Physical and Psychosocial Correlates of Head and Neck Cancer: A Review of the Literature

Abstract

This article reviews recent literature on the physical and psychosocial correlates of head and neck cancer, with a focus on quality-of-life issues, rehabilitation outcomes, and changes in the literature from the previous decade. These studies have shown that head and neck cancer has an enormous impact on the quality of life of patients. The most important physical symptoms are speech problems, dry mouth and throat, and swallowing problems. Pain is also frequently reported. Disturbances in psychosocial functioning and psychological distress are reported by a considerable number of patients; worry, anxiety, mood disorder, fatigue, and depression are the main symptoms. Cancer of the head and neck has a negative effect on social, recreational, and sexual functioning. Despite a growing number of longitudinal studies, little is known about the rehabilitation outcomes over a longer period of time. Future research is necessary to form a consensus about the further development and use of specific instruments to study patients with cancer of the head and neck, to conduct more prospective studies, and to develop programs that are aimed at maximizing rehabilitation outcomes and evaluate these programs with randomized designs.

Avaliação da qualidade de vida em pacientes laringectomizados: uma revisão sistemática

“…Tal fato tem a importân-cia de trazer para este estudo a corroboração de que avaliar qualidade de vida é tarefa recente que tem tido um significativo crescimento ao longo do período (Batel-Copel et al, 1997;Boer et al, 1999;Camilleri-Brennan & Steele, 1998).…”

“…No que se refere às características metodológicas dos estudos analisados, apenas cinco estudos eram estudos de coorte, o que traz para esta revisão, à semelhança do que se encontra em Boer et al (1999) e Gotay & Muraoka (1998), a possibilidade de mostrar que não existe um número significativo de estudos observacionais prospectivos que possam abarcar com maior especificidade a questão da qualidade de vida em pacientes laringectomizados, o que não se coaduna com o fato de que a sobrevida na maioria dos casos é considerada satisfatória (65% de taxa de sobrevida global em cinco anos).…”

“…Além disso, constatase que os estudos que pretendem obedecer aos preceitos metodológicos exigidos para tanto ainda o fazem, em sua maioria, de maneira incipiente. Afinal, foi constatado que a construção de instrumentos de domínios específicos se apresenta bastante aquém do pretendido por investigações que almejam consolidar os seus achados por meio de ferramentas de magnitude considerável (Batel-Copel et al, 1997;Boer et al, 1999). Além disso, deve-se considerar, também, o que assinalam Batel-Copel et al (1997:31): "a despeito de um crescente interesse dos oncologistas na qualidade de vida, ela é ainda raramente incluída como um objetivo em seus ensaios clínicos".…”

Goal processes & self-efficacy related to psychological distress in head & neck cancer patients and their partners

“…Vital functions can be affected and minor disturbances of anatomy by surgery or chemo/radiation therapy may lead to significant dysfunction and disfigurement, and hence to psychosocial complaints (De Boer et al, 1999). Recent literature suggests that such psychosocial consequences are not only observed in H&N cancer patients themselves.…”

Health-related quality of life in long-term head and neck cancer survivors: a comparison with general population norms

“…Although tumour sites (larynx, oral cavity, oropharynx, sinus and nose and the salivary glands) are known to affect crucial functions, such as the ability to breath, speak, eat and smell, until recently little has been known about how such impairments impact on the HRQL of H&N cancer patients.The first HRQL studies of H&N cancer patients were crosssectional or retrospective (Pruyn et al, 1986;de Boer et al, 1999), but during the last few years prospective studies have also been published (Jones et al, 1992; List et al, 1996;Deleyiannis et al, 1997;Funk et al, 1997;Hammerlid et al, 1997;Hammerlid et al 1997; Morton, 1997; Hammerlid et al, 1998; Hammerlid et al, 1998;Bjordal et al, 1999; de Graeff et al, 1999; de Graeff et al, 1999;Deleyiannis et al, 1999; List et al, 1999; Rogers et al, 1999). These studies have been performed with validated questionnaires and have consistently shown that H&N cancer patients' HRQL is significantly below norm values at diagnosis and decreases during and immediately after treatment.…”