Annual Report 2006/07 - Royal Devon & Exeter Hospital

Head & Neck Team
Cancers around
the mouth,
jaw and face are
on the increase;
in the last year
47 separate
resections were
carried out within
the maxillofacial
unit at the RD&E,
15 requiring
complex
reconstructions.
Although cancer
work takes
precedence,
consultant
maxillofacial surgeon Andrew McLennan and his
team also care for patients with major facial
deformity, facial trauma and routine non-cancer
work around the mouth, face and jaws.
Someone who has reason to thank the team for
their expertise is Stuart Waine (above), who was
diagnosed with cancer of the tongue aged 24.
Says Andrew McLennan: “Stuart had several
areas of invasive cancer, needing extensive
surgery. The operation involved a tracheostomy
to secure the airway, and major surgery to
remove both the tumour and the surrounding
lymph glands. We then carried out
reconstructive surgery by taking a skin flap from
Stuart’s arm, together with its artery and vein,
to be reconnected to artery and veins in the
neck. The operation took the whole day and
Stuart spent 12 hours recovering in intensive
care before returning to the ward. He then
had to cope with a six-week course of radical
radiotherapy.”
Five years on
Stuart has made
a fantastic
recovery. He is
an architectural
stonemason
and has raised
hundreds of
pounds for the
Macmillan cancer
fund, even
travelling as far
as Mount Everest!
“Everyone in the maxillofacial
department showed both professionalism
and compassion in treating me
and supporting my recovery. Whilst
I can only guess at the huge workload
of the department, I was – and
continue to be – treated as if I were
the most important person in the
world. I am in their debt.”
Stuart Waine
Andrew concludes: “Although Stuart moved away
we remain in contact and he has recently been
giving invaluable counselling and support for
another ‘youngster’ with a similar diagnosis and
treatment plan. He’s an impressive guy.”
Key to t h e s u c c e s s of the ‘maxfax’ team is one of the RD&E’s many clinical nurse specialists, Claire Barber.
Her role is to act as an expert resource, not just here at the RD&E, but across the whole healthcare
community, offering support and specialist care for patients with head and neck related cancers. This
involves the development of a co-ordinated and integrated approach between organisations and agencies
and close workings with key members of other health-related specialities such as doctors, speech
therapists, dieticians and radiographers.
“I care for patients with multiple health and social-care needs and carry out home visits for those who are
too ill to travel or who are about to undergo major complex head and neck reconstructions. Some patients,
due to the extensive nature of their surgery, have to rely on neck breathing (via a tracheostomy); others
have complex nursing needs due to unhealed wounds and artificial feeding tubes. I also run a clinic jointly
with the head and neck speech and language therapist, senior dietician and radiographer. Together we
carry out a full assessment of every patient who has just completed a course of chemo or radiotherapy to
the head and neck, and decide on treatments to encourage a more rapid recovery.
“It’s wonderful to be involved in the care of someone like Stuart. His determination to return to a normal
life is a real inspiration to others.”
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