Patient experience and anxiety during and after treatment for an HPV-related oropharyngeal cancer

Abstract

Objectives Diagnosis with an HPV-related oropharyngeal cancer includes unique social issues. However, it is unknown how common these psychosocial issues are for patients and whether they continue after treatment. Materials and Methods Patients with pathologically confirmed HPV-positive oropharyngeal cancer (HPV-OPC, n=48) were recruited from two medical centers. Participants completed a computer assisted self interview that explored their psychosocial experiences during and after treatment. We examined responses overall and by age. Results The majority of participants with confirmed HPV-OPC, reported being told that HPV could have (90%) or did cause (77%) their malignancy, but only 52% believed that HPV was the main cause of their OPC. Participants over 65 years were less likely than younger participants to report that their doctors told them their tumor was HPV-positive (50% vs 84%, p=0.03). Anxiety that their tumor was HPV-related was a major issue among participants when first diagnosed (93%). However, only 17% still reported anxiety after treatment was complete. While many patients reported that providers discussed the emotional effects of diagnosis and treatment adequately (58%), almost half reported discussing these emotional effects inadequately (24%), or not at all (18%). Further, 18% reported that their families still wondered about some questions that they had never asked. Conclusion After treatment, some HPV-OPC patients remain concerned about HPV and have unanswered questions about HPV. Older patients had lower awareness of the role of HPV in their cancer.

Increasing prevalence of human papillomavirus–positive oropharyngeal cancers among older adults

“…The majority were unable to show a significant difference in OS with each treatment modality by chronological age, yet there was a substantive correlation with the patient functional status instead . Older adults require more supportive care and have unique psychosocial experiences . They may potentially have distinct goals of treatment in the context of aging, a greater number of comorbidities, and a shorter posttreatment life expectancy.…”

Symptom burden as a driver of decisional regret in long‐term oropharyngeal carcinoma survivors

“…As many clinicians can attest, guiding a nonsmoking, physically active 50‐year‐old with low‐volume, HPV‐associated OPC through the treatment decision‐making process is increasingly complex . In the scenario in which various curative treatment options exist and functional outcomes are prioritized, decisional conflict can arise with the potential for decisional regret among survivors .…”

AHNS series: Do you know your guidelines? Management of head and neck cancer in the era of human papillomavirus: Educating our patients on human papillomavirus

“…When the diagnosis of HPV is made through cervical cancer screening, many women experience negative emotions, such as anger, isolation, guilt, and shame . In patients with oropharyngeal cancer, emotional reactions range from optimism related to an improved prognosis, to anxiety about transmission, or embarrassment from the HPV diagnosis . Understanding patients' emotions and experiences can help to facilitate conversations on these sensitive topics.…”

“…Transmission of HPV is a concern for many patients . A vast majority of patients (95%) discuss their HPV status with their partner, and 20% reported that this had some negative impact on their relationship .…”