Quality of life in head and neck cancer patients: A physiotherapist′s perspective

Abstract

Sir,We read with great interest the guest editorial by Kazi et al., [1] in the July-September 2010 issue of your journal. The rehabilitation of head and neck cancer patients is a subject of increasing importance. A physiotherapist can play an important role in the rehabilitation of a head and neck cancer patient thus improving the quality of life.Oral mucositis a common complication of cancer treatment in head and neck cancer patients leads to difficulty in tolerating food, affects speech and self esteem thus compromising patients' response to treatment which further affects the quality of life. It is therefore very important to prevent or treat oral mucositis. From the physiotherapy perspective, a study done in our institute showed that low level helium-neon laser therapy during chemo-radiotherapy was found to be effective in preventing and treating oral mucositis in head and neck cancer patients. [2] In addition head and neck cancer patients undergoing chemo-radiotherapy also exhibit decreased functional capacity and quality of life due to the adverse effects of chemo-radiotherapy like cancer related fatigue. A recent Cochrane review concluded that a structured exercise program during chemo-radiotherapy improves the quality of life in patients undergoing chemo-radiotherapy. [3] Unpublished data from a study done in our institute shows that a structured and individualized exercise program during chemo-radiotherapy leads to improvement in the physical as well as mental component on the medical outcomes study Short Form-36 questionnaire. Exercise also improves the psychological state of the patient by infusing self confidence and a feeling of well being. Thus a structured exercise program can play an important role in improving the functional capacity and quality of life in head and neck cancer patients receiving chemo-radiotherapy. A physiotherapy program can also play an important role in improving the decreased neck range of motion often seen in post surgical cases. Thus a structured physiotherapy program during chemo-radiotherapy and post surgery can play a major role in improving the quality of life in head and neck cancer patients by preventing complications like oral mucositis, decreased neck range of motion and cancer related fatigue which leads to decreased functional capacity.

Feasibility of a supervised and home‐based tailored exercise intervention in head and neck cancer patients during chemoradiotherapy

“…Firstly, participants of our study are likely to already be more active than non‐participants, which might have resulted in selection bias. This can be inferred from the baseline results of the 6MWT, which show higher scores as compared to comparable HNC populations (Samuel et al, 2013; Zhao et al, 2016). Also, compared to data from the Dutch Head and Neck audit, participants in our study are younger, and the prevalence of HPV is high (44.1%) (van Overveld et al, 2018).…”

“…Therefore, effects from exercise interventions in other cancer populations may not be generalizable to the HNC population. Pilot studies investigating physical exercise during (chemo)radiation in HNC are limited, have small sample sizes, and mainly focus on efficacy outcomes (e.g., physical functioning and HR‐QoL) instead of feasibility outcomes (Rogers et al, 2013; Samuel et al, 2013; Zhao et al, 2016). It therefore remains unclear whether patients with HNC will be able to complete an exercise intervention to a sufficient degree for the intended effects to occur during CRT.…”

Feasibility of individualized home exercise programs for patients with head and neck cancer – study protocol and first results of a multicentre single-arm intervention trial (OSHO #94)

“…To our knowledge, the OSHO #94 study is the first study to investigate the short-and medium-term effects of 100% individualized home training in PwHNC after completion of cancer therapy or in a stable situation under immunotherapy. In contrast to previous studies (28,(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60)(61), participants do not receive an exercise program with defined FITT criteria (FITT frequency, intensity, time, type) that apply equally to all intervention participants, but rather exercise recommendations based on the current physical activity guidelines for cancer survivors (62). The participants can perform the endurance training according to their preferences, and the recommendations regarding strength and mobility are adapted to the individual's needs/deficits.…”

Impact of Sarcopenia on Outcome of Exercise Therapy in Older Non-Hodgkin Lymphoma Patients

“…This self-administered questionnaire is widely used to examine patients undergoing chemotherapy for various types of cancer and those who have undergone hematopoietic stem cell transplantation. [27][28][29]…”