Pharmacists May Play a Greater Role in Head and Neck Cancer Diagnosis

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Community pharmacists could play a key role in the early identification and referral of patients with suspected head and neck cancer (HNC), according to a multi-institute team of researchers.

The study, now underway, has the potential to improve the rates of early formal cancer assessment, diagnosis, and treatment, the researchers said. It also will explore whether community pharmacies could offer a pathway for people with HNC symptoms to seek further medical help and advice. 

Most head and neck cancers are in the mouth and throat, so they could potentially be identified early by a dentist, the researchers said. But recent studies have found that patients frequently present late with advanced stages of the disease and have not seen their dentist in the two years prior to diagnosis, mainly due to uncertainties about dental costs and dental anxiety.

Community pharmacists now provide an increasing range of healthcare services, the researchers said, routinely offering advice to patients seeking over-the-counter treatments for common symptoms including those that may be related to HNC.

This places community pharmacists in an ideal position to potentially intervene at an early stage for at-risk patients and to promote and facilitate health-seeking behaviors and potentially refer patients at an earlier stage of their disease for formal diagnosis of the condition, the researchers said.

“Over the course of our study we hope to demonstrate the critical role community pharmacists could play in spotting the first signs of this common cancer, such as non-healing mouth ulcers, potentially providing a life-saving link for people who may have limited contact with other oral and general healthcare services due to their marginalization,” said lead researcher Dr. Andrew Sturrock, a principal lecturer in pharmacy at the University of Sunderland.

“Pharmacist services are easily accessible to most of us, with 95% of the population living within 20 minutes of a pharmacy. Their role has certainly provide critical during COVID-19,” Sturrock said.

“For individual reasons, people are not going into GP practices or hospitals since the start of the pandemic, yet pharmacists have been accessible for advice throughout to people who are trying to self-manage their conditions,” he continued.

“That represents an opportunity for pharmacists to offer an intervention that would enable early identification and offer advice for patients who may be tempted to delay seeking help,” Sturrock said.

“We believe the project is an excellent example of an applied multi-disciplinary research collaboration between pharmacy, dentistry and medicine, HNC clinicians, and patients. We hope our results will lead to future funding and to further develop the project nationally and begin a large-scale clinical trial,” he said.

As part of the 18-month project, the researchers will interview community pharmacists to explore their knowledge, current practice, and appetite for delivering HNC early identification. Interviews with HNC patients will explore past engagement with pharmacy services and attitudes toward the roles of pharmacists taking part in this engagement.

“Awareness is key with cancer. The earlier a suspected lesion is identified, the earlier it can be investigated, diagnosed, and treated. In the North East, we have access to fantastic HNC services, and the clear message is to act quickly,” said Dr. Susan Bissett of the School of Dental Sciences at Newcastle University.

“Unfortunately, many people are reluctant to go to the dentist, for many reasons. I am looking forward to working with our collaborative team and finding out more about the potential for a community pharmacy intervention for HNC,” Bissett said.

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