Skip to main content Accessibility help
×
Home

Palliative and supportive care in head and neck cancer: United Kingdom National Multidisciplinary Guidelines

  • H Cocks (a1), K Ah-See (a2), M Capel (a3) and P Taylor (a4)

Abstract

This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. It provides recommendations on the assessments and interventions for this group of patients receiving palliative and supportive care.

Recommendations

• Palliative and supportive care must be multidisciplinary. (G)

• All core team members should have training in advanced communication skills. (G)

• Palliative surgery should be considered in selected cases. (R)

• Hypofractionated or short course radiotherapy should be considered for local pain control and for painful bony metastases. (R)

• All palliative patients should have a functional endoscopic evaluation of swallowing (FEES) assessment of swallow to assess for risk of aspiration. (G)

• Pain relief should be based on the World Health Organization pain ladder. (R)

• Specialist pain management service involvement should be considered early for those with refractory pain. (G)

• Constipation should be avoided by the judicious use of prophylactic laxatives and the correction of systemic causes such as dehydration, hypercalcaemia and hypothyroidism. (G)

• Organic causes of confusion should be identified and corrected where appropriate, failing this, treatment with benzodiazepines or antipsychotics should be considered. (G)

• Patients with symptoms suggestive of spinal metastases or metastatic cord compression must be managed in accordance with the National Institute for Health and Care Excellence guidance. (R)

• Cardiopulmonary resuscitation is inappropriate in the palliative dying patient. (R)

• ‘Do not attempt cardiopulmonary resuscitation’ orders should be completed and discussed with the patient and/or the family unless good reasons exist not to do so where appropriate. This is absolutely necessary when a patient's care is to be managed at home. (G)

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Palliative and supportive care in head and neck cancer: United Kingdom National Multidisciplinary Guidelines
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Palliative and supportive care in head and neck cancer: United Kingdom National Multidisciplinary Guidelines
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Palliative and supportive care in head and neck cancer: United Kingdom National Multidisciplinary Guidelines
      Available formats
      ×

Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

Address for correspondence: Helen Cocks, ENT Department, City Hospitals Sunderland, Sunderland E-mail: helen.cocks@chfst.nhs.uk

References

Hide All
1 Booth, S, Davies, A (eds). Palliative Care Consultations in Head and Neck Cancer. Oxford: Oxford University Press, 2006
2 National Institute for Health and Care Excellence. Improving Supportive and Palliative for Adults with Cancer. London: National Institute for Health and Care Excellence, 2004. https://www.nice.org.uk/guidance/csgsp/evidence/supportive-and-palliative-care-the-manual-2 (accessed 15 October 2015)
3 Nicholson, A. North of England Strategic Clinical Network Palliative Care Guidelines. Newcastle Upon Tyne: North of England Cancer Network, 2015. http://www.nescn.nhs.uk/wp-content/uploads/2014/05/NESCN-Palliative-Care-Guidelines-Guidance-Sheets.pdf (accessed 15 October 2015)
4 Wong, RKS, Wiffen, PJ. Bisphosphonates for the relief of pain secondary to bone metastases. Cochrane Database Syst Rev 2002;(2):CD002068
5 Wee, B, Hillier, R. Interventions for noisy breathing in patients near to death. Cochrane Database Syst Rev 2008;(1):CD005177
6 Hardy, JR, Rees, E, Ling, J, Burman, R, Feuer, D, Broadley, K et al. A prospective study of the use of steroids on a palliative care unit. Palliative Med. 2001;15:38
7 National Institute for Health and Care Excellence. Metastatic Spinal Cord Compression in Adults. London: National Institute for Health and Care Excellence, 2014. NICE quality standard QS56, https://www.nice.org.uk/guidance/qs56 (accessed 20 October 2015)
8 Regnard, C, Randall, F. A framework for making advance decisions on resuscitation. Clin Med 2005;5:354–60
9 National Institute for Health and Care Excellence. End of Life Care for Adults. London: National Institute for Health and Care Excellence, 2011. NICE quality standard QS13, http://www.nice.org.uk/guidance/qs13 (accessed 20 October 2015)
10 Guidance from the British Medical Association, Resuscitation Council (UK), Royal College of Nursing. Decisions Relating to Cardiopulmonary Resuscitation, 3rd edn, 2014. http://www.resus.org.uk/pages/dnar.pdf (accessed 20 October 2015)

Related content

Powered by UNSILO
Type Description Title
PDF
Full supplement PDF

Full supplement PDF
Full supplement PDF

 PDF (10.5 MB)
10.5 MB

Palliative and supportive care in head and neck cancer: United Kingdom National Multidisciplinary Guidelines

  • H Cocks (a1), K Ah-See (a2), M Capel (a3) and P Taylor (a4)

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.