Nottinghamshire Head and Neck Cancer Services (HNCS)
The aim of this website is to provide you and your family with relevant information:-
- About the care you can expect to receive from the Nottingham University Hospitals Head & Neck service.
- To better understand many of the complex medical issues that may be discussed with you, thus helping you make more informed decisions about your ongoing care.
- About practical issues of coping and managing the problems of having Head and Neck cancer, and the possible effects of treatment
We hope it will also be a useful resource for family members, carers, and any health professionals who might be involved in your care. Although it is impossible to avoid use of medical terminology we hope the information we provide is in an easily understood format with clear explanations of terms that are used.
We realise that there are already some great resources available on-line but accessing them and dealing with conflicting information can be difficult. Another main aim of our site, is to direct you to other helpful sites that are consistent with the way we think as part of our service.
We hope you find this website useful and we always welcome feedback (good,positive or constructive criticism and the pointing out of inaccuracies, errors, out of date information and links that do not work!), suggestions for improvement or future topics for inclusion. We can only do so much ourselves, and we need you-the users of our service, to give us the benefit of your experience to the benefit of others.
Nottinghamshire Head and Neck Cancer Services - Mission statement
We are a team of health professionals who care for adults with all sorts of head and neck cancers. We provide a service for the population of Nottinghamshire, parts of Leicestershire and Derbyshire. We also provide a complex specialist service for Lincolnshire.
We strive:
- For excellence in the provision of care of patients with Head & Neck cancers along their journey from the time of their referral.
- To work in partnership with patients, their families and carers whilst being as responsive as possible to their diverse individual needs and circumstances.
- To provide timely information and support for patients in aiming for a normal, full and healthy lifestyle as is possible after treatment.
- To educate all staff and professionals in contact with patients, both from other hospital services and in the community about the special and complex requirements in caring for Head & Neck cancers.
- To carry out research on clinical care and to implement new scientific knowledge in maintaining the unit at the leading edge of Head & Neck cancer care provision.
- To continually review on our provision of care through audit and reflect on feedback from patients, carers & relatives to ensure that the highest standards are achieved.
History of the Head & Neck service in Nottingham
The current Nottingham Multidisciplinary Team (MDT) was founded in the early 1980’s following the appointment of Dr P J Bradley (ENT surgeon) and Dr. David Morgan (radiotherapist). They worked closely together with major specialist input from pathology, dental surgery, speech and language therapy, dietetics and senior nurses. Prior to the 1980’s each radiotherapist and surgeon (ENT, Plastic Surgery, General Surgery) involved in the diagnosis of head and neck cancer had a semi-structured clinical arrangement which met fortnightly to monthly to discuss newly diagnosed or patients who’s disease had recurred.
The first recorded management of a patient presenting with airway obstruction was at the Nottingham and Notts. Hospital for Diseases of the Throat, Nose and Ear, at 33 Peachey Terrace (now Mansfield Road) in 1889. The patient underwent a tracheostomy and laryngofissure and was nursed for several days before being discharged from hospital. Dr. Alexander Tweedie is credited with performing the first total laryngectomy, assisted by Mr. E Gilroy Glass in 1925. The patient survived for 7 years before eventiually succumbing from oesophageal cancer. The surgical records from the late 1890’s – 1925 from the Nottingham General Hospital (NGH) Annual Reports, lists many operations for parotid tumours, thyroid tumours, larygeal, nose and mouth tumours. Unfortunately at that time the patients’ outcome was uniformly dismal.
Radiotherapy was practiced at Nottingham General Hospital from 1903. However with the opening of the Ropewalk Wing in 1927, the ENT and Radiology/Radiotherapy Departments were accommodated in close proximity, separated by a floor or two, until the reorganisation and closure of NGH. In 1984 the ENT service transferred to the Queens Medical Centre and in 1992 Radiotherapy went to the City Hospital.
With the development of “modern working” with Multidisciplinary Teams of medical and non-medical staff, the team in Nottingham has expanded into a weekly MDT with video-Linkage to the Lincoln County Hospital. All facets of treatment and care is now available in Nottingham and it remains as one of the leading Head and Neck cancer centres in the United Kingdom.
Patrick Bradley
On the day of your surgery
Being admitted for surgery
Ward C24 is our day surgery unit. Ward C25 is the main inpatient ward.
Before your operation
- On arrival you will be taken to your recliner chair, if you are in as a daycase or your bed, if you are staying in hospital overnight.
- You will meet your nurse who will ask you some questions before you go to theatre.
- You will have your blood pressure, pulse and temperature measured.
- Female patients may be required to provide a urine sample as this allows us to check that you are not pregnant.
- Your surgeon will discuss your operation with you and answer any questions you may have.
- Your anaesthetist will check your general health, discuss the anaesthetic itself, tell you about pain-killers and anti-sickness drugs.
- Your nurse will tell you when to put on your theatre gown. You will also be asked to wear anti-embolism stockings to prevent blood clots occurring (which are a bit like flight socks and can be a little tight around your lower legs).
- You may wear your pants, dressing gown and slippers.
What about hearing aids, glasses and dentures?
You need to bring any hearing aids and glasses and reading glasses to help you can understand the information you will be given. Hearing aids, glasses and dentures can be worn to theatres but need to be removed prior to your anaesthetic. They will be kept safe for you.
What about my medication?
Please bring all your medications with you on the day of your operation.
Going to theatre
You will be collected from the ward and checked into the reception area.
In the anaesthetic room you will have:
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Sticky discs placed on your chest to monitor your heart beat
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A clip placed on your finger to monitor your pulse
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A blood pressure cuff on one arm
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A small plastic tube, called a cannula, usually put into a vein in the back of your hand, to give you drugs and fluids
The operating room
When you are asleep from the anaesthetic, you will be taken through to the operating room.
During your operation, the theatre team will ensure your safety, dignity, privacy and comfort.
At the end of your operation, your anaesthetist will wake you up in theatre before transferring you to the recovery room.
The recovery room
Due to the anaesthesia you may not remember much about waking up in theatre or your stay in the recovery room, however, you will be closely monitored until you are ready to be taken back to the ward.