Follow-up in head and neck cancer: patients' perspective

The purpose of this paper is to determine head and neck cancer patients' perspective of their follow-up regime and to suggest ways in which these perspectives can be incorporated into current practice.

This is a prospective survey-based study. A total of 263 patients consecutively attending a head and neck cancer clinic completed a survey about their experience of the follow-up process in the post-treatment period between January 2009 and October 2009.

The paper finds that, of the patients, 67 per cent (n = 176) felt that the clinic met the goals they hoped would be achieved during their visit; 84 per cent (n = 221) felt that their follow-up visits were too frequent. In total 60 per cent (n = 159) were booked to see both an allied health professional and the attending clinician. Of these, 84 per cent (n = 134/159) felt that issues addressed at follow-up with the clinician duplicated those addressed by the allied healthcare professionals. When asked about their opinion of a less intensive follow-up system based on patients reporting problems and requesting appointments, 73 per cent (n = 192) favoured it. When asked who they would like to contact first in such a system, most patients (n = 118, 45 per cent) stated a clinical nurse specialist.

Current follow-up regimes may be too prescriptive in their approach without taking patient perspective into consideration. Patients felt that being seen intensively for the first year, then having visits tapered off over the next two years and finally being seen according to symptoms thereafter to be appropriate and felt that this represented an overall better system.

These data suggest the need for a more patient-focused, individualised approach to follow-up in head and neck cancer.