Mode of treatment affects quality of life in head and neck cancer survivors: Implications for holistic care

• Published in: Acta oto-laryngologica Vol. 130; no. 10; pp. 1185 - 1192
• Main Authors: Bower, Wendy Fiona, Vlantis, Alexander Christopher, Chung, Tiffany M. L., Van Hasselt, C. Andrew
• Format: Journal Article
• Language: English
• Published: Stockholm Informa Healthcare 01-10-2010; Taylor & Francis; Informa
• Subjects: Aged; Biological and medical sciences; Combined Modality Therapy - methods; Female; Head and neck cancer; Head and Neck Neoplasms - psychology; Head and Neck Neoplasms - therapy; Holistic Health; Humans; Male; Medical sciences; Middle Aged; Otorhinolaryngology (head neck, general aspects and miscellaneous); Otorhinolaryngology. Stomatology; Quality of Life; radiotherapy; surgery; Surveys and Questionnaires; Survivors; Tumors; Treatment; Surgery; ENT disease; Head and neck cancer; ENT; Malignant tumor; Radiotherapy; Care; Cancer; Quality of life
• DOI: 10.3109/00016481003667366
• EISSN: 1651-2251
• ISSN: 0001-6489

Abstract
Conclusion: As adverse effects of live-saving treatment are unavoidable surgeons have a duty to address physical changes and quality of life issues that matter to head and neck (H&N) cancer patients. We propose a tailored holistic care package. Objectives: This study compared the quality of life of H&N cancer survivors managed with different approaches in the follow-up phase after initial treatment and identified factors adversely impacting quality of life parameters. Methods: H&N cancer patients studied: 1) surgery only, 2) radiotherapy only, 3) surgery and radiotherapy, and 4) any combination of surgery, chemotherapy or radiotherapy. Patients unable to communicate in Cantonese, with thyroid cancer or end-of-life disease were excluded. EORTC QLQ-H&N35 Cantonese version was administered at least 1 year after initial H&N cancer treatment. Results: Quality of life impairment was worse in all of the domains for combination therapy versus monotherapy patients. Scores between surgery or radiotherapy-only patients were not significantly different. Radiotherapy preceding surgery impacted significantly more on speech than surgery before the radiotherapy. Patients with advanced disease had more impairment of quality of life in each domain than patients with early disease. Coughing, eating problems, sticky saliva, and difficulties with social contact were all significant predictors of problems associated with a dry mouth.