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  P27 - Nursing and Allied Health Professionals - Symptom Management (ID 158)

  • Event: WCLC 2020
  • Type: Posters
  • Track: Nursing and Allied Health Professionals
  • Presentations: 1
  • Moderators:
  • Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall

  • 35461

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    P27.01 - Multidisciplinary Management of Lung Cancer Patients Presenting with Oropharyngeal Dysphagia (ID 2207)

    00:00 - 00:00  |  Presenting Author(s): Abigail Esther Camps
    • Abstract
    • Slides

    Introduction
    

    Oropharyngeal dysphagia (OPD) can occur in lung cancer due to neck node compression, laryngeal nerve injury, comorbidities and weakness^1,2,3. OPD increases the risk of malnutrition and aspiration pneumonia which impact on quality of life (QOL), fitness for treatment and survival^{4 5,6}. Collaborative working between the speech and language therapist (SLT) and dietitian (DT) aims to support safe and adequate oral intake in patients with OPD, but dedicated resource in lung cancer is uncommon. This service evaluation reviewed SLT/DT interventions implemented for patients reporting OPD within the GSTT MDT thoracic oncology clinic, where SLT/DT are core members.

    Methods
    

    A retrospective notes review was conducted within the thoracic oncology clinic of all patients referred to SLT between June-December 2019 for OPD who also received DT input. Data collected included: diagnosis, signs of OPD, malnutrition risk (using the Royal Marsden Nutrition Screening Tool)⁷, swallow function (using the Functional Oral Intake Scale (FOIS))⁸ and intervention received.

    Results
    

    19 patients (11m, 8f), aged 39-82years with various tumour locations, pathologies and comorbidities were included. 47% patients were seen by DT and 37% by SLT on the day of referral and 84% within two weeks. 58% patients were referred to a single discipline but on assessment required intervention from both SLT/DT.

    OPD signs were: coughing, breathlessness, wet voice on intake/saliva (95%), intake sticking in throat (42%), discomfort on swallowing (26%). Patients were classified as high (42%), medium (37%) or low (21%) risk of malnutrition⁷.

    A range of interventions were offered to support safe and adequate intake (Fig. 1).

    

    All patients received dysphagia education and dietary counselling. 16% were considered at a high risk of aspiration and/or malnutrition following assessment and were admitted to hospital for specialist management and continued with their oncology treatment. All patients could continue with oral intake safely (median FOIS 6 (range 5-7)) with SLT advice. Joint appointments and instrumental swallowing assessment supported progression to more varied diets.

    Conclusion
    

    Working within a MDT clinic enabled rapid therapy response times with many patients seen on the day of referral, leading to fewer hospital visits. This setting also facilitated interdisciplinary discussion for timely onward referral. Early access to therapies provided opportunities for education, which aimed to empower patients to self-manage and potentially prevent complications leading to admissions or treatment breaks^9,10.

    It is acknowledged this is a small cohort of patients and full outcomes were not included. Further research assessing the effectiveness of interventions on a larger population is recommended.

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