Selfcare Laryngectomy

Selfcare in patients after laryngectomy

Patients with advanced laryngeal cancer sometimes undergo a laryngectomy as part of their cancer treatment. A laryngectomy is the surgical removal of the larynx and separation of the airway from the mouth, nose and esophagus. The laryngectomee breathes through an opening in the neck, a laryngectomy stoma. Patients treated with a laryngectomy often report speech, swallowing and shoulder problems following treatment.

To target these problems, the intervention In Tune without Cords (in Dutch: Verder Zonder Stembanden) has been developed. This intervention encompasses a guided self-help exercise program with exercises targeting speech, swallowing and shoulder problems and a self-care education program with information and self-care advice on speech, nutrition and mobility, as well as smelling, stoma care and voice prosthesis care. In Tune without Cords was developed as an online application and as booklet plus DVD version.

The self-care education program has been found to be feasible and was positively valued by laryngectomy patients in terms of general impression, ease of use, willingness to use and satisfaction with the content. In addition, a recent randomization controlled trial showed that the guided self-help exercise program built into the In Tune without Cords application improves swallowing and communication in comparison to care as usual among laryngectomy patients.

Collaboration
This project is a collaboration with the department of Otolaryngology / head and neck surgery, department of Radiotherapy and Oncology and department of Rehabilitation Medicine, departments Physiotherapy, Dietetics and Medical Social Work of the VUmc, and the Radboud University Medical Center, the University Medical Center Groningen, University Medical Center Utrecht, Erasmus University Medical Center, Maastricht University Medical Center and Leiden University Medical Center.

Funding

Michel Keijzer Fonds / the Netherlands Society of Laryngectomees (NSvG) (2011 – 2015)

Publicaties

  • Jansen F, Eerenstein SEJ, Cnossen IC, Lissenberg-Witte BI, de Bree R, Doornaert P, Halmos GB, Hardillo JAU, van Hinte G, Honings J, van Uden-Kraan CF, Leemans CR and Verdonck-de Leeuw IM. Effectiveness of a guided self-help head and neck exercise program for patients treated with total laryngectomy: results of a multicenter randomized controlled trial. Oral Oncology 2020
  • van Uden-Kraan CF, Jansen F, Lissenberg-Witte BI, Eerenstein SEJ, Leemans CR, Verdonck-de Leeuw IM. Health-related and cancer-related Internet use by patients treated with total laryngectomy. Support Care Cancer. 2019 Apr 16.
  • Jansen F, Eerenstein SEJ, Lissenberg-Witte BI, van Uden-Kraan CF, Leemans CR, Leeuw IMV. Unmet supportive care needs in patients treated with total laryngectomy and its associated factors. Head Neck. 2018 Dec;40(12):2633-2641.
  • Jansen F, Coupé VMH, Eerenstein SEJ, Leemans CR, Verdonck-de Leeuw IM. Costs from a healthcare and societal perspective among cancer patients after total laryngectomy: are they related to patient activation? Support Care Cancer. 2018 Apr;26(4):1221-1231.
  • Cnossen IC, van Uden-Kraan CF, Witte BI, Aalders YJ, de Goede CJ, de Bree R, Doornaert P, Rietveld DH, Buter J, Langendijk JA, Leemans CR, Verdonck-de Leeuw IM. Prophylactic exercises among head and neck cancer patients during and after swallowing sparing intensity modulated radiation: adherence and exercise performance levels of a 12-week guided home-based program. Eur Arch Otorhinolaryngol. 2017;274(2):1129-1138.
  • Jansen F, Cnossen IC, Eerenstein SE, Coupé VM, Witte BI, van Uden-Kraan CF, Doornaert P, Braunius WW, De Bree R, Hardillo JA, Honings J, Halmos GB, Leemans CR, Verdonck-de Leeuw IM. Effectiveness and cost-utility of a guided self-help exercise program for patients treated with total laryngectomy: protocol of a multi-center randomized controlled trial. BMC Cancer. 2016;16:580.
  • Cnossen IC, van Uden-Kraan CF, Eerenstein SE, Jansen F, Witte BI, Lacko M, Hardillo JA, Honings J, Halmos GB, Goedhart-Schwandt NL, de Bree R, Leemans CR, Verdonck-Leeuw IM. An online self-care education program to support patients after total laryngectomy: feasibility and satisfaction. Support Care Cancer. 2016;24(3):1261-1268.
  • Cnossen IC, van Uden-Kraan CF, Eerenstein SE, Rinkel RN, Aalders IJ, van den Berg K, de Goede CJ, van Stijgeren AJ, Cruijff-Bijl Y, de Bree R, Leemans CR, Verdonck-de Leeuw IM. A Participatory Design Approach to Develop a Web-Based Self-Care Program Supporting Early Rehabilitation among Patients after Total Laryngectomy. Folia Phoniatr Logop. 2016;67(4):193-201.

Questions?
For questions, please contact Dr Femke Jansen, prof dr Irma Verdonck-de Leeuw,  f.jansen1@amsterdamumc.nl