Survivorship support in head and neck cancer: American Head and Neck Society survey

Abstract

Background: The value of supporting cancer survivors beyond formal treatment has become increasingly recognized among clinicians who care for patients with head and neck cancer. Methods: A survey was developed by the American Head and Neck Society (AHNS) Survivorship Committee and distributed to members of the AHNS electronically. Results: The survey was distributed to 1403 AHNS members, with 202 responses (14.4%). Among survivorship topics, respondents were most likely to address detection of recurrence/second primary malignancies (97.5%), dysphagia (93.1%), and thyroid function (90.1%) with their patients; they were least likely to address sleep disturbance/apnea (27.7%) and body and self-image issues (29.7%.) Less than half provide patients with a written treatment summary (43.1%) or follow-up care plan (36.9%). Conclusions: These results highlight the need for improved survivorship care planning and offer an opportunity for the development of educational and survivorship research in head and neck cancer care. K E Y W O R D S head and neck cancer, surveillance, survivorship, treatment plan

Identification and management of late dysfunction in survivors of head and neck cancer: Implementation and outcomes of an interdisciplinary quality of life (IQOL) clinic

“…Determining the best method for survivorship care delivery is especially salient when considering that up to 68% of HNC survivors report unmet needs, the majority of which surround physical functioning, psychosocial distress, and coordination of care 17,18,20,21 . The nature and degree of anticipated functional deterioration in HNC survivors poses unique challenges to delivering comprehensive survivorship care.…”

“…Specific to HNC survivorship care, the American Society of Clinical Oncology and the American Cancer Society (ACS) endorse a model whereby HNC providers inform primary care providers (PCPs) of treatments administered, risks for recurrence and long‐term/late sequelae, and the PCP performs necessary screening and surveillance, making recommendations and referrals to ancillary/support services as needed 4,16 . In a recently published survey of the American Academy of Otolaryngology‐Head and Neck Surgery, 63% of respondents reported they follow their HNC survivors for life, with only 25.2% reporting that a dedicated head and neck survivorship clinic existed at their institution 17 . Whether led by a primary care or oncology provider, this single provider survivorship clinic model constitutes the bulk of published papers discussing HNC survivorship 15,17‐20 .…”

“…4,16 In a recently published survey of the American Academy of Otolaryngology-Head and Neck Surgery, 63% of respondents reported they follow their HNC survivors for life, with only 25.2% reporting that a dedicated head and neck survivorship clinic existed at their institution. 17 Whether led by a primary care or oncology provider, this single provider survivorship clinic model constitutes the bulk of published papers discussing HNC survivorship. 15,[17][18][19][20] Few papers report a multidisciplinary clinic approach (i.e., multiple disciplines evaluate a patient separately during a coordinated visit), and none report an interdisciplinary clinic approach (i.e., multiple disciplines evaluate a patient collaboratively in a single, shared clinic visit).…”

“…17 Whether led by a primary care or oncology provider, this single provider survivorship clinic model constitutes the bulk of published papers discussing HNC survivorship. 15,[17][18][19][20] Few papers report a multidisciplinary clinic approach (i.e., multiple disciplines evaluate a patient separately during a coordinated visit), and none report an interdisciplinary clinic approach (i.e., multiple disciplines evaluate a patient collaboratively in a single, shared clinic visit). Nilsen et al 21,22 report the use of a multidisciplinary survivorship clinic, however, provide few details about the model of care such as when survivorship care begins, which providers are present in the clinic, and what clinician-administered functional assessment measures are routinely utilized.…”

“…14,[24][25][26] Determining the best method for survivorship care delivery is especially salient when considering that up to 68% of HNC survivors report unmet needs, the majority of which surround physical functioning, psychosocial distress, and coordination of care. 17,18,20,21 The nature and degree of anticipated functional deterioration in HNC survivors poses unique challenges to delivering comprehensive survivorship care. The ACS details 21 aspects of physical and psychosocial functioning that should be monitored in HNC survivors, 4 including dysphagia, trismus, dysphonia, dysarthria, neck and shoulder dysfunction, hearing loss, dyspnea, and postural dysfunction.…”