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Cancers of the Mouth, Voice Box (Larynx), Throat, Thyroid Gland, Saliva Glands, Nose and Sinuses. Also, Facial Skin Cancer.

"Head and Neck cancer”

A wide variety of cancer-like changes occur in the tissue of the head and neck area , both inside the mouth, throat and nose, and also in the glands around these areas, and the skin. These changes are often caused by excessive smoking and drinking alcohol.

The changes can broadly be defined into those conditions which are benign (non cancerous) and malignant cancerous swellings. Some benign type diseases can later turn into cancer. These diseases may manifest with many symptoms including voice change, throat pain, the feeling of a lump in the throat, catarrh, nose discharge or blockage, lumps in the neck, ear pain, white patches, bleeding etc.

If you suspect, or are worried about, cancers in this area, it is better that you are checked by a specialist sooner rather than later, since early head and neck cancer is usually quite simple to cure (it is one of the best cancers to have, if you have to have one). However, large cancers that are left to grow are much more difficult to cure. The surgeons at The London Laser Clinic are linked to the Barts and the London Head and Neck Cancer Centre (BLHNCC), and The London Head and Neck Clinic, 27 Harley Street. The BLHNCC was established to help treat the population of northeast London who have head and neck tumours or cancer, and to provide a referral centre from far afield when specialist treatment is required. The approach taken is multidisciplinary, the weekly cancer group meetings are attended by over 40 people. The workload is busy, 3 of the LLC surgeons (Mr Dilkes (lead clinician), Mr Ghufoor and Mr Alusi) are the 3 main ENT surgeons in this team, which covers a population of over 2,000,000 people. The London Head and Neck Clinic uses these 3 LLC surgeons from BLHNCC. This group has been established in order to give private patients the same quality of care as in the NHS, whilst also allowing a faster, more personal and tailor-made service to its patients.

Currently operating from the Hospital of St John and St Elizabeth, with clinic appointments and special investigations at the prestigious new development at 27, Harley Street, London W1 - The London Head and Neck Clinic comprises a team of doctors and associated healthcare professionals, who are experts in the treatment of head and neck problems, particularly in the screening, diagnosis and treatment of cancer. Head and Neck problems relates to those conditions affecting the neck - eg salivary gland or thyroid lumps, and the upper breathing and swallowing passages, namely the mouth, nose, throat, upper oesophagus, larynx (voice box) etc.

The treatment of diseases in this area is usually very successful, however a multi-disciplinary team approach is required, as well as early access to imaging, endoscopy and the relevant curative treatment options. The team therefore comprises 5 ENT - Head and Neck surgeons (3 from LLC), who are consultants with a special interest in Head and Neck diseases, all of whom are based at major Central London Teaching Hospitals. They each sit at The London Head and Neck Clinic on one separate day per week, so there should be no delay more than 24 hours before seeing someone. These Head and Neck surgeons are support by 3 dedicated radiologists (xray doctors), who have a special interest in Head and Neck imaging, and in particular ultrasound, which is one of the main imaging modalities used. Same day access to Ultrasound, Computerised Tomography (CT) and Magnetic Resonance Imaging (MRI) is part of the core standard of the Clinic. Expert cytology and histology is immediately on hand, so that needle aspirates of lumps etc. can be diagnosed and reported within one hour. Thus a patient with a neck lump or suspected cancer can be seen, imaged and diagnosed all in the same visit (“one stop”).

Other members of the medical team include two clinical oncologists (radiotherapists), a plastic surgeon and an oral/maxillofacial surgeon. All of these Consultants are from major London Teaching Hospitals, and work closely together in the NHS. The non-medical part of the team comprises speech and language therapists, physiotherapists, dieticians and palliative care nurses. Access to a trained cancer nurse specialist for counselling etc is also available.

Multi-disciplinary team meeting: One day of the week, the group will meet to discuss the treatment plan for new patients referred to the Clinic. The decision to treat in a certain manner will be ratified by all members of the group, and this will be formally documented in the patient's notes. Those patients who are having problems or issues post-treatment will also be discussed in this forum.

Treatments offered: Apart from standard surgical and oncological techniques for head and neck disease, the clinicians at The London Head and Neck Clinic are experts in particular fields of treatment. These include: Intensity modulated radiotherapy (IMRT – preserves taste and saliva), Steiner laser surgery, laser excision of small tumours, Photodynamic Therapy, Image guided surgery, intra-operative nerve monitoring for thyroid and salivary gland disease, revision thyroid surgery.

Other modalities: The Clinic also has a rapid access agreement for combined CT-PET imaging, sialography and nuclear medicine.

Standards: Our audit standard is that 95% of new referrals are seen within 24 hours of the date of referral, except at weekends, when an emergency service will be available. Also, 95% of patients will have completed their imaging and diagnostic work up at the first visit. Within 7 days, full staging endocopy for those with suspected cancer will have been performed, and the patient will have been discussed at the MDT meeting and a treatment plan agreed. The start of definitive treatment will be within 14 days of this date, in 95% of cases. This standard of 1, 7 and 14 days compares well with the NHS standard of 14, 31 and 62 days.