Summary of the Clinical Practice Guideline

Article Citation

Cancer of the Upper Aerodigestive Tract: Assessment and Management in People Aged 16 and Over

National Collaborating Centre for Cancer. (2016).
London (United Kingdom): National Institute for Health and Care Excellence, (NICE Guideline 36), 1-330.
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National Institute for Health and Care Excellence (United Kingdom)

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Article Details

Description

This guideline provides recommendations for healthcare professionals involved in the care of individuals with cancer of the upper aerodigestive tract (oral cavity, oropharynx, nasopharynx, hypopharynx, larynx, and paranasal sinuses). Many of the recommendations address medical management of the disease; however some sections are applicable to speech-language pathologists.

Evidence Ratings for This Document

Levels of Evidence were defined as:
  • High: Further research is very unlikely to change the guideline committee's confidence in the estimate of effect
  • Moderate: Further research is likely to have an important impact on the guideline committee's confidence in the estimate of effect, and may change the estimate.
  • Low: Further research is very likely to have an important impact on the guideline committee's confidence in the estimate of effect, and likely will change the estimate.
  • Very low: Estimates of effect are very uncertain.

Recommendations from This Guideline

What are Recommendations?

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Assessment

At diagnosis of upper aerodigestive tract cancer, the multidisciplinary team should assess need for enteral nutrition, including possible prophylactic tube placement. Pre-existing dysphagia and nutritional status (e.g., ability to meet estimated nutritional needs) should be taken into consideration (Moderate Quality Evidence).

Keywords: Provider (e.g. SLP/Audiologist/Caregiver), Provider (SLP/Caregiver), Adults, Swallowing, Head and Neck Cancer, Dysphagia, Head and Neck Cancer

Treatment

Individuals who have upper aerodigestive tract cancer and are receiving radiotherapy should be considered for swallowing exercise programs, and mouth-opening exercises if they are at risk for reduced mouth opening (Low Quality Evidence). 

Keywords: Oral-Motor Exercises, Cancer Treatment Received (Laryngectomy/Chemotherapy), Radiotherapy, Swallowing, Head and Neck Cancer, Oral Motor Treatments (includes Shaker Exercises)

Service Delivery

At diagnosis of upper aerodigestive tract cancer, the multidisciplinary team should assess need for enteral nutrition, including possible prophylactic tube placement. Pre-existing dysphagia and nutritional status (e.g., ability to meet estimated nutritional needs) should be taken into consideration (Moderate Quality Evidence).

Keywords: Provider (e.g. SLP/Audiologist/Caregiver), Provider (SLP/Caregiver), Adults, Swallowing, Head and Neck Cancer, Dysphagia, Head and Neck Cancer

Go to Map

Assessment

At diagnosis of upper aerodigestive tract cancer, the multidisciplinary team should assess need for enteral nutrition, including possible prophylactic tube placement. Pre-existing dysphagia and nutritional status (e.g., ability to meet estimated nutritional needs) should be taken into consideration (Moderate Quality Evidence).

Keywords: Provider (e.g. SLP/Audiologist/Caregiver), Provider (SLP/Caregiver), Adults, Swallowing, Head and Neck Cancer, Dysphagia, Head and Neck Cancer

Treatment

Individuals who have upper aerodigestive tract cancer should be considered for voice therapy if their voice has changed from treatment (Low Quality Evidence). 

Keywords: Adults, Age, Speech/Voice

Individuals who have upper aerodigestive tract cancer and are receiving radiotherapy should be considered for swallowing exercise programs, and mouth-opening exercises if they are at risk for reduced mouth opening (Low Quality Evidence). 

Keywords: Oral-Motor Exercises, Cancer Treatment Received (Laryngectomy/Chemotherapy), Radiotherapy, Swallowing, Head and Neck Cancer, Oral Motor Treatments (includes Shaker Exercises)

Service Delivery

At diagnosis of upper aerodigestive tract cancer, the multidisciplinary team should assess need for enteral nutrition, including possible prophylactic tube placement. Pre-existing dysphagia and nutritional status (e.g., ability to meet estimated nutritional needs) should be taken into consideration (Moderate Quality Evidence).

Keywords: Provider (e.g. SLP/Audiologist/Caregiver), Provider (SLP/Caregiver), Adults, Swallowing, Head and Neck Cancer, Dysphagia, Head and Neck Cancer

Go to Map

Assessment

At diagnosis of upper aerodigestive tract cancer, the multidisciplinary team should assess need for enteral nutrition, including possible prophylactic tube placement. Pre-existing dysphagia and nutritional status (e.g., ability to meet estimated nutritional needs) should be taken into consideration (Moderate Quality Evidence).

Keywords: Provider (e.g. SLP/Audiologist/Caregiver), Provider (SLP/Caregiver), Adults, Swallowing, Head and Neck Cancer, Dysphagia, Head and Neck Cancer

Go to Map

Assessment

Individuals who have upper aerodigestive tract cancer should be considered for voice therapy if their voice has changed from treatment (Low Quality Evidence). 

Keywords: Adults, Age, Speech/Voice

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