Speech and Language Therapy Service Head and Neck Cancer 

The Speech and Language Therapy Service for Head and Neck Cancer work with patients who have difficulty swallowing or speaking following treatment for head and neck cancer. They also provide voice rehabilitation following total removal of the larynx. The team are highly specialist speech and language therapists, providing services to head and neck cancer patients as inpatients and out patients.

They will be involved in your care throughout your entire cancer pathway. This begins at the point of diagnosis with information and advice prior to treatment starting and continues through to the rehabilitation of speech, voice and swallow once treatment is finished.

As core members of the head and neck cancer multidisciplinary team (MDT), they provide care to patients within the surgical centre of the London Cancer network and as a national tertiary centre. They have recognised expertise in dysphagia (swallowing difficulties), speech, voice and laryngectomy rehabilitation, tracheostomy management, palliative care and research.

Specialist services

  • Swallowing

    The team assess and manage swallowing disorders. They evaluate the anatomy and physiology of the muscles used for swallowing.

    • Nasendoscopy: a small, flexible tube with a light and video camera at one end (endoscope) is inserted into one of your nostrils and passed down the back of your throat.
    • Videofluoroscopy: A videofluoroscopy, or modified barium swallow, is one of the most effective ways of assessing your swallowing ability and finding exactly where the problem is.
    • Surface electromyography: evaluation of your nerve functions.
    • Tongue pressure analysis: used to measure the strength of your tongue.
  • Voice

    The team assess and manage voice disorders following treatment.

    • Videostroboscopy: Slow motion view of the vocal folds to assess movement.
    • Videolaryngeal evaluation: A small flexible scope is passed through your nose to assess entire larynx for airway and voice production.
    • Computerised voice analysis: Measurement of the acoustic parameters of voice such as frequency (pitch), intensity (loudness) and clarity (quality).
  • Surgical voice restoration (following laryngectomy)

    The team work to restore your voice function following removal of the voice box.

    • Air insufflation radiological studies: x-ray to evaluate the tone of your muscles used for voice.
    • Voice prostheses: the team provide you with instructions on care, maintenance and emergency procedures when using the device required for voice restoration
    • Advanced problem solving: working with you to ensure your voice continues to function successfully.
    • Manometry: measuring your lung air pressure to optimise voice.
  • Research and education

    The team have a strong commitment to research, audit and education. Therapists have published in peer reviewed journals and present regularly at national and international conferences. They provide a range of graduate and postgraduate education opportunities, including student placements and sponsorship of student MSc projects. They hold honorary contracts at both University College London and City University, London and are involved directly in the pre and post registration speech and language therapy programmes. Team members have served on a number of special interest group committees and regularly advise the Royal College of Speech and Language Therapists on national policy and best practice guidelines.

  • Clinical observer programme

    We offer  a one and a half day programme to observe in our specialist Speech and Language Therapy Service within the Head and Neck Cancer Centre. There are opportunities to observe specialist clinics in diagnosis of swallowing and voice disorders, as well as multi-disciplinary cancer team discussions on treatment for head and neck cancer.

    Please contact Rachel Sylla, head and neck speech and language therapist on Rachel.Sylla@uclh.nhs.uk for more information.

 Speech and language therapists (SLT)

Roganie Govender, Consultant Speech and Language Therapist

Roganie Govender

Roganie is a consultant speech and language therapist with expertise in the assessment and rehabilitation of swallowing and communication difficulties in individuals with head and neck cancer. She has both a clinical and research role within the team. Her research work is funded by the National Institute of Health Research. Alongside her clinical work and patient research, she is also involved in teaching and training of undergraduate and postgraduate students. She engages in the development of clinical guidelines and policy work for The Royal College of Speech & Language Therapists.

“I enjoy the privilege of being able to work with individual patients in the clinic and to impact the lives of many more patients through research and policy work”.

Email: roganie.govender@uclh.nhs.uk

Samantha Holmes, Macmillan Head and Neck Speech and Language Therapist

Samantha joined UCLH as a Macmillan speech and language therapist within the head and neck team in late 2016, having previously managed a head and neck SLT service in north-west London. Samantha trained in New Zealand, and has worked at a number of London hospitals since 2010, specialising solely in head and neck cancer since 2013. Her current role involves working across the entire head and neck cancer pathway, managing complex clinical issues in speech, swallowing and voice following surgical and oncological treatment for head and neck cancer. Samantha has a particular interest in instrumental assessment of swallowing, including FEES and videofluoroscopy, and surgical voice restoration in laryngectomy.

Mary Lee, Specialist Speech and Language Therapist

Mary Lee

Mary is a senior specialist speech and language therapist within the head and neck cancer team. Her role involves management of complex clinical issues in voice, speech and swallowing following both surgical and oncological treatment for head and neck cancer. She leads advanced diagnostic clinics in surgical voice restoration following total laryngectomy and instrumental assessment of dysphagia.

Mary is actively involved in research projects within the head and neck team, writing grant submissions, teaching on post graduate programmes and supervision of Master’s level research projects. She has published in peer reviewed journals on the benign disorders of voice, quality of life after total laryngectomy, differences in adjustment across gender in laryngectomees as well as aspects of dysphagia.

"I enjoy the feeling of making a real difference to the patient that comes with this role"

Phone: 02034472137

Email: mary.lee@uclh.nhs.uk

Rachel Sylla, Specialist Speech and Language Therapist

Rachel Sylla

Rachel joined the team in June 2013 in order to specialise in the assessment and treatment of communication and swallowing disorders related to cancers of the head and neck. She works in both the inpatient and outpatient settings and enjoys her involvement in the entire patient pathway, from pre-treatment to rehabilitation post-treatment.

Rachel’s role involves implementing an outpatient radiotherapy clinic alongside her dietetic colleagues, management of surgical voice restoration following total laryngectomy, supervision of students on their clinical placements, and participation in teaching and departmental audits.

“I am passionate about empowering our patients to make educated decisions regarding their treatment and rehabilitation processes.”

Tel: 020 3447 2138

Email: Rachel.Sylla@uclh.nhs.uk