RecruitingInterventional

Getting recovery from head and neck cancer right after neck dissection

Head and neck cancer affects over 12,000 people in the UK each year. Many people have surgery called a neck dissection to remove lymph nodes. While this surgery is often successful at treating cancer, it can leave people with stiff shoulders, neck pain, tiredness, and low mood. This UK study, called GRRAND, is testing whether an extra physiotherapy programme helps people recover more easily. Half of the people taking part will receive standard NHS care, which includes basic hospital physiotherapy and an advice leaflet. The other half will receive standard care plus the GRRAND programme, which offers tailored exercises, pain management advice, and relaxation techniques. Researchers will follow participants for one year to see if the extra support improves daily life and provides good value for the NHS.

At a glance

Status

Recruiting

Sponsor

University of Warwick

Enrolment target

390

Start

30 Apr 2025

Estimated completion

31 Dec 2026

Rehabilitation after neck dissection for head and neck cancer

What is this study about?

Head and neck cancer can start in places like the mouth, throat, or voice box. A very common part of treatment is an operation called a neck dissection, where surgeons remove lymph nodes from the neck to help clear the cancer. While this surgery saves lives, it can cause lasting side effects. Many people find their neck and shoulder feel stiff or painful, and they may struggle with extreme tiredness and low mood. In fact, only about half of patients are able to return to work.

Right now, doctors do not know the best way to help people recover from this operation. Standard NHS care usually includes seeing a physiotherapist while on the hospital ward and getting a leaflet with basic exercises to try at home. Researchers want to know if giving people a more structured, personalised physiotherapy programme makes a real difference to their long-term recovery.

A previous, smaller study showed that patients really valued having extra physiotherapy sessions that taught targeted movements, pain relief strategies, and relaxation techniques. This larger study is running across at least 12 NHS hospitals to confirm whether this special programme (called GRRAND) helps people move better and feel happier, and whether it makes sense financially for the NHS to offer it to everyone in the future.

Key takeaways

The study tests whether extra physiotherapy helps people recover better after neck cancer surgery.
Participants are randomly chosen to receive either standard NHS care or standard care plus the GRRAND exercise programme.
The extra programme focuses on shoulder movement, pain control, and relaxation.
Taking part involves no new medicines and carries very low risk.
Your progress and quality of life will be followed for 12 months.

Who may be eligible?

This study is open to adults aged 18 and older who are having neck dissection surgery in the UK to treat head and neck cancer. To take part, you must be able to attend regular outpatient physiotherapy appointments at one of the participating hospitals and give your informed consent.

The study is not suitable for everyone. People who need very complex reconstructive surgery involving muscle from the back or shoulder blade will not be included, as they already need intensive therapy. You also cannot take part if you have a long-term condition that already severely limits your shoulder (such as weakness from a stroke), or if you have previously had neck dissection surgery on the same side of your neck.

Finally, people who are having only a small lymph node biopsy rather than a full neck dissection, or who cannot attend the follow-up sessions, will not be able to join.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

I am aged 18 or older.
I have been diagnosed with head and neck cancer.
I am scheduled to have a neck dissection operation.
I can attend outpatient physiotherapy appointments at an NHS hospital.
I do not have a pre-existing condition that severely affects my shoulder (such as paralysis from a stroke).
I have not had a full neck dissection on this side of my neck before.

Answer every question to see your result.

What does participation involve?

If you decide to join, a computer will place you at random into one of two groups. One group receives routine NHS care, which involves seeing a physiotherapist on the hospital ward after surgery and receiving an exercise leaflet. The other group receives routine NHS care plus the GRRAND programme, which includes extra outpatient physiotherapy visits tailored to you, focusing on neck and shoulder exercises, managing pain, and coping with fatigue.

There are no trial drugs involved. You will be asked to fill in questionnaires about your movement, pain, and quality of life over the course of one year. A small number of patients and physiotherapists will also be invited to take part in an interview to share their thoughts on how the programme worked. The overall study runs until March 2028.

Potential risks and benefits

Taking part might not help you directly, but you could gain extra support with your physical recovery if you are placed in the GRRAND programme group. The research will also help improve future care for others having neck surgery. The risks of taking part are very low. You might feel a little sore or stiff after doing the exercises, but the physiotherapists will guide you gently and adjust any movement to suit your comfort. You are free to leave the study at any time without giving a reason, and your normal cancer care will not be affected in any way.

Locations (8)

Norfolk and Norwich University Hospital
Approximate
Norwich, England
Oxford University Hospitals
City only
Oxford, England
University Hospitals Dorset NHS Foundation Trust
City only
Poole, England
Liverpool University Hospitals NHS Foundation Trust
City only
Liverpool, England
Royal Marsden Hospital
Approximate
London, England
East Kent Hospitals University NHS Foundation Trust
Unverified
Canterbury, England
Mid and South Essex NHS Foundation Trust
Unverified
Westcliff-on-sea, England
Somerset NHS Foundation Trust
Unverified
Taunton, England

Common questions

What is the GRRAND programme?

It is an extra physiotherapy package designed for neck surgery recovery. It includes personalised neck and shoulder exercises, practical advice on managing pain, and relaxation techniques to help with fatigue and worry.

Can I choose which group I am in?

No. A computer will randomly assign you to either standard NHS care or standard care plus the GRRAND programme. This ensures the results are fair and reliable.

Will taking part affect my cancer treatment?

No. Your main cancer treatments, such as surgery, radiotherapy, or chemotherapy, will continue exactly as planned by your medical team.

Does the study cost me anything?

No, taking part is free. However, you will need to be able to travel to hospital outpatient appointments if you are in the extra physiotherapy group.

What happens if an exercise hurts?

You should stop any movement that causes sharp pain. Your physiotherapist will work closely with you to adjust the exercises so they feel safe and manageable.

How to find out more

Chrissy Evans

grrand@warwick.ac.uk - Official trial record

Always speak to your GP or specialist before deciding to take part in a study.