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The British Lymphology Society

MANAGING LYMPHOEDEMA AFTER TREATMENT FOR HEAD AND NECK CANCER

Identification of head and neck lymphoedema A person with lymphoedema in the head and neck may experience a range of physical, functional and psychological symptoms. These may vary from tightness of the skin and sensations of heaviness without any visible swelling, to a combination of internal and external swelling with functional and psychological consequences. Palpation and visual examination form the basis for the identification of swelling whilst photography enables changes in appearance to be determined. In severe cases of internal oedema, investigations may be required to establish safety during swallowing. Collaboration with the patient’s oncology team, dietitian and speech and language therapist is essential. Surgical assistance may be necessary if there is respiratory obstruction.

Impact of head and neck lymphoedema The impact of lymphoedema in the head and neck can be significant. Physical effects can include facial disfigurement due to the swelling, which may be combined with an altered appearance and body image issues due to weight loss and the effects of surgery. There may be altered sensations in the head and neck region and reduced range of movement affecting the face, head, neck and shoulders. Swelling can influence communication, respiration, swallowing, hearing and vision. A person with swelling in the head and neck can also experience loss of identity

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Professor Iain Hutchison

Civilian Consultant in OMFS – The British Army

Honorary Chief Executive – Saving Faces-The Facial Surgery Research Foundation

Director – The National Facial, Oral and Oculoplastic Research Centre (NFORC)

Honorary Consultant Oral and Maxillofacial Surgeon – Barts Health

Professor of Oral and Maxillofacial Surgery – Barts and the London Medical and Dental School, Queen Mary University of London

Professor Iain Hutchison treated patients with diseases, deformity and injuries affecting the most socially important part of our bodies – the face.

He funded the Saving Faces art project which has toured the world demystifying facial surgery for the general public and participated in many programmes about facial surgery including a TED talk entitled “Saving Faces

He founded the surgical research charity Saving Faces 24 years ago which leads international multi-centre clinical trials improving the prevention of and treatment for facial disease and injury.

Just one of Saving Faces research projects was the first ever, and still the only, nationwide surgical prospective trial of any head and neck cancer. The trial (SEND) compared two standard treatments for early mouth cancer evaluating which had the highest cure rate. We found that both treatments were very successful in curing early mouth cancer without any need for chemotherapy or radiotherapy. However one method, taking out the neck glands as well as the cancer, cured 30% more patients. This means that every year 30,000 more patients worldwide are cured as a result of the SEND Study.

Since the results were published in 2019, all the world guidelines have changed to recommend the better of two good treatments and save the lives of 30,000 patients around the world every year. You can read the full paper here.

We succeeded where many other studies failed because of our collaboration between 68 UK surgeons treating 614 patients at 26 UK hospitals. This national collaboration is still the only nationwide multi-centre study comparing two different surgical treatments for any head and neck cancer. Our findings are applicable for all surgeons worldwide because of the large numbers of surgeons from different backgrounds who operated on the patients.

Saving Faces is now running a campaign to fund the Alan Rickman Professorship of Facial Surgery. Alan was a founding Patron of Saving Faces and when he launched their National Research Centre (NFORC) said “I believe Saving Faces next project is to appoint an outstanding surgical Professor”.

This campaign has two aims, firstly, the Professor’s research will improve the faces and lives of thousands of people worldwide. Secondly, keeping the name and voice of Alan alive, forever associating him with this Professor’s research and great advances in treating facial disorders. Millions of people loved Alan and miss him. We are giving them an opportunity to honour him.

Michael Caines MBE DL

Chef Owner Michael Caines Collection

Title of Talk: Michael Caines – The Art of Flavour

Michael Caines MBE, chef patron of Lympstone Manor, is known as one of Britain’s most celebrated and acclaimed Michelinstarred chefs.

Having grown up in the South West of England, Michael has earned a global reputation for his distinctive modern cuisine,
which champions the finest local produce and suppliers, combined with influences from his global travels.

After attending a local Catering College in Exeter Michael’s talent was evident and this was followed by three years at Le Manoir aux Quat’Saisons with Raymond Blanc. He then furthered his experience travelling to France to study under Bernard Loiseau and Joël Robuchon.

In 1994 Michael returned to the UK to take up the position of head chef at Gidleigh Park in his home county of Devon. It was at Gidleigh that Michael achieved two Michelin stars. Both of which he retained for 18 years and earned within just four After 21 years at Gidleigh, in April 2017 Michael struck out on his own, opening Lympstone Manor – the luxury 21- bedroom country house hotel in a Grade II Georgian mansion in East Devon.

Lympstone achieved its first Michelin star within six months of opening. The hotel now holds 5 AA Rosettes as of the AA Hospitality Awards 2020. Keen to keep Lympstone fresh, Michael has built a vineyard on site, overlooking the Exe estuary and featuring approximately 17,500 vines. Lympstone is also the home to motoring festival – Celebration of Speed- an annual event commemorating Michael’s love of all things motoring.

In 2006 Michael was awarded an MBE for contributions and services to the hospitality industry and made a Freeman of the City of Exeter for his work impassioning the hospitality industry in the local area. Michael also created the Michael Caines Academy at Exeter College – of which he is alumnus – as well as The Michael Caines Foundation which supports numerous charities including Families for Children, Farms for City Children, The Exeter Foundation, One for the Boys, WESC and Devon Wildlife Trust.

Firmly rooting himself in the South West, Michael’s other projects include The Cove Restaurant and Bar at Maenporth, The Harbourside Refuge in Porthleven and 2021 will welcome a fourth site, Mickeys Beach Bar and Restaurant on the Exmouth shoreside.

Michael is a familiar face on television, appearing regularly on BBC’s Saturday Kitchen, Great British Menu and MasterChef and has authored a cookbook, Michael Caines at Home. He is an AA Chef’s Chef of the Year and has cooked at 10 Downing Street as well as being partner and ambassador for the Williams Formula 1 Motor Racing team, overseeing catering for the Grand Prix across the globe. Michael is also the co-founder of UK hotel chain, aBode and the Chef Representative of luxury hotel group, Relais & Chateaux, of which Lympstone is a proud member. More recently, Michael created a selection of all-natural flavours for premium US-based CBD soda brand, Isca.

www.michaelcaines.com

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Michael J Passineau, PhD

Vice President and Head of Salivary Gland Therapeutics

MeiraGTx

Title of Talk: Results of a phase 1 open-label, dose escalation study of gene therapy with AAV2-hAQP1 as treatment for radiation‑induced xerostomia and parotid gland hypofunction

2021- Present, Vice President and Head of Salivary Gland Therapeutics, MeiraGTx (NASDAQ:MGTX). MeiraGTx is a global gene therapy company with corporate headquarters in New York City, and primary manufacturing facilities in London and Shannon, Ireland. MeiraGTx develops and manufacturers and develops gene therapy vectors in inherited retinal diseases (partnership with Janssen), central nervous system disorders and salivary gland dysfunction. My role encompasses oversight of clinical drug development and research for the company’s lead candidate, AAV2-hAQP1, a gene therapy agent intended to treat radiation-induced xerostomia and Sjogren’s disease, as well as other undisclosed therapeutic candidates. AAV2-hAQP1 completed a Phase 1 clinical trial in March 2023, and the company has begun dosing a Phase 2 trial in June, 2023.

Formerly 13 years at Allegheny Health Network, Drexel University College of Medicine, Pittsburgh Campus (Allegheny General Hospital). Retired as full Professor, Drexel University CoM, in 2021.

BA in Chemistry/Bible – Cedarville University

PhD (Neuroscience) – University of Miami

Post-doctoral fellowship – University of Alabama at Birmingham

Formerly 13 years at Allegheny Health Network, Drexel University College of Medicine, Pittsburgh Campus (Allegheny General Hospital). Retired as full Professor, Drexel University CoM, in 2021.

BA in Chemistry/Bible – Cedarville University

PhD (Neuroscience) – University of Miami

Post-doctoral fellowship – University of Alabama at Birmingham