Research Projects Funded and Supported by HaNC

HaNC funded this pilot study to target sequence DNA of Head & Neck Cancer tumour samples to support an application for a larger study. The work, carried out by The University of Liverpool (Cancer Research Centre) aimed to determine whether gene mutations affect the outcome of Head & Neck Cancer treatment. Some patients respond better to treatment and the research aimed to ascertain reasons for this and to identify potential targets in individual patients in order to personalise treatments to optimise outcome and minimise side-effects.

Osteoradionecrosis is a devastating long term consequence of radiotherapy treatment for Head & Neck Cancer. The formation of a non-healing ulcer can lead to severe functional and cosmetic outcomes including pain, poor function, and possible jawbone replacement.

HaNC funded a study by University of Liverpool, (Cancer Research Centre) to attempt to identify common genetic variants and validate previous knowledge of causal genetic characteristics that increase susceptibility to Osteoradionecrosis. The aim being to design bespoke radiotherapy for individual patients to optimise the effective dose with minimal side-effects.

Delayed presentation of Head & Neck Cancer patients can have a significant impact on future treatment, severity of side-effects and ultimate outcome/quality of life. This study undertaken by the Department of Psychological Sciences at University of Liverpool and funded by HaNC, focussed on reasons for delayed presentation and investigated the factors influencing presentation time in Head & Neck Cancer patients.

The funding which included the recruitment of a PhD student resulted in a number of published papers. It is planned that the study will lead to the development of a public health campaign to address the problem of late presentation with consequent improvements in outcomes and quality of life for patients.

This post graduate research, also carried out by University of Liverpool (Department of Health Services Research), looked into the question of communication between clinician and patients from lower socio-economic backgrounds. This patient group can sometimes find it difficult to express concerns and seek help from professionals with resulting adverse impact on outcomes. The work examined the use of the Patient Concerns Inventory to test whether its use in clinic could help to mitigate this problem.

The Patient Concerns Inventory is a tool designed to improve communication during outpatient appointments. It is a touch screen based list which allows the patient to select concerns they wish to discuss at the consultation – More details of the PCI can be found on the HaNC web-page.

Temporary Tracheostomies are routinely used following surgery for Head & Neck Cancer as a preventative measure to ensure that patient’s breathing is not compromised. HaNC members identified that many patients reported a negative experience of Temporary Tracheostomies and so HaNC supported this study to investigate patients’ experiences. The study by Edge Hill University, sought to identify patients’ concerns and to better understand patients’ perception and improve quality of care.

The study found that what is sometimes regarded as a routine procedure is not perceived as such by patients. Patients reported difficulties with communication and also fear of choking. A majority said they would avoid the procedure if possible. Patients felt that there was a lack of information prior to the procedure and felt that specialist assistance would help. The study supported a more tailored approach involving a risk stratification for use of TTs.

This study by Edge Hill University focussed on the cohort of Head & Neck Cancer patients with advance disease, undergoing radical treatment. The aims of this study were twofold. First, to explore patient and carer experiences of treatment, outcomes and decision making for patients receiving radical treatment with curative intent. Second, to identify factors to assist future decision making in cases where there is a choice between radical treatment with curative intent and palliation.

From this research HaNC produced a number of action points including improving quality of information given to patients, improving follow up care and disparities between inpatient and outpatient care. The action points were submitted to the Clinical Director of Head & Neck Service at Aintree NHS Trust. This HaNC funded research was instrumental in influencing the creation of a specialist clinical role at Aintree, to improve the patient experience in palliative cases. The role will provide specialist care in the patient’s own locality and during critical moments. The role will also include an educational element.

HaNC provided funding to allow completion of this study of patients with advanced Head & Neck Cancer where curative treatment is not possible. The research was undertaken by the Marie Curie Palliative Care Institute (University of Liverpool). The work explored challenges facing patients, carers and clinicians dealing with Advanced Head & Neck Cancer. The researchers also investigated how existing services were used and how these might be improved.

The HaNC Research Forum commissioned a study to investigate the financial impact on individuals. There was a lack of research data in this subject and members felt this was an important issue for patients. The study found that many Head & Neck cancer patients reported real financial hardship with half of those interviewed reporting that illness had caused a large or unbearable financial burden. The study led to the recruitment of a benefits adviser in the Head & Neck Centre at Aintree.

HaNC supported and funded a workshop event hosted by Liverpool Cancer Inequalities Network. This organisation was established to foster, support and undertake research into socioeconomic inequalities in cancer outcomes. The event was attended by charities, academics, patients and carers to discuss inequalities in Head & Neck Cancer and to develop a research programme to understand and address these. Topics included earlier diagnosis, patient support and palliative support. The research into palliative care, funded by HaNC was presented and discussed.

HaNC organised, funded and managed a Study Day, with the aim of bringing together with patients, surgeons, nurse specialists, dietitians and speech and language therapists, in order to discuss the latest developments in head & neck cancer research and establish the support that is available to patients.