The head and neck Speech and Language Therapy team provide a highly specialist service to both inpatients and outpatients who may experience difficulty swallowing or speaking following treatment for head and neck cancer. Speech and language therapists (SLTs) are core members of the head and neck cancer multidisciplinary team (MDT). They have expertise in dysphagia (swallowing difficulties), speech, voice and laryngectomy rehabilitation, tracheostomy management and palliative care. They also actively engage in patient related research to improve functional outcomes for people with head and neck cancer.
If you are referred to the service, the SLT team will be involved in your care throughout your cancer pathway if you are local to UCLH, or will work closely with your local specialist team to ensure a smooth transition of services if your treatment and rehabilitation takes place at different sites. SLT involvement begins at the point of diagnosis with provision of information and advice prior to commencement of treatment, and continues through to the rehabilitation of speech, voice and swallow after cancer treatment has finished.
The team assess and manage swallowing disorders. They evaluate the anatomy and physiology of the muscles used for swallowing, and provide a variety of different interventions. They sometimes use instrumental assessments to guide rehabilitation:
- Fiberoptic Nasendoscopy (FEES): 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 a dynamic x-ray and is an effective way of assessing your swallowing ability by finding exactly where the problem is occurring.
- Tongue pressure analysis: used to measure the strength of your tongue.
- Expiratory muscle strength training (EMST): used to strengthen breathing muscles to improve outcomes for swallowing, cough, and voice.
- Bootcamp: intensive rehabilitation programme using a combination of exercises and swallow driven rehabilitation to maximise swallowing function following some treatment, suitable for some patients.
The team assess and manage voice disorders following treatment.
- Videostroboscopy: Slow motion view of the vocal folds to assess movement.
- Videolaryngeal evaluation (VLE): A small flexible scope is passed through your nose to assess entire larynx for airway and voice production.
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.
Central London Laryngectomy Club: a bimonthly group that provides a safe space for socializing and support, enabling people living with a laryngectomy to share experiences, ask questions and offer advice.
The SLT team has a strong commitment to research, audit and education. Our 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 UCL and City University, and are involved in the pre- and post-registration SLT 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.
The team is currently involved in a number of research projects, including:
- PATHOS: A multi-centre randomised controlled trial looking at post-operative adjuvant treatment for HPV-positive tumours.
- PITSTOP: A multi-centre randomised trial of treatment with pentoxifylline and tocopherol in addition to best standard therapy (rehabilitation exercises) compared to best standard therapy alone in individuals with radiotherapy-induced fibrosis of the head and neck.
We offer a 1.5-day observership programme to prospective SLT students or other healthcare professionals wishing to observe specialist SLTs working within the head and neck cancer centre. There are opportunities to observe inpatient and outpatient SLT working, including specialist clinics in diagnosis of swallowing and voice disorders, instrumental assessments (VFS, FEES and VLE), management of surgical voice restoration after total laryngectomy, as well as multidisciplinary cancer team discussions on treatment for head and neck cancer.
Please contact Caitlin Reilly, head and neck speech and language therapist, on firstname.lastname@example.org for more information.
Our Speech and Language Therapists
The head and neck cancer speech and language therapy team can be contacted by telephone on 020 3447 2156, or by email on email@example.com
Mary is a senior specialist speech and language therapist clinical lead in 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 postgraduate programmes and supervision of Master’s level research projects. She has published in peer-reviewed journals on swallowing outcomes following total laryngectomy, quality of life after total laryngectomy, differences in adjustment across gender in laryngectomies, as well as aspects of dysphagia and voice.
"I enjoy the feeling of making a real difference to the patient that comes with this role"
Roganie is a consultant speech and language therapist and a clinical lecturer. As a clinical-academic she works across UCL and UCLH. She has clinical expertise in the assessment and rehabilitation of swallowing and communication difficulties in people with head and neck cancer. Alongside her clinical work and patient research, she is also involved in teaching and training of undergraduate and postgraduate students.
Roganie has published widely in her field and has presented her work internationally. She also engages in the development of clinical guidelines and policy work for the Royal College of Speech & Language Therapists. Roganie was appointed as a National Institute for Health Research training advocate for speech and language therapy in November 2019.
“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”
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 management of complex issues in speech, swallowing and voice post-surgical and oncological treatment for head and neck cancer. She manages surgical voice restoration following total laryngectomy and conducts instrumental assessments of voice and swallow, including VFS, FEES and VLE, for diagnostic and therapeutic measures. Rachel enjoys supervising junior members of staff, students, and delivering internal and external teaching. Rachel also actively participates in developmental research and audits.
“I am passionate about empowering our patients to make educated decisions about their treatment and rehabilitation”
Jo has had a varied career working in a number of the specialist head and neck cancer centres in London as well as in overseas. She joined the UCLH head and neck cancer team in 2015 and works with patients across the head and neck cancer pathway. She has specialist training in complex management of surgical voice restoration after laryngectomy and instrumental assessment of voice and swallowing. She is particularly interested in developing innovative and more effective programmes of swallowing therapy and voice therapy following head and neck cancer treatment, and providing increased support to patients into their cancer survivorship.
“I love working within a multidisciplinary team, and get huge satisfaction out of finding different ways to support people going through this difficult treatment”
Lucy joined UCLH in February 2018 as a specialist speech and language therapist within the head and neck team. Her role involves assessment and treatment of patients across the entire head and neck cancer pathway. This includes surgical voice restoration following laryngectomy, instrumental assessment of swallowing and voice (FEES and videofluoroscopy), and use of a range of therapeutic tools to manage complex clinical issues in speech, swallowing and voice following surgical and oncological treatment. Additionally, Lucy has enjoyed being increasingly involved in research, teaching and audits at UCH.
“I enjoy exploring new therapeutic tools and approaches available, supported by the evidence available, to achieve the best possible outcomes and fulfil patient’s goals”
Caitlin joined UCLH in April 2018 as a specialist speech and language therapist within the head and neck team. Her role involves working with patients across the entire head and neck cancer pathway for management of complex issues in speech, swallowing and voice post-surgical and oncological treatment for head and neck cancer. This includes surgical voice restoration after laryngectomy, instrumental assessment of swallowing, and supporting patients through the on-treatment radiotherapy clinic as part of the multidisciplinary team.
“I enjoy building a relationship with our patients and helping them to achieve meaningful goals”
Lisa joined UCLH in 2020 as a speech and language therapist within the head and neck team. Her 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. Lisa has a particular interest in post-surgical management of swallowing and communication, rehabilitation and also surgical voice restoration in laryngectomy.
"I enjoy working in Head and Neck Cancer because it's such a privilege to be able to make a difference to someone’s life"