Disability in Patients With Head and Neck Cancer

Abstract

Background: Patients with head and neck cancer often experience debilitating speech, eating, and respiratory problems as well as the psychological effects of loss of function and change in body image. These patients often become unemployed as a result of their disease process, which adds financial burden to their already stressful lives. Yet the specific factors associated with unemployment have not been systematically studied.Methods: This multisite study used survey and chart data to determine the predictors of work-related disability.Results: Of the 384 patients who were working prior to their diagnosis of head and neck cancer, 52% (n=201) were disabled by their cancer treatment. Multivariate analysis demonstrated significant links between disabil-ity and chemotherapy (odds ratio [OR], 3.4; PϽ.001), neck dissection status (OR, 2.3; P=.01), pain scores (OR, 1.2; P =.01), and time since diagnosis (OR, 0.9; P=.04).Conclusions: More than half of the patients in this study were disabled by their head and neck cancer or treatment. Patients with head and neck cancer who have undergone chemotherapy or neck dissection or have high pain scores are at increased risk for disability from their cancer or their treatment. Efforts to prevent (if possible), better assess, and treat pain and other adverse effects of head and neck cancer treatments may also have the potential to reduce patient disability.

Patient-Reported Factors Associated With Discontinuing Employment Following Head and Neck Cancer Treatment

“…3 Compared with patients with other types of cancer, those with head and neck cancer (HNC) have the third highest rate of discontinuing work because of their illness. 9 Prior studies [11][12][13][14] have reported that 28% to 52% of patients with HNC who were employed at the time of their diagnosis were disabled by their illness. With an increase in the survival of many patients with HNC over the past 30 years and an increase in the age at which retirement is anticipated, the importance of returning to work becomes a substantial concern for this group of patients who have previously been presumed to contribute relatively little to the work force.…”

Apoptosis and Expression of AQP5 and TGF-β in the Irradiated Rat Submandibular Gland

“…The exposure of the salivary glands to high doses of radiation during radiotherapy results in salivary hypofunction, which may persist during the rest of the life of the patient leading to irreversible and distressing oral complaints. These consequences of treatment have a negative impact on the quality of life (1). Protection of the salivary glands against radiation damage is of great importance.…”

Policy issues related to the rehabilitation of the surgical cancer patient

“…Nearly one out of five cancer survivors reported cancer-related limitations in ability to work when interviewed 1-5 years following their diagnosis in one of the largest cross-sectional studies to date [23]. Work-related outcomes are significantly worse for cancers of the central nervous system, hematologic cancers [23], and cancer of the head and neck [24]. Other investigators point to the vulnerability of cancer survivors with jobs involving manual labor [25].…”