This week has seen the publication of an important source of information and support for head and neck cancer patients about the challenge of returning to work after treatment. Chris Curtis and The Swallows, with support from others, deserve great credit for raising awareness of this issue in their Back to Work Guide. It is available here

LINK

In the last couple of decades the age profile of patients has changed, with the increasing causal involvement of HPV in head and neck cancer. With patients consequently presenting at a younger age, the wish to return to work is of even more importance.

I had a laryngectomy aged 51, which was at the lower part of the usual age range at the time. As a secondary school teacher my employment depended on my voice and I had no certainty of being able to return after the operation. As it happened, after primary surgical voice restoration, I had reasonable valve speech but it was not up to speaking several hours during a working day. Fortunately the surgery left a great sweet spot on my neck for placement of an electrolarynx (EL). Subsequently the EL has been my primary method of speech and enabled 4 more years work as a teacher, before taking early retirement in 2007.

My experience illustrates a key factor in determining the ability to return to work – the functional outcomes after cancer treatment and how the demands of the job can be met. There are many other relevant factors but some of these pose important questions about impact of equality issues on the ability to return to work.

As a teacher, I was a public sector employee. With that came many benefits, such as decent sick pay, continuing for many months. Recovering from a laryngectomy takes a long time and it was nearly a year before I returned to work full-time. Had my employment circumstances been different, with less advantageous terms of service or had I been self-employed, the outcome may not have been so positive.

This is an area where there has been little research to guide us. Abi Miller, SLT at Chesterfield Royal Hospital, and Emma Kinloch, NCRI Consumer Lead, have both been working recently to remedy this. However this is only a start.  In the meantime the Back to Work Guide will be of great benefit to patients accepting the challenge of returning to work.

Our group had intended to organise, later this month, its first indoor meeting since March 2020. However, despite all of us having had both jabs we have changed our plans.

Even as early as February 2020, some members changed their plans including cancelling trips to London, given reports of the arrival of coronavirus. Most members later received shielding letters, being extremely clinically vulnerable,  and have been taking every precaution to avoid infection. There is a reluctance, given the high current infection rates, to return meeting indoors. So for the moment we will meet outdoors or via Zoom.

Whilst this is disappointing, we are not back to square one. The vaccinations continue to appear to give protection against severe disease needing ICU care. Speech and language therapists have developed some excellent strategies to ensure speech valve services can continue. We will be meeting together again, as usual, before long. In the meantime we will be staying in touch and supporting each other as best we can.

As well as looking to stay safe ourselves we are thinking of the nurses, doctors and SLTs who support us. They face many pressures if there is another wave of infection and our thoughts are with them.