Improving mouth cancer care

We speak to an award-winning nurse who’s made huge improvements in care for patients undergoing treatment

Around 8,300 people are diagnosed with mouth cancer each year in the UK, which is about 1 in every 50 cancers diagnosed.

“Mouth cancers can affect the tongue, gums, inside of the cheeks, lips, roof and floor of mouth,” says Dr Cherith Semple, who has committed much of her nursing career to improving the outcomes and treatment for people diagnosed with mouth cancer.

Vulnerable patients

Cherith spent 18 years as a Macmillan head and neck cancer specialist nurse before starting a unique clinical academic role last year at Ulster University. She balances research and supporting students with a clinical caseload of people newly-diagnosed with mouth cancers at the South Eastern Health and Social Care Trust.

“Early in my career, I realised that people with this type of cancer felt very vulnerable once they were discharged from hospital. One minute they’re surrounded by their specialist clinical team, the next they’re going home. In fact, when asked about their aftercare, one patient said ‘It felt like my cord was cut from the specialist multidisciplinary team’. I wanted to make a difference in promoting patients’ quality of life following treatment.

The idea is to focus on the patients

Cherith has been awarded an MBE for services to nursing and was named RCN Northern Ireland Nurse of the Year in 2015. She has led initiatives to improve aftercare for people diagnosed with head and neck cancers and acted on research from her PhD exploring psycho-social difficulties post-surgery.

“Treatment for this type of cancer can impact on many daily functions, such as eating and speaking, especially if part of the tongue or palate has been removed,” says Cherith. “Post-treatment can be the most challenging time for patients as they learn to adjust and cope with how they look, speak and eat.” 

Cherith was instrumental in developing a telephone support service, surgical follow-up clinic and educational leaflet for patients post-treatment for her trust. A nurse-led clinic was also established for patients who were in year three of their cancer follow-up.

“People with head and neck cancer can often have low self-esteem as the treatment is very visual. The idea behind all of these initiatives is to focus on the patients’ wants and needs and help them move forward with their lives.”

Patient perspective

A visit to the dentist revealed more than just a cavity for 51-year-old mechanic Vic Shield, when a lump in his mouth turned out to be cancer

I’d noticed a lump on my gum for a while and was told it was nothing serious after a biopsy. I went to the dentist who suggested a second opinion and was referred to another hospital.
I’ve never smoked and hardly drink alcohol, so it was a shock when I found out it was cancer. As it was a rare cancer, I was sent to a specialist at University College London Hospital and had an operation to remove my jaw bone and replace it with titanium. I also had muscle removed from my chest to replace my facial muscles.

Because it was an aggressive sarcoma, I also had six months of intense chemotherapy. I understood the physical side of treatment, but I found it hard to deal with the mental side of things – fearing about every lump and bump and waking in the night with anxiety. Less is spoken about the mental side effects of chemo, but now I understand.

Three years on from that trip to the dentist and I am doing much better than expected. I cannot fault the NHS and the nursing staff who looked after me when I had the operation and the nurses who helped me during chemo at the MacMillan Centre in London.

We always had a laugh and a joke throughout it all which made me feel comfortable and kept me going. I can’t thank them enough.

Mouth cancer is the sixth most common cancer in the world, but it's much less common in the UK. More than two in three cases develop in adults over the age of 55 but it can also develop in younger adults. HPV infection is thought to be linked with the most mouth cancers that happen in younger people.

Five signs and symptoms of mouth cancer

  • A painful mouth ulcer that doesn’t heal in three weeks.
  • Any red and white patches in your mouth.
  • Loose teeth or dentures.
  • Swallowing and speech difficulties.
  • Any unusual lumps or swellings on the mouth or neck.

November is Mouth Cancer Action month. Find out more

Words by Susan Embley 

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