Gaps in Depression Symptom Management for Patients With Head and Neck Cancer

Noel, Christopher W.; Sutradhar, Rinku; Chan, Wing Cheuk; Fu, Rui; Philteos, Justine; Forner, David; Irish, Jonathan C.; Vigod, Simone N.; Isenberg‐Grzeda, Elie; Coburn, Natalie; Hallet, Julie; Eskander, Antoine

doi:10.1002/lary.30595

Cited by 6 publications

(1 citation statement)

References 58 publications

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“…This approach has shown promise for decreasing health care resource utilization and cost, which is especially important for patients with low income and/or of minority groups who may have limited access to care. Given that the availability of collaborative care models remains limited, further study is needed to determine how best to implement care models on a widespread, feasible, and sustainable basis, especially among patients with low income and populations in rural areas …”

Section: Discussionmentioning

confidence: 99%

Depressive Symptoms, Systemic Inflammation, and Survival Among Patients With Head and Neck Cancer

Cash,

Albert,

Palmer

et al. 2024

JAMA Otolaryngol Head Neck Surg

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ImportancePatients with head and neck cancer experience high rates of depression. Depression and systemic inflammation have been found to be associated in numerous cancer types, often independently from disease status. Depression-related inflammation may elevate the risks for poor tumor response to treatment and early mortality, and comprises a mechanism by which depression is associated with survival in head and neck cancer.ObjectiveTo assess mediation pathways incorporating pretreatment depressive symptoms, pretreatment inflammation, and tumor response posttreatment on overall survival among patients with head and neck cancer.Design, Setting, and ParticipantsThis was a prospective observational cohort study of patients with head and neck cancer treated in a single multidisciplinary head and neck cancer clinic from May 10, 2013, to December 30, 2019, and followed up for 2 years. Data analysis was performed from June 29, 2022, to June 23, 2023.ExposuresPatient-reported depressive symptoms using the Patient Health Questionnaire−9 item (PHQ−9) at treatment planning; pretreatment hematology workup for systemic inflammation index (SII) score; and clinical data review for tumor response (complete vs incomplete) and overall survival.Main OutcomesTwo-year overall survival.ResultsThe total study cohort included 394 patients (mean [SD] age, 62.5 [11.5] years; 277 [70.3%] males) with head and neck cancer. Among 285 patients (72.3%) who scored below the clinical cutoff for depression on the PHQ−9, depressive symptoms were significantly associated with inflammation (partial r, 0.168; 95% CI, 0.007-0.038). In addition, both depression and inflammation were associated with early mortality (PHQ−9: hazard ratio [HR], 1.04; 95% CI, 1.02-1.07; SII: HR, 1.36; 95% CI, 1.08-1.71). The depression-survival association was fully mediated by inflammation (HR, 1.28; 95% CI, 1.00-1.64). Depressive symptoms were also associated with poorer tumor response (odds ratio, 1.05; 95% CI, 1.01-1.08), and the depression-survival association was partially mediated by tumor response (HR, 9.44; 95% CI, 6.23-14.32). Systemic inflammation was not associated with tumor response.ConclusionsIn this cohort study, systemic inflammation emerged as a novel candidate mechanism of the association of depression with mortality. Tumor response partially mediated effects of depression on mortality, replicating prior work. Thus, depression stands out as a highly feasible target for renewed clinical attention. Even mild symptoms of depression during the treatment-planning phase may be associated with higher systemic inflammation in addition to poorer tumor response to treatment and survival outcomes; therefore, depression should be clinically addressed.

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Section: Discussionmentioning

confidence: 99%

Depressive Symptoms, Systemic Inflammation, and Survival Among Patients With Head and Neck Cancer

Cash,

Albert,

Palmer

et al. 2024

JAMA Otolaryngol Head Neck Surg

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Survivorship Needs in Patients With Head and Neck Cancer in Regional, Rural and Remote Areas: A Systematic Review

Pradhan,

Sharman,

Palme

et al. 2024

Psycho-Oncology

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ObjectiveUnderstanding survivorship issues among people with head and neck cancer (HNC) is important as survival rates increase. Most research has focused on urban patients, leaving a gap in understanding the challenges faced by those in rural areas. This study aims to summarise the literature on survivorship needs for people with HNC in rural areas.MethodsPubMed, PsycINFO, Scopus, Medline, CINAHL, Web of Science, and Embase were searched from database inception to 10 July 2024, with no restriction on publication period, country, or language. Data on study aims, country, methodology, and major findings related to HNC survivors in rural areas were extracted. Study quality was assessed using the Joanna Briggs Institute critical appraisal checklists.ResultsTwenty‐one studies met the inclusion criteria. Eight studies were qualitative, 11 were quantitative, and two adopted a mixed‐methods approach. Results demonstrate the impact of complex treatments on physical (n = 13) and psychosocial (n = 14) functioning. This study also emphasises multifaceted challenges, including reduced access to specialised services, resulting in greater travel and financial burden, extending to caregivers. Hence, primary healthcare services are crucial in supporting these patients closer to home.ConclusionsAddressing the gaps in equitable post‐treatment care requires an even distribution of healthcare funding and workforce in rural areas. Future research could target these issues to develop tailored interventions or models of care, such as shared care, to ease access and financial burden.

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A population-based analysis of the management of symptoms of depression among patients with stage IV non-small cell lung cancer (NSCLC) in Ontario, Canada

Tan,

Tjong,

Chan

et al. 2024

Support Care Cancer

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Gaps in Depression Symptom Management for Patients With Head and Neck Cancer

Cited by 6 publications

References 58 publications

Depressive Symptoms, Systemic Inflammation, and Survival Among Patients With Head and Neck Cancer

Depressive Symptoms, Systemic Inflammation, and Survival Among Patients With Head and Neck Cancer

Survivorship Needs in Patients With Head and Neck Cancer in Regional, Rural and Remote Areas: A Systematic Review

A population-based analysis of the management of symptoms of depression among patients with stage IV non-small cell lung cancer (NSCLC) in Ontario, Canada

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