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 under the care of a UCLH Head and Neck Consultant and referred to the SLT Head and neck cancer service, the SLT team will be involved in your care throughout your cancer pathway. If not, we will work closely with your local specialist team to ensure a smooth transition of services if your treatment and rehabilitation takes place at a different hospital. 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:
- Fibreoptic
- Videofluoroscopy (VFS): 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. This is suitable for some patients but not all, based on our selection criteria
The team assess and manage voice disorders following treatment.
- Videostroboscopy: Slow motion view of the vocal folds to assess movement
- Videolaryngeal endocsopy (VLE): A small flexible scope is passed through your nose to assess entire larynx for airway and voice production
The team support you 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 group that provides a safe space for socialising and support, enabling people living with a laryngectomy to share experiences, ask questions and offer advice. Please contact the SLT team for further information, including upcoming dates.
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. Some 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 Clinical Excellence Network 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 several research projects.
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 Jess Sin, Jessica.
Contacting the Head and Neck cancer SLTs
The head and neck cancer speech and language therapy team can be contacted by telephone on 020 3447 2156, or by email on uclh.
