A Nordic survey of the management of palliative care in patients with head and neck cancer
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HEAD AND NECK
A Nordic survey of the management of palliative care in patients with head and neck cancer Helena Boëthius1,2 · Tiina Saarto3 · Göran Laurell4 · Lovisa Farnebo1,2 · Antti A. Mäkitie5,6,7 Received: 8 June 2020 / Accepted: 19 August 2020 © The Author(s) 2020
Abstract Background The five Nordic countries with a population of 27M people form a rather homogenous region in terms of health care. The management of Head and Neck Cancer (HNC) is centralized to the 21 university hospitals in these countries. Our aim was to survey the current status of organization of palliative care for patients with HNC in the Nordic countries as the field is rapidly developing. Materials and methods A structured web-based questionnaire was sent to all the Departments of Otorhinolaryngology—Head and Neck Surgery and Oncology managing HNC in the Nordic countries. Results All 21 (100%) Nordic university hospitals responded to the survey. A majority (over 90%) of the patients are discussed at diagnosis in a multidisciplinary tumor board (MDT), but the presence of a palliative care specialist is lacking in 95% of these MDT’s. The patients have access to specialized palliative care units (n = 14, 67%), teams (n = 10, 48%), and consultants (n = 4, 19%) in the majority of the hospitals. Conclusion The present results show that specialized palliative care services are available at the Nordic university hospitals. A major finding was that the collaboration between head and neck surgeons, oncologists and palliative care specialists is not well structured and the palliative care pathway of patients with HNC is not systematically organized. We suggest that early integrated palliative care needs to be included as an addition to the already existing HNC care pathways in the Nordic countries. Keywords Head and neck cancer · Palliative care · End-of-life care · Palliative guidelines · Best-supportive care · Early integrated palliative care
Introduction
Lovisa Farnebo and Antti A. Mäkitie have contributed equally. * Antti A. Mäkitie [email protected] 1
Department of Otorhinolaryngology, Anaesthetics, Operations and Specialty Surgery Center, Region Östergötland, Linköping, Sweden
2
Department of Biomedical and Clinical Sciences, Linköping University, Region Östergötland, Linköping, Sweden
3
Department of Palliative Care, Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
4
Department of Surgical Sciences, ENT, Uppsala University, 75185 Uppsala, Sweden
More than 500,000 patients worldwide are annually diagnosed with Head and Neck squamous cell cancer and this corresponds with 380,000 deaths each year [1]. At the same 5
Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, PO Box 263, 00029 HUS, Helsinki, Finland
6
Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
7
Division of Ear, Nose and Throat Diseases, Department of Clinical Sci
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