The current Nottingham Multidisciplinary Team (MDT) was founded in the early 1980’s following the appointment of Dr P J Bradley (ENT surgeon) and Dr. David Morgan (radiotherapist). They worked closely together with major specialist input from pathology, dental surgery, speech and language therapy, dietetics and senior nurses. Prior to the 1980’s each radiotherapist and surgeon (ENT, Plastic Surgery, General Surgery) involved in the diagnosis of head and neck cancer had a semi-structured clinical arrangement which met fortnightly to monthly to discuss newly diagnosed or patients who’s disease had recurred.

The first recorded management of a patient presenting with airway obstruction was at the Nottingham and Notts. Hospital for Diseases of the Throat, Nose and Ear, at 33 Peachey Terrace (now Mansfield Road) in 1889. The patient underwent a tracheostomy and laryngofissure and was nursed for several days before being discharged from hospital. Dr. Alexander Tweedie is credited with performing the first total laryngectomy, assisted by Mr. E Gilroy Glass in 1925. The patient survived for 7 years before eventiually succumbing from oesophageal cancer. The surgical records from the late 1890’s – 1925 from the Nottingham General Hospital (NGH) Annual Reports, lists many operations for parotid tumours, thyroid tumours, larygeal, nose and mouth tumours. Unfortunately at that time the patients’ outcome was uniformly dismal.

Radiotherapy was practiced at Nottingham General Hospital from 1903. However with the opening of the Ropewalk Wing in 1927, the ENT and Radiology/Radiotherapy Departments were accommodated in close proximity, separated by a floor or two, until the reorganisation and closure of NGH. In 1984 the ENT service transferred to the Queens Medical Centre and in 1992 Radiotherapy went to the City Hospital. 

With the development of “modern working” with Multidisciplinary Teams of medical and non-medical staff, the team in Nottingham has expanded into a weekly MDT with video-Linkage to the Lincoln County Hospital. All facets of treatment and care is now available in Nottingham and it remains as one of the leading Head and Neck cancer centres in the United Kingdom.

Patrick Bradley