes among patients with head and neck cancer, in line with our mission.

Campaign Successes

Launch of Pan-European  Website
www.makesensecampaign.eu

  • Available in 13 European languages

Launch of Head and Neck Cancer White Paper in European Parliament

  • 10 Members of the European Parliament (MEP) in attendance
  • Call to Action signed by 12 MEPs and passed to the European Commission

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Early Diagnosis Days

  • 100 free early diagnosis days held across Europe
  • Over 250 people referred for screening
  • Multiple confirmed cases of head and neck cancer diagnosed and treated as a result of Early Diagnosis Days

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Media Coverage

  • Over 1,100 media reports of the Make Sense Campaign across Europe

The Make Sense Campaign, run by the EHNS, aims to raise awareness of head and neck cancer and ultimately improve outcomes for patients with the disease. It will do this through:
Education on disease prevention Driving understanding of the signs and symptoms of the disease Encouraging earlier presentation, diagnosis and referral

Our focus for 2014 – Multidisciplinary Care:
Advocating for Care that Makes Sense

While  early  diagnosis  remains  at  the  forefront  of  the  fight  against  head  and neck  cancer,  optimal  and  standardised  care  of  patients  throughout  Europe  is paramount. Clinical recommendations for diagnosis, treatment and follow-up of patients with head and neck cancer were published by the European Society for Medical  Oncology  (ESMO)  in  2009,  in  which  the  need  for  multidisciplinary  care was highlighted. Five years on, limited multidisciplinary care provision is in place across  Europe,  with  only  four  EU  member  states  (France,  Belgium,  The Netherlands  and  UK)  adopting  this  approach.  To  overcome  this,  the  2014  Make Sense  Campaign  will  centre  around  the  need  for,  and  benefits  of multidisciplinary  care,  with  the  availability  of  new  educational  materials,  and through  ongoing  European  Parliamentary  and  healthcare  congress  activities throughout the year.

An In-depth Look at Multidisciplinary Care

The  effective  management  of  a  patient  with  head  and  neck  cancer  requires  the expertise  of  a  number  of  healthcare  professionals,  including  surgeons,  medical oncologists,  radiation  oncologists,  pathologist,  oncology  nurses,  pain  specialists, speech  therapists  and  dentist..  This  multidisciplinary  approach  leads  to  a  care plan  that  combines  the  skills,  experience  and  up-to-date  knowledge  of  each discipline  involved  in  the  patient’s  care,  through  diagnosis,  treatment  and  posttreatment  care.  While  there  is  little  published  research  that  conclusively  argues the  case  for  multidisciplinary care  improving  clinical  outcomes  in  head  and  neck cancer patients, the benefits of such an approach are widely accepted within the oncology community.

A 2011 study published in the British Journal of Cancer analysed the outcomes of over  700  head  and  neck  cancer  patients  who  had  been  managed  either  in  a multidisciplinary  clinic  or  team  setting  (MDT),  or  by  individual  disciplines (non-MDT)  within  the  same  institution.  Results  demonstrated  that  there  was  a significant  (p=0.004)  improvement  in  5-year  survival  rate  among  stage  IV patients  who  had  been  treated  within  a  MDT,  compared  with  those  in  a non-MDT  setting.  While  definitive  conclusions  cannot  be  drawn  from  one  study, it  is  nevertheless  an  interesting  finding,  given  that,  currently,  60%  of  patients with  head  and  neck  cancer  present  with  locally  advanced  disease  at  the  time  of diagnosis.

Scepticism and Driving Positive Change

Despite  the  implementation  of  multidisciplinary  care  for  head  and  neck  cancer patients  in  a  number  of  European  counties,  the  lack  of  robust  evidence  for improved  patient  outcomes  and  the  associated  cost  implications  have  led  to scepticism  as  to  whether  moving  to  an  MDT  model  is  cost  effective.  While  the many  patient  benefits  are  recognised,  cost  will  always  be  a consideration  within government  decision  making  when  implementing  guidelines  and  policies.  In collaboration  with  the  European  Parliament  and  the  European  Cancer  Patient Coalition  (ECPC), the EHNS  is  continuing to work with the European Commission (EC),  to  drive  change  for  head  and  neck  cancer  patients  in  Europe.  Part  of  the call  to  action  aims  to  harness  support  from  the  EC  to  support  a  multidisciplinary treatment approach for head and neck cancer, thus leading to wider adoption of multidisciplinary  care  for  patients  across  Europe,  and  ultimately  improving patient outcomes.

Benefits of a Multidisciplinary Team

  • Reduced time to diagnosis and treatment
  • Accurate disease staging
  • Increased opportunity for patients to be recruited into clinical trials
  • Being treated in line with agreed national/local policies or guidelines
  • Consideration of patients’physical and emotional needs
  • Increased access to knowledge about supportgroups
  • Being offered a choice of the most up-to-date and appropriate treatmentsdecided by a group of HCPs,rather than an individual
  • Optimal coordination and continuity of care through all stages of the cancertreatment, includingpost-treatment care
  • Improved patient satisfaction
  • Personalised treatment

Centres of Excellence

The  EHNS  is  working  on  an  initiative  to  change  how  and  where  head  and  neck  cancer  patients  receive  treatment,  by ensuring  that  every  patient  is  treated  by  an  MDT  in  a  ‘Centre  of  Excellence’.  Furthermore,  treatment  criteria  are  being devised,  including  details  of  the  optimum  number  of  patients  that  should  be  treated  at  any  one  time,  the  types  of technologies  and  treatments  that  should  be  available,  and  which  healthcare  professionals  should  form  part  of  the  MDT.
The  criteria  will  also  include  details  of  how  to  report  patient  outcomes.  The  implementation  of  these  ‘Centres  of Excellence’  and  dedicated  treatment  guidelines  will  have  a  huge  impact  on  the  way  head  and  neck  cancer  patients  are treated  in  Europe,  and  improve  the  way  medical  knowledge  and  best  practice  is  transferred.  Most  importantly,  the initiative  aims  to  optimise  the  way  patients  are  diagnosed  and  treated,  leading  to  greatly  improved  patient  outcomes and better quality of life.

Multidisciplinary Care in Practice
Q&A with Dr Marcin Sówka  MD, Poland

- How long have you been operating within a multidisciplinary care model?
The MDT was established 4 years ago.

- How soon after the model was implemented did you start to see a benefit for patients?
The first benefits were observed after 6 months.

- What challenges did you have to overcome to successfully implement the MDT?
The main challenge was to convince a number of specialists, from different departments, about the need for the establishment of the MDT; and also to prove the aim and benefits of this form of care.

- Who was involved in the organisation and agreement of the care pathway / model?
The most involved were the head and neck surgeons, radiation oncologists and radiologists.

- How have your head and neck cancer patients benefited from being treated and managed by an MDT?
The main benefit for the patients was the reduction in the time between diagnosis and starting treatment.

- Do you think that the patient experience (rather than outcome) is improved under the care of an MDT?
Comparing patients treated by the MDT, and patients treated before the creation of the MDT, we observed an increase in  their treatment satisfaction and improved quality of life.

- Do you think multidisciplinary care of head and neck cancer patients is cost effective for healthcare authorities?
Yes, the organisation of MDT is cost effective. All the decisions about any additional testing ,imaging studies and consultations are made together, which allows for elimination of unnecessary costs.

- Do you think there are any disadvantages?
We do not observe any disadvantages.

- What advice would you give to help other organisations who are moving to a multidisciplinary care offering?
It is important to make the MDT meetings  open, or even mandatory, for trainees, residents etc. Also the MDT coordinator should be well chosen. The organisers should also be patient when facing any sceptics that could present a position against the MDT (other specialists, authorities etc.)

- Please summarise the advantages of treating head and neck cancer patients under an MDT?
The main advantages are: precise disease staging; involving a multi-specialist team in decision-making rather than one person; improved coordination and continuity of patients care; and individualisation of care.

 

Conclusion

While  there  is  still  more  to  be  done  to  ensure  that  all  head  and  neck  cancer  patients  receive  optimal  care  from  a multidisciplinary  team,  progress  has  been  made,  with  a  number  of  European  countries  now  offering  multidisciplinary care.  Although scepticism remains regarding the cost-effectiveness of such a care model, we must ensure that patient outcome is at the forefront of our thinking, so that we can effectively identify, treat and manage head and neck cancer
patients. Multidisciplinary  care must remain at the heart of the change.