Ethical considerations in screening head and neck cancer patients for psychosocial distress

Deleemans, Julie; Mothersill, Kerry J.; Bultz, Barry D.; Schulte, Fiona

doi:10.1007/s00520-019-04860-8

Cited by 17 publications

(11 citation statements)

References 35 publications

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“…Better understanding how these early determinants interface with later body image concerns would be of merit to tailor interventions addressing this often-neglected component of HNC. Until then, screening for distress, collaborative care models, and patient-health care provider communication skills training ( Barth and Lannen, 2011 ; Alias and Henry, 2018 ; Deleemans et al, 2020 ) remain mainstays in HNC oncology clinics.…”

Section: Discussionmentioning

confidence: 99%

Body Image Concerns in Patients With Head and Neck Cancer: A Longitudinal Study

et al. 2022

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ObjectiveHead and neck cancer (HNC) treatments are known to significantly affect functionality and appearance, leading to an increased risk for body image disturbances. Yet, few longitudinal studies exist to examine body image in these patients. Based on a conceptual model, the current study aimed to determine, in patients newly diagnosed with HNC: (1) the prevalence, level, and course of body image concerns; (2) correlates of upon cancer diagnosis (pre-treatment) body image concerns; (3) predictors of immediate post-treatment body image concerns; and (4) association between body image concerns and levels of anxiety, depression, suicidal ideation, support (i.e., satisfaction with support from physician, social/family wellbeing, and unmet support needs), and alcohol and drug misuse.MethodsTwo hundred and twenty-three (participation rate = 72%), newly diagnosed with a primary HNC were assessed using structured clinical interviews and psychometric measures at three, and 6 months after diagnosis. Primary outcome was 3-month, as it was most salient to body image disturbance. Multiple linear regression analyses were conducted on the potential body image predictors, based on the model.ResultsSixty-eight percent of patients with HNC (n = 148 of 218) presented some level of body image concerns. Body image concerns at baseline (i.e., upon cancer diagnosis, pre-treatment) and post-treatment were significantly related and significantly increased from pre- to post-treatment. Immediately post-treatment (i.e., at 3 month follow-up), 89% (n = 132 of 148) presented some level of body image concerns. Correlates of body image concerns in patients with HNC at baseline included: physical symptom burden, difficulties with communication and eating, coping with the cancer diagnosis using denial, suicidal ideation, and having had a past anxiety diagnosis. When controlling for sociodemographic and medical variables, body image concerns in patients with HNC in the immediate post-treatment were predicted by: baseline body image, physical symptom burden, and neuroticism.ConclusionThis longitudinal study helps identify patients more susceptible to experience body image disturbance following head and neck cancer. Clinicians ought to pay special attention to body image concerns upon cancer diagnosis, physical symptom burden, and neuroticism, and may want to target these factors in future preventive interventions.

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Section: Discussionmentioning

confidence: 99%

Body Image Concerns in Patients With Head and Neck Cancer: A Longitudinal Study

et al. 2022

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“…Fourth, the impact of HPV status did not seem to translate into the immediate posttreatment period in terms of its impact on levels of anxiety and depression, QoL, and sexuality needs. considered an ethical imperative more generally for patients with HNC 30 and should be attended to early on, as part of prehabilitation efforts in this population. Generally targeting patients with HPV-negative status as well as patients with HPV-positive status presenting with comorbid MDD in screening for distress initiatives may be warranted.…”

Section: Discussionmentioning

confidence: 99%

Psychosocial outcomes of human papillomavirus (HPV)‐ and non‐HPV‐related head and neck cancers: A longitudinal study

et al. 2021

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Objectives: Human papillomavirus (HPV) has prompted a need to further investigate how this new biomarker changes the head and neck cancer (HNC) psychosocial landscape. This study aimed to: (a) characterize the sociodemographic, psychological, and social profiles of patients with HPV-positive versus -negative squamous cell carcinoma of the head and neck; and (b) identify how HPV status contributes to anxiety and depression (primary outcome), quality of life (QoL), and sexuality needs. Methods: We conducted a prospective longitudinal study of 146 patients newly diagnosed with oral, oropharyngeal, nasopharyngeal, and hypopharyngeal cancer. Seventy-nine patients were HPV-positive and 67 HPV-negative. Patients completed self-administered psychometric measures upon HNC and 3-month follow-up, and Structured Clinical Interviews for DSM Diagnoses. Results: Patients with HPV-negative tumors generally presented with higher anxiety and depression and lower QoL immediately post-HNC diagnosis (<2 weeks) compared to HPV-positive cancers. A Major Depressive Disorder (MDD) immediately post-HNC diagnosis negatively affected patients' anxiety and depression and QoL levels upon diagnosis only when the cancer was HPV-positive. Immediately posttreatment, HPV status was not associated with outcomes. A previous history of suicidal ideation, and upon cancer diagnosis cigarette smoking, anxiety and depression, and feeling close to one's partner were instead explanatory. Conclusion: While patients with HPV-positive HNC generally present with initially lower psychological distress, their vulnerability immediately posttreatment indicates an equal need for support. Head and neck clinics may need to better address MDD, anxiety and depression, a prior history of suicidal ideation, health behavior change, and quality of relationships.

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“…Information processing and complex decision making regarding treatment can be overwhelming for patients. Patients who have completed oncologic treatment are often still burdened by anxiety and fear of cancer recurrence, functional changes and disfigurement, and chronic pain [ 22 , 23 , 24 ]. The Diathesis Stress model is a psychological theory that mental health disorders develop from a biologic predisposition in combination with stressful conditions or environment [ 25 ].…”

Section: Psychosocial Assessment: Implications Of Delays In Carementioning

confidence: 99%

Psychosocial Implications of COVID-19 on Head and Neck Cancer

Dermody

Shuman

2022

Current Oncology

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The COVID-19 pandemic has fundamentally changed healthcare access, delivery, and treatment paradigms throughout oncology. Patients with head and neck cancer comprise an especially vulnerable population due to the nature of their disease and the transmission mechanism of the SARS-CoV-2 virus. The consequences of triage decisions and delays in care have serious psychosocial implications for patients. The development of structured psychosocial support programs, coupled with clear and consistent communication from treating physicians, can help mitigate perceptions of abandonment and distress that may accompany delays in care. As the unpredictability of the pandemic’s course continues to burden both providers and patients, we must be proactive in addressing the psychosocial implications of these delays in care.

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Ethical considerations in screening head and neck cancer patients for psychosocial distress

Cited by 17 publications

References 35 publications

Body Image Concerns in Patients With Head and Neck Cancer: A Longitudinal Study

Body Image Concerns in Patients With Head and Neck Cancer: A Longitudinal Study

Psychosocial outcomes of human papillomavirus (HPV)‐ and non‐HPV‐related head and neck cancers: A longitudinal study

Psychosocial Implications of COVID-19 on Head and Neck Cancer

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