Spotlight on: Martin Heaton, Consultant Plastic Surgeon

One of our consultant plastic surgeons has been appointed as clinical lead on a national improvement programme for patients with head and neck cancer.

Martin Heaton will lead the GIRFT (Get It Right First Time) national programme to seek out best practice across the UK to assess whether it could be rolled out nationally.

Martin successfully applied for the position after being encouraged to do so by the British Association of Plastic Reconstructive and Aesthetics Surgeons.

He will now help lead a multi-disciplinary team which will take in performance data from hospitals all over the UK who specialise in treating patients with head and neck cancer.

“I want to get a feel for what different units are doing. I want to see where we at the Norfolk and Norwich fit in and what we do, which could be offered elsewhere and what work is going on elsewhere that could be adopted here,” said Martin.

There are 53 head and neck cancer units across the UK, which all individually manage head and neck cancer patients. Martin’s team will assess what each one does, how it carries out treatment and whether the process can be rolled out elsewhere to offer a high level of consistency and best practice for all patients.

Head and neck cancer treatment brings together a cast of many to provide an expert multidisciplinary team which includes, plastic surgeons, ear nose and throat specialists, maxillofacial experts, oncologists, radiotherapy specialists, chemotherapy experts, clinical nurse specialists, dieticians and speech and language therapists.

“The list of experts involved just goes on and on,” said Martin.

“Surgical procedures are hugely complex with one group of surgeons performing the initial procedure to remove the mouth or jaw tumour and then a plastic surgeon is required to rebuild the jaw by taking bone from the leg to make a new jaw, for instance.”

Martin has been a head and neck specialist at the hospital for 12 years having spent his career gaining experience and expertise in his field including working in Australia.

Graduating from Nottingham University Medical School, Martin trained in the North West, North East and Midlands.

He did an MD doctorate in developing artificial skin at the University of Sheffield before undertaking advanced Fellowships at the Royal Marsden Hospital, the Pulvertaft Centre in Derby as well as the Royal Adelaide Hospital, South Australia. Amongst other roles Martin is Training Programme Director for plastic surgery in the East of England and an examiner for the FRCS (PLAST) – the final qualifying exam for plastic surgeons prior to starting as consultants.

“The technology we use is cutting edge,” he said. “We use computer assisted drawings (CAD) and cameras to make templates and robotic surgery to get into really small areas, without causing extensive damage to the jaw. After we have done that, the patient might need an extensive period of radiotherapy or chemotherapy, so this is a massive undertaking for the patient.

“Head and neck cancer is not like other more well-known cancers like breast cancer. I describe this as the visible and the invisible. Visible because patients may not be able to talk, breathe or eat properly. Invisible because they do not like to show that they dribble, can’t breathe easily, or eat properly.

“For most of our patients it has a major and fundamental impact on their lives. These patients put up with massive amounts of disruption and disability in their lives so we need to find best practice wherever it might be and see that this is then rolled out across the country, so we get the best possible outcomes for them. Anything we can do to best manage very difficult problems is to be commended.

As with all cancers early diagnosis is key, however head and neck cancer can start with a simple mouth ulcer, a small lump on the neck or a hoarse voice.

“Lots of us get mouth ulcers and after one to four weeks it will go, “ added Martin.

“Mouth cancer patients will have a painful ulcer which will get bigger, so at what point have they had enough and seek attention?  Often it is a dentist who will have spotted the signs and refer them to us.

“Covid did present us with a problem as we are now seeing cancers at a more advanced stage. Whereas before we might have done a six-hour procedure now it takes 12 hours, when before no ongoing treatment was necessary, now they may be a course of radiotherapy or chemotherapy. Unfortunately for some patients the cancer is incurable.”

Weekly multidisciplinary groups will involve up to 30 specialists discussing 30-40 new cases and those patients currently in treatment.

“Life as a consultant can be quite isolating, you perfect new techniques and so on at your own hospital, but you don’t always know what is going on elsewhere. This will give me an opportunity to find out what is going on in London, Newcastle, Plymouth, everywhere; what works and what does not work. A real opportunity.”

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