Speak Out December 2018

Out & About

Inside the Head & Neck Cancer Unit at Tata Memorial Cancer Centre in India

As a student , the opportunity to complete an internship under the sole speech pathologist at Tata Memorial Hospital (TMH), a specialised public cancer centre in India, was an invaluable experience. TMH is the national centre for the prevention, treatment, education and research in cancer with patients travelling there from clinics all around India and neighbouring countries. Over 1000 patients attend the Out Patient Department (OPD) every day for medical advice and follow-up. From 7am in the morning hundreds of patients sit outside the speech therapy office, of which approximately 50 could be seen in the seven-hour OPD block. TMH acknowledge that their existing infrastructure is stretched given the patient load, nevertheless, they aim to provide best- practice client-centred services with the resources available. Effective management of head and neck cancer (HNC) is difficult due to loss of contact during follow-up. While patients access affordable services, the cost of travel, accommodation and loss of earnings during treatment is significant. For example, a 70-year- old patient who had completed chemoradiation therapy and had a nasogastric tube (NGT) inserted was due to return one week later for review of her nil by mouth status. She presented to OPD 10 months later after travelling five hours from her village with her son and her NGT was still in place. Her family relied solely on the income of her son and could not afford to continue follow-up after treatment ceased.

India continues to face an extremely high incidence of HNC, despite documentation of a slow decline. Of the 2–2.25 million cases of cancer in India, between 60-80% are late to be detected and are classified as advanced by the time patients report for treatment. The hospital has increased emphasis on public awareness of early detection to address these large numbers and hopefully mitigate avoidable burden of unnecessary suffering and the financial burden on public hospital services. Acknowledgement: Mr. Arun Balaji (Speech Pathologist at TMH). It was an honour to see a true advocate for our profession.

Aashna Vazirani Student

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December 2018 www.speechpathologyaustralia.org.au

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