Body image: a critical psychosocial issue for patients with head and neck cancer

Salient body image concerns of patients with cancer undergoing head and neck reconstruction

BACKGROUND

Patients with cancer undergoing head and neck reconstruction can experience significant distress from alterations in appearance and bodily functioning. We sought to delineate salient dimensions of body image concerns in this patient population preparing for reconstructive surgery.

METHODS

Participants completed self-report questionnaires evaluating numerous aspects of body image. We used Bayesian factor analysis modeling methods to identify latent factors emerging from the data.

RESULTS

We identified 2 latent factors: appearance distress and functional difficulties. The highest level of preoperative body image concerns were related to distress about appearance changes and its perceived social consequences. Appearance distress items displayed greater variability compared with functional difficulties.

CONCLUSION

Appearance and functional changes to body image are important areas of concern for patients with head and neck cancer as they prepare for reconstructive surgery. Knowledge regarding specific body image issues can be used to guide psychosocial assessments and intervention to enhance patient care. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1035-1042, 2016.

Changes in the body image of bone sarcoma survivors following surgical treatment--A qualitative study

Background and Objectives

Among several long‐term effects, people treated for cancer may experience an altered appearance. Our study aims to identify how visible body changes following surgical treatment affect the life and identity of primary bone sarcoma survivors 3–10 years after diagnosis. A qualitative, phenomenological, and hermeneutic design was applied.

Methods

Sarcoma survivors (n = 18) who were previously treated at Norwegian Radium Hospital, Oslo University Hospital, participated in the study. In‐depth and semi‐structured interviews were conducted and analyzed using inductive thematic analysis.

Results

The main finding of this study concerned how altered appearance after bone cancer treatment in the hip/pelvis or lower extremities affected the participants’ self‐esteem. Half of the participants expressed concerns about their visible differences, particularly those with functional impairment. They felt that it is important to hide the bodily signs of changes to appear as normal as possible, as well as attractive and healthy. They describe, with specific examples, how these changes influence their self‐realization, especially their social life.

Conclusions

Healthcare providers who guide bone sarcoma survivors during follow‐up should develop a comprehensive understanding of what it means to cope with a changed and challenging body. J. Surg. Oncol. 2016;113:229–234. © 2015 The Authors. Journal of Surgical Oncology Published by Wiley Periodicals, Inc.

Management of post-operative fistula in head and neck surgery: Sweeping it under the carpet?

The most dreaded complication in head and neck surgery is the development of fistula. Fistulas are common and devastating. The prevalence and the risk factors that contribute to fistula formation after head and neck procedures were discussed briefly. The main goal of this manuscript is to discuss current management of head and neck fistula. We believed that the best management strategy for head and neck fistulas is prevention. We recommend a holistic preventive approach during the perioperative period. The roles of different types of wound products and hyperbaric oxygen therapy were also discussed and highlighted. We also discussed the operative repair of fistulas, which relies on the tenet of providing well-vascularized tissue to an area of poor wound healing. Most often, the surgeon’s preference and range of operative skills dictate the timing and the type of repair. We highlighted the use of the pectoralis major, a well-known flap, as well as a novel technique in the surgical repair of complex, difficult-to-heal head and neck fistula.