Cutting cancer waiting times: streamlining cervical lymph node biopsy

Interventions to reduce times to diagnosis and treatment of head and neck cancer: A systematic review and narrative synthesis

BACKGROUND

We systematically reviewed evidence of health system interventions to reduce diagnostic and treatment intervals for people with head and neck cancer (HNC).

METHODS

Electronic databases were searched from inception to 30 April 2020 for controlled or uncontrolled comparative studies. Primary outcome was any time interval between first clinical presentation and treatment onset.

RESULTS

Thirty-seven studies were included. Four types of interventions were identified: single clinic-based (N = 4), multidisciplinary clinic-based (N = 15), hospital or service re-design (N = 12), and health system re-design (N = 6). There was some evidence that multidisciplinary interventions improve timeliness of diagnosis and treatment; however, evidence of long-term effectiveness was lacking. Study quality was assessed as either low or moderate.

CONCLUSIONS

Interventions to reduce times to diagnosis and treatment of HNC are heterogeneous, with limited evidence of effectiveness. Future interventions should account for the complex and dynamic nature of health systems and adhere to best-practice principles for early-diagnosis research.

Patients' experience of receiving radiation treatment for head and neck cancer: Before, during and after treatment

Most research to date in the area of head and neck cancer has focused on the efficacy of treatment modalities and the assessment and management of treatment side effects and toxicities. Little or no attention has been directed toward understanding patients' experience of receiving radiation treatment for the management of their cancer. The purpose of this qualitative study was to explore the experience of individuals receiving radiation treatment for a cancer of the head and neck. Face-to-face interviews were conducted with 17 individuals. Thorne's (1997) approach of interpretive description along with Giorgi's analytical technique for analysis were used. Experiences across interviews revealed five main themes: 1) making sense of the diagnosis, 2) distress from disrupted expectations, 3) heightened awareness of self, others and the health care system, 4) strategies to 'get through' treatment, and 5) living with uncertainty. Findings from the study have contributed to the development of head and neck cancer-specific patient support and education programs for patients and families.