Biopsychosocial Markers of Body Image Concerns in Patients with Head and Neck Cancer: A Prospective Longitudinal Study

Abstract

(1) Background: Patients and survivors of head and neck cancer (HNC) are at a high risk of developing body image concerns. Despite the prevalence of body image concerns in patients with HNC, there is a lack of longitudinal research exploring the wide array of its associated determinants. The current longitudinal study examined the determinants and longitudinal course of body image dissatisfaction in patients with HNC. (2) Methods: Patients participated in Structured Clinical Interviews and self-administered questionnaires at four time-points: (T1) upon cancer diagnosis, (T2) at 3 months post-diagnosis, (T3) at 6 months post-diagnosis, and (T4) at 12 months post-diagnosis. They also underwent a disfigurement rating on an objective scale. (3) Results: Two hundred and twenty-four patients participated in our study. Fourteen percent to twenty-eight percent of patients reported at least moderate body image concerns across time points, with the lowest rates at baseline and the highest at 3 months (T1). It was found that patients more predisposed to developing higher levels of body image concerns presented physical markers (i.e., advanced cancer stage, lower physical functioning, higher disfigurement), psychosocial markers (i.e., higher depression, higher anxiety, and higher levels of coping with denial), and health disparities (i.e., younger age, female sex, French language, and marital status, with divorced and widowers most affected). (4) Conclusions: The findings of this study highlight the multifaceted nature of body image concerns in patients with HNC and its biopsychosocial determinants. Clinicians should pay specific attention to these biopsychosocial markers in their clinics to predict high levels of body image concerns and tailor communication/refer for support accordingly.

Cancer-Related Fatigue and Its Influencing Factors Among Colorectal Cancer Patients: A Generalized Linear Modeling Approach

“…Body image was defined as an individual’s subjective thoughts and perceptions of their physical appearance. 23 The levels of body image were assessed using BIS, a brief instrument for measuring body image changes in cancer patients. In the present study, the mean score of BIS was 5.419, with a prevalence rate of 11.8% for body image disorder.…”

“… 55 , 56 Body image disorder can cause social alienation, which leads to higher rates of morbidity and mortality, having a satisfactory perceived body image contributes to better treatment and health outcomes and a better ability to deal with the disease. 23 Compared to other symptoms, body image disorder was rarely discussed between clinicians and survivors with colorectal cancer. 57 Hence, medical workers should also pay specific attention to those patients with body image concerns, tailor communication and take appropriate psychological interventions (eg, psychoeducation about the cognitive model of body image, cognitive-behavioral therapy on building a renewed image after cancer treatment) 58 accordingly, so as to help them correct wrong cognition, promote psychological adjustment, and contribute to good clinical outcomes.…”

“…From the perspectives of supportive care, understanding the modifiable or controllable psychosocial factors of CRF, early identifying the patients at a high risk of experiencing fatigue, and offering some tailored interventions are of great significance for improving the quality of life and positive health outcomes of cancer patients. Cancer itself and related treatments may also bring a series of psychosocial concerns to patients, such as various negative emotions (eg, anxiety, depression), changes in coping styles (eg, coping with avoidance or denial), changes to patients’ appearance (eg, body image concerns), 23 etc. Up to now, the research on the psychosocial factors affecting CRF in colorectal cancer patients are relatively scarce.…”

Efficacy of a Brief Cognitive Behavioral Therapy for Head and Neck Cancer Survivors with Body Image Distress: Secondary Outcomes from the BRIGHT Pilot Randomized Clinical Trial

“…Second, limited data from two prospective cohort studies suggest that pre-treatment depression is not a risk factor for HNC-related BID, that BID develops temporally prior to depression in patients for whom the conditions co-occur. 13,43 Additional research is therefore necessary to disentangle the temporal relationship between changes in depression and BID among HNC survivors following BRIGHT. Shame, stigma, and social isolation are all important, if understudied, psychosocial outcomes for HNC survivors.…”

Editorial: Body image following cancer treatment

“…For instance, a recent systematic review of older breast cancer survivors found that older women, particularly those who are post-menopausal, may be less affected by changes to their appearance following breast cancer treatment (Davis et al, 2020 ). In addition to these variables, other socio-demographic and clinical factors which have been demonstrated to affect the relationship between body image and wellbeing following cancer treatment, include gender, marital status, income, education level, cancer stage, treatment type, and many other such variables (Rezaei et al, 2016 ; Albert et al, 2022 ). This demonstrates the need for a nuanced understanding of the complex inter-relationship between body image and clinical, demographic, functional, and psychosocial variables.…”