Authors (including presenting author) :
Lee YT(1), Koo L P(1), Ng K W(1), Yu W S(1), Cheung KW(2), Chan PC(2) Mak MY(1)
Affiliation :
(1) Department of Physiotherapy, Tuen Mun Hospital Authority (2) Department of Clinical Oncology, Tuen Mun Hospital Authority
Introduction :
The management of nasopharyngeal cancer (NPC) involves a multidisciplinary team (oncologist, ENT specialist and rehabilitation specialist etc.). Although advances in (NPC) treatments have led to improvements in survival rates, survivors often live with numerous cancer or treatment-related symptoms that cause dysfunctions and a reduction in quality of life. Particularly, survivors generally experience many musculoskeletal adverse effects after radiotherapy, such as neck muscle fibrosis, trismus, and shoulder dysfunctions. To date, musculoskeletal adverse effects after radiotherapy have been less emphasized and inadequately reported. Moreover, physiotherapy service provision for NPC patients in Hong Kong has been unstructured and there is no existing protocol guiding when and under what criteria a patient having NPC should be referred for physiotherapy in NTWC.
Objectives :
1. To improve standard of care for patients with NPC. 2. To develop an evidence-based physiotherapy program for patients with NPC in preventing and minimizing various musculoskeletal adverse effects after radiotherapy.
Methodology :
This pilot program was co-organized with the Department of Clinical oncology in TMH. All patients who were newly diagnosed NPC with nodal involvement and showed interest to the program were invited to join. The aim of the program was to prevent and minimize various musculoskeletal adverse effects after radiotherapy (temporomandibular joint, cervical, shoulder dysfunction, postural and balance problem). The content of the program included 1. educational talk 2. demonstration and practice of exercise (temporomandibular, cervical, and shoulder exercise etc.) 3. discussion and sharing, which was conducted by a physiotherapist with experience in cancer care. The program was about one hour. An exercise booklet was compiled to facilitate home exercise. Self-monitoring of common musculoskeletal adverse effects was emphasized and patients were suggested to report any early symptom at their oncological follow-up to ensure a timely referral to rehabilitation professionals.
Result & Outcome :
Thirty-one patients met the inclusion criteria and expressed interest in the program since June 2019 (20 males, 11 females; mean age: 50.0). Five of them attended the pilot program and completed the program evaluation. All the respondents were satisfied/very satisfied with the program and found it useful in preventing the musculoskeletal adverse effects. Specifically, they found the program helpful to increase their disease knowledge, awareness of musculoskeletal adverse effects, interest and confidence in exercise. The preliminary response from the patients was promising. Follow-up of exercise compliance and occurrence of musculoskeletal adverse effects may be considered for evaluation of program in long term.
