Acting Locally to Fight Head and Neck Cancer Stacey Brill saw a health care system that took too long to diagnose and treat oral cancers. So she set out to change it. In the Limelight
In the Limelight  |   December 01, 2018
Acting Locally to Fight Head and Neck Cancer
Author Notes
  • Shelley D. Hutchins is content producer/editor for the ASHA Leader.
    Shelley D. Hutchins is content producer/editor for the ASHA Leader.×
Article Information
Special Populations / In the Limelight
In the Limelight   |   December 01, 2018
Acting Locally to Fight Head and Neck Cancer
The ASHA Leader, December 2018, Vol. 23, 26-27. doi:10.1044/leader.LML.23122018.26
The ASHA Leader, December 2018, Vol. 23, 26-27. doi:10.1044/leader.LML.23122018.26
Name: Stacey Brill
Title: Speech-language pathologist, Lee Health
Hometown: Fort Myers, Florida
Stacey Brill devised a head and neck cancer patient pathway to ease the treatment process from diagnosis to discharge. She then convinced her employer—Lee Health—to implement it system-wide. For those same patients, Brill also runs a monthly support group. And she trains her own therapy dogs and organizes three annual events to raise money and awareness.
She does all this on top of her full-time job as a speech-language pathologist.
About 14 years ago, Brill lost her mother to ovarian cancer. She cared for her mother during the nearly two-year battle with the disease, including navigating the often confusing and slow-moving health care system. Brill vowed to improve the experience for patients and caregivers.
“I promised Mom I’d make a difference for cancer patients,” Brill says, “so every year I try to make the process easier in our hospital system or create a program to help them.”
Patient pathway
The SLP started by investigating the program for head and neck cancer treatment. She interviewed survivors, patients and caregivers she’d worked with about parts of the process they wish had moved faster or information they would have liked sooner.
After she gathered patients’ perspectives, she talked with her colleagues—otolaryngologists (ENTs), oncologists, dietitians and other members of the treatment teams—about what they felt would make the process more efficient.
“I also gathered patient reports showing what spots where patient care—lack of rehab referrals, education on what to expect during and after treatment, and financial assistance resources—missed the mark and why we needed change,” Brill explains. “Then I devised a flow chart for what an interdisciplinary pathway would look like. An ENT and I presented to the hospital cancer committee, who passed the proposal easily.”
In the eight years since the hospital implemented Brill’s patient pathway, they’ve noted improved outcomes, such as faster rehabilitation time, earlier removal of feeding tubes, and fewer repeat hospitalizations due to complications.
Brill also believes the system benefits the hospital financially with more outpatient rehab referrals. One of the key components involves referrals to SLPs and oncology dieticians immediately after diagnosis for pre-op sessions to educate patients and assign exercises before treatment. Brill can often detect if patients need sessions with occupational and physical therapists, and makes those referrals earlier, too.
“Now we work as one interdisciplinary team from the beginning,” Brill says. “Before it was fragmented and referrals to me or other therapists happened much later.”

“The more awareness and early detection information you can spread, the more lives you save.”

Annual 5K
Brill’s fulfillment of the promise to her mom extends beyond work. Over the past six years, she raised more than $200,000 through an annual fundraising 5K run/2-mile walk. Every cent of those funds goes toward providing treatment, equipment, nutritional supplements, education, screenings, co-pays or other monetary support for people dealing with head and neck cancer in southwest Florida.
The race takes place each April, with around 350 people gathering at a local ballpark to run, walk or volunteer. The local nonprofit cancer foundation, 21st Century Care, partners with Brill for the event, so all donated money, goods and services can be tax-deductible.
Brill also determines who receives the money, with the foundation board’s approval.
“I wrote the financial plan with me in mind—I have insurance, a home and a job, but co-pays and expensive medical devices can add up,” Brill says. “One patient who had a laryngectomy has Medicaid that doesn’t cover his voice-processor prosthesis, so we paid for one and his quality of life vastly improved.”
Free screenings
Some funds raised at the 5K go toward free head and neck cancer screenings, also in April. A local ENT usually donates his office and asks staff to volunteer. Brill recruits other doctors and dentists to perform exams and solicits donated medical supplies.
“The more awareness and early-detection information you can spread, the more lives you save,” Brill says. “We’re also able to identify possible other concerns like reflux, skin cancer and dental issues.”
Brill publicizes the screenings by distributing fliers, taking out ads and appearing on local news programs. Of the approximately 100 people screened each year, 12 to 15 are referred for immediate follow-up exams.
Additional efforts
Brill wants even more people—from health care professionals to parents—to know about head and neck cancer. So, five years ago, she launched a free community dinner to educate her community. Around 50 people attend—a good mix of health care pros and the general public—and 5K funds cover all costs.
“This year a pediatric oncologist came to talk about HPV,” Brill says.
A self-proclaimed multitasker, Brill also trains her own English bulldogs as certified therapy animals. She’s trained five dogs over the past 14 years. Brill’s rehab patients tell her the dogs help them relax and engage in treatment, as well as distract them from pain.
“These activities are a lot of work, but I truly enjoy it. I also get a tremendous amount of support from my co-workers,” Brill says. “And nothing beats the feeling of telling a patient their therapy or medication is covered.”
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December 2018
Volume 23, Issue 12