Doctor receives first NHS prosthetic tongue after cancer treatment

Dr. Imogen Brooks, a 30-year-old scientist from London, has received what is believed to be the first custom prosthetic tongue fitted on the NHS. After losing most of her tongue to squamous cell carcinoma at age 26, post-surgery radiotherapy shrank her reconstructed tissue, leaving her with severe speech difficulties and social isolation. Experts at Guy's and St Thomas' NHS Foundation Trust developed a bespoke silicone and cobalt chrome device that clips to her teeth, restoring her speech clarity and physical ease of communication within days.

Development of the prosthetic tongue

• ▪The custom prosthetic features a U-shaped cobalt chrome frame that clips onto Dr. Imogen Brooks' lower teeth and holds a personalized silicone tongue.
• ▪The prosthetic tongue was developed and fitted by a multidisciplinary team of experts at Guy's and St Thomas' NHS Foundation Trust.
• ▪The dental and speech therapy team at Guy's and St Thomas' NHS Foundation Trust produced two trial versions before refining the final design with Dr. Imogen Brooks.
• ▪Dr. Imogen Brooks, a 30-year-old medical writer and scientist from Newham, east London, has been fitted with what is believed to be the first prosthetic tongue made on the NHS.

Benefits of the prosthetic tongue

• ▪Dr. Imogen Brooks noticed an improvement in her speech within three days of using the prosthetic, and fully adapted to the device within two weeks.
• ▪The prosthetic tongue reduced Dr. Imogen Brooks' physical speaking effort, allowing her to speak more fluidly, for longer periods, and with less fatigue.
• ▪Dr. Imogen Brooks used the prosthetic tongue to help her pass an oral exam for her doctorate in skin disease therapies at King's College London.

Cancer treatment and speech loss

• ▪Dr. Imogen Brooks was diagnosed with squamous cell carcinoma, the most common type of head and neck cancer, at the age of 26.
• ▪Radiotherapy treatment following cancer surgery caused Dr. Imogen Brooks' reconstructed tongue tissue to shrink, severely affecting her speech clarity.
• ▪Surgeons removed most of Dr. Imogen Brooks' tongue and reconstructed it using tissue from elsewhere in her body to treat the cancer.

Challenges of living with speech difficulties

• ▪Dr. Imogen Brooks experienced social isolation as acquaintances and former colleagues avoided face-to-face conversations, while strangers looked at her in fear when she spoke.
• ▪To communicate before receiving the prosthetic, Dr. Imogen Brooks relied on speech-assistance technology for phone calls, hand gestures, and written notes.
• ▪Speech difficulties caused Dr. Imogen Brooks frustration due to workplace communication problems and receiving incorrect information during medical appointments.

Debatable claims

• ▪Dedicating large specialist teams to individual custom treatments is an efficient use of healthcare resources
• ▪Patient-led research is an appropriate driver of clinical innovation in public healthcare
• ▪The NHS should routinely fund custom speech prosthetics for post-cancer patients