Smoking, drinking, and depression: comorbidity in head and neck cancer patients undergoing radiotherapy

McCarter, Kristen; Baker, Amanda; Britton, Ben; Wolfenden, Luke; Wratten, Chris; Bauer, Judith; Halpin, Sean; Carter, Gregory; Beck, Alison; Leigh, Lucy; Oldmeadow, Christopher

doi:10.1002/cam4.1497

Cited by 26 publications

(40 citation statements)

References 40 publications

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“…These symptoms may cause circadian rhythm changes among HNC patients and may contribute to the high prevalence of insomnia and hypersomnolence during treatment. Moreover, one out of five HNC patients continues smoking or drinking alcohol during cancer treatment [69] which may worsen their sleep problems. Pain-relievers such as opioids are also often prescribed during cancer treatment and may result in sleepewake rhythm changes [16,17].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of sleep disturbances among head and neck cancer patients: A systematic review and meta-analysis

Santoso

Jansen

Vries

et al. 2019

Sleep Medicine Reviews

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This systematic review and meta-analysis aim to investigate the prevalence rates of various types of sleep disturbances among head and neck cancer (HNC) patients before, during, and after cancer treatment. We performed a systematic search on PubMed, Embase, CINAHL, and PsycINFO to find studies that reported the prevalence of any type of sleep disturbance among adult HNC patients. Meta-analyses of prevalence were performed using random effects models, with I 2 values to indicate the extent of heterogeneity. In total, 29 studies of accumulatively 2315 HNC patients were included. The quality of the studies was fairly low and the heterogeneity was high. Studies on three types of sleep disturbances were found: insomnia (17 studies), hypersomnolence (12 studies), and sleep-related breathing disturbances (14 studies). The prevalence of insomnia was 29% (95% CI 20e41%) before treatment, 45% (95% CI 33e58%) during treatment, and 40% (95% CI 24e58%) after treatment, while for hypersomnolence the prevalence was 16% (95% CI 7e32%) before treatment and 32% (95% CI 20e48%) after treatment. The prevalence of sleeprelated breathing disturbances before and after treatment was 66% (95% CI 44e82%) and 51% (95% CI 34e67%), respectively. These results imply that sleep disturbances are highly prevalent among HNC patients before, during, and after treatment.

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Section: Discussionmentioning

confidence: 99%

Prevalence of sleep disturbances among head and neck cancer patients: A systematic review and meta-analysis

Santoso

Jansen

Vries

et al. 2019

Sleep Medicine Reviews

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“…Only recently, we reported on inferior survival rates even for HPVpositive HNSCCs cases when the patients were former or active smokers (5). Since it is established that a positive smoking history is significantly linked to the presence of co-morbidities (11)(12)(13) it could be assumed that not the smoking habit per se is causally linked to poor survival rates of smokers but rather to smoking associated co-morbidities of these patients (14). Smoking induced co-morbidity might therefore affect therapy compliance and regimens for example in terms of not reaching planned dosage of radiation or chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

The Influence of Smoking and Co-morbidity on Dose Achievement in Primary or Adjuvant Radio(Chemo)Therapy in Head and Neck Squamous Cell Carcinoma (HNSCC)

et al. 2020

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Introduction: Smoking has a negative impact on survival of HNSCC patients. In addition, smoking is associated with the prevalence of co-morbidities and, thus, it may be assumed that not smoking per se but co-morbidities impact the course of therapy in terms of lower compliance and dose-reduction. However, data addressing this issue is sparse and conflicting at present, specifically for HNSCCs. Patients and methods: Patient files and tumor documentation from 643 consecutive cases of the University Head and Neck Cancer Centre Kiel were analyzed retrospectively. Patient characteristics and smoking habits were assessed and correlated with co-morbidities and course of treatment. Results: The examined 643 patient files showed that 113 (17.6%), 349 (54.3%), and 180 (28%) patients were never, active, and former smokers, respectively. Three hundred fifteen (49%) were treated by surgery only; 121 (18.8%) received surgery + adjuvant RCT and 72 (11.2%) surgery + adjuvant RT. 111 (17.3%) received primary RCT and 24 (3.7%) primary RT. 131 (20.4%) and 512 (79.6%) had no or had co-morbidities, respectively. Smoking (>10 py) was significantly associated with co-morbidities (p = 0.002). However, smoking and co-morbidities, neither alone nor in combination, were correlated with failure in reaching target doses of radio(chemo)therapy (p > 0.05). Applying (verified) Carlson-Comorbidity-Index (CCI) did not change the results. Conclusions: As expected, smoking is significantly associated with co-morbidities. Dose-reduction of radio(chemo)therapy is as common among active smokers and patients with co-morbidities as among never smokers and patients without comorbidities. Thus, smoking and co-morbidity seems to impact survival by other means than impairing planned therapy regimens.

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“…Problem alcohol use is a known risk factor for the development of head and neck cancer (HNC) and continued use after diagnosis is associated with cancer recurrence, significant comorbidities including poor long‐term survival, and poor psychosocial outcomes including depression and reduced HNC‐specific health‐related quality of life (HRQOL) 1–5 . Estimates suggest that upwards of thirty percent of HNC patients demonstrate problem alcohol use with many continuing to exhibit this behavior into the survivorship period 6–9 …”

Section: Introductionmentioning

confidence: 99%

Problem alcohol use among rural head and neck cancer patients at diagnosis: Associations with health‐related quality of life

et al. 2021

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Objective Problem alcohol use in persons with head and neck cancer (HNC) is associated with poor outcomes, including survival. Some evidence suggests that individuals living in rural areas may be at greater risk of problem alcohol use. The present exploratory cross‐sectional study sought to examine problem alcohol use at diagnosis in a sample of HNC patients by rural versus urban status. Methods Self‐reported problem alcohol use as measured by the Short Michigan Alcoholism Screening Test (SMAST) was examined in rural and urban HNC patients at diagnosis (N = 454). Multivariable linear regression analysis was conducted to examine correlates of problem alcohol use. Subgroup analyses examined HNC‐specific health‐related quality of life (HRQOL) by problem drinking status at diagnosis and 3‐ and 12‐month postdiagnosis in rural patients. Results Multivariable linear regression analysis controlling for age, cancer site, cancer stage, depressive symptoms at diagnosis, and tobacco use at diagnosis indicated that rural residence was significantly associated with SMAST scores at diagnosis such that rural patients were more likely to report higher scores (ß = 0.095, sr2 = 0.010, p = 0.04). Covariate‐adjusted subgroup analyses suggest that rural patients with self‐reported problem alcohol use may exhibit deficits in HNC‐specific HRQOL at diagnosis and 3‐ and 12‐month postdiagnosis. Conclusions HNC patients should be screened for problem alcohol use at diagnosis and counseled regarding the deleterious effects of continued drinking during treatment and beyond. Because access to treatment and referral options may be lacking in rural areas, additional ways of connecting rural patients to specialty care should be explored.

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Smoking, drinking, and depression: comorbidity in head and neck cancer patients undergoing radiotherapy

Cited by 26 publications

References 40 publications

Prevalence of sleep disturbances among head and neck cancer patients: A systematic review and meta-analysis

Prevalence of sleep disturbances among head and neck cancer patients: A systematic review and meta-analysis

The Influence of Smoking and Co-morbidity on Dose Achievement in Primary or Adjuvant Radio(Chemo)Therapy in Head and Neck Squamous Cell Carcinoma (HNSCC)

Problem alcohol use among rural head and neck cancer patients at diagnosis: Associations with health‐related quality of life

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