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.

Changes and challenges to patients’ lifestyle patterns following treatment for head and neck cancer

“…Moreover, the physical and psychological effects of H&NC can have an impact on ability to work. This finding supports that of Taylor et al. (2004), who reported that 52% of patients in their study ( n = 384) were disabled by their cancer and were not able to return to their usual place of work.…”

Return to work and its determinants among head and neck cancer survivors: a cross-sectional study

“…Regarding treatment type, surgery alone did not significantly affect RW rates but was associated with more favorable outcomes compared to multimodal approaches, such as surgery combined with chemotherapy or radiotherapy, which often result in greater impairments ( 7 , 20 , 25 , 26 ). Patients who did not receive radiotherapy or chemotherapy demonstrated higher RW rates, consistent with Taylor et al ( 27 ), who reported increased disability linked to chemotherapy in HNC survivors. The findings suggest that combined treatments may amplify side effects, reduce quality of life, and hinder workforce reintegration.…”

Quality of Life, Uncertainty, and Perceived Involvement in Decision Making in Patients With Head and Neck Cancer

“…That might have contributed to the significance of unemployment on QOL in this study, as being employed might be more critical for working-or younger-aged people than for retired or older people. However, age was not a significant factor on whether patients with head and neck cancer were able to return to work after treatment (Taylor et al, 2004), and was not significantly associated with QOL in this study.…”