Multidisciplinary Care of Locally Advanced Mucosal Head and Neck Cancer: An Australian Perspective.

Abstract

Locally advanced mucosal head and neck squamous cell carcinoma (LA-HNSCC) is associated with several key risk factors including smoking, alcohol, and human papillomavirus (HPV) infection. Unfortunately, the current treatment modalities for LA-HNSCC, which can include combinations of surgery, radiotherapy, and systemic therapy, may result in substantial treatment-related toxicity and functional consequences for patients with a significant impact on quality of life. Due to the complex nature of the disease and acute and delayed treatment-related morbidity, treatment of LA-HNSCC requires a multidisciplinary approach that is optimally funded and accessible for patients regardless of geography. This review discusses the importance of a multidisciplinary approach throughout optimal care pathways for LA-HNSCC. Additionally, it identifies and discusses key unmet clinical needs associated with the multidisciplinary approach for LA-HNSCC in Australia. This includes further investigations into pre-habilitation and individualized follow-up protocols, and the development of biomarkers to enable selection of patients for the most appropriate treatment modality and predict response and relapse. Furthermore, there are inadequate supports to enable critical survivorship care and significant inequity in access to care across Australia. This is especially true in regional and rural areas, and urgent interventions to improve equity of access and surveillance in these populations are required.