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Wang HQ, Lin H, Liu B. Research progress on the psychological burden and intervention measures in cancer patients. Front Psychiatry 2024; 15:1408762. [PMID: 38938456 PMCID: PMC11208330 DOI: 10.3389/fpsyt.2024.1408762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 05/16/2024] [Indexed: 06/29/2024] Open
Abstract
In the past 40 years, the gradually increasing incidence and mortality rates of malignant tumors have severely impacted the quality of life of patients, bringing significant physical and psychological burdens and becoming an increasingly serious social issue. With the development of medical standards, new methods for cancer detection and treatment have been continuously proposed. Although it has been proven that cancer is related to increased psychological burden and suicidal behaviors in patients, current research on the psychological burden caused by cancer is insufficient. Clinicians often overlook the psychological health issues of patients while treating their physical diseases. Considering the high incidence of cancer, this review will outline the psychological burdens of cancer patients worldwide in recent years and its high-risk factors. Moreover, this review will summarize the common methods for evaluating psychological burdens, present current predictive models and treatment methods for the psychological burden of cancer patients, aiming to provide a research basis and future direction for the timely and accurate assessment of the psychological burden in cancer patients.
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Affiliation(s)
- Han-Qi Wang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Hao Lin
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Bing Liu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral & Maxillofacial Head Neck Oncology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
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Kabalan S, Papadopoulos-Nydam G, Jeffery CC, Rieger J, Constantinescu G. Temporal Trends in Clinician-Assessed and Patient-Reported Swallowing Outcomes in Oropharyngeal Cancer Patients. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:492-505. [PMID: 36630888 DOI: 10.1044/2022_ajslp-22-00196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
BACKGROUND Dysphagia is a consequence of oropharyngeal squamous cell carcinoma (OPSCC) treatments and often results in a devastating reduction in quality of life (QoL; Nguyen et al., 2005; Pauloski, 2008). OBJECTIVES This study aimed to report temporal trends in swallowing outcomes using the Modified Barium Swallow Impairment Profile (MBSImP) and the M.D. Anderson Dysphagia Inventory (MDADI) and to study the relationship between these two measures. METHOD This was a retrospective review of clinical data collected in January 2013 to December 2017 from a tertiary care center. MBSImP PI scores and MDADI composite scores were collected pretreatment and 1, 6, and 12 months posttreatment. Data were analyzed in aggregate and stratified by treatment modality. To address the primary objective, descriptive statistics were used. To address the secondary objective, four Spearman tests were run between MBSImP PI and MDADI composite scores. RESULTS A total of 123 OPSCC participants were included. With respect to trends, MBSImP PI scores worsened 1 month posttreatment and remained impaired at 6 and 12 months. For MDADI composite scores, patient reports worsened 1 month posttreatment and subsequently improved at 6 and 12 months. MBSImP PI and MDADI composite scores were weakly negatively correlated (i.e., in agreement) at the pre- and 12-month posttreatment appointments. CONCLUSIONS Swallowing outcomes in OPSCC patients have distinct yet predictable trends for both clinician-assessed and patient-reported swallowing outcomes during the first year following cancer treatment. However, unlike previous findings, these two types of measures were in agreement at the pretreatment and 12 months posttreatment appointments.
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Affiliation(s)
- Sarah Kabalan
- Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Georgina Papadopoulos-Nydam
- Institute for Reconstructive Sciences in Medicine (iRSM), Misericordia Community Hospital, Edmonton, Alberta, Canada
| | - Caroline C Jeffery
- Institute for Reconstructive Sciences in Medicine (iRSM), Misericordia Community Hospital, Edmonton, Alberta, Canada
- Faculty of Medicine and Dentistry, Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Canada
| | - Jana Rieger
- Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
- Institute for Reconstructive Sciences in Medicine (iRSM), Misericordia Community Hospital, Edmonton, Alberta, Canada
| | - Gabriela Constantinescu
- Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
- Institute for Reconstructive Sciences in Medicine (iRSM), Misericordia Community Hospital, Edmonton, Alberta, Canada
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3
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Abstract
Survivorship for head and neck cancer patients presents unique challenges related to the anatomic location of their disease. After treatment, patients often have functional impairments requiring additional care and support. In addition, patients may have psychological challenges managing the effect of the disease and treatment. Routine screening is recommended for the identification of psychological conditions. This article reviews the latest research on key psychological conditions associated with head and neck cancer. It discusses risk factors for the development of each condition and provides recommendations for the management of patients who may present with psychological concerns.
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Affiliation(s)
- Ciaran Lane
- Department of Otolaryngology – Head and Neck Surgery, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Ryan C. Higgins
- Department of Otolaryngology – Head and Neck Surgery, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Neerav Goyal
- Department of Otolaryngology – Head and Neck Surgery, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania
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4
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Philteos J, Noel CW, Hallet J, Eskander A. Mental health considerations in patients undergoing complex head and neck reconstruction. Curr Opin Otolaryngol Head Neck Surg 2022; 30:380-383. [PMID: 35924661 DOI: 10.1097/moo.0000000000000827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW To summarize recent advances in the psycho-oncology literature, with a focus on findings relevant to the head and neck cancer patient. RECENT FINDINGS Patients with cancer are at an increased risk of suicide and self-harm. Head and neck cancer patients are among the highest risk compared with other cancer patients. Unique challenges pertaining to disfigurement and voicelessness may, in part, explain these observations. Patient-reported outcome measures can be used to help identify high-risk patients. SUMMARY Psychosocial support needs are highest for head and neck cancer patients. Patient-reported outcome measures should be integrated within clinical workflows to identify high-risk patients.
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Affiliation(s)
- Justine Philteos
- Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre and Michael Garron Hospital
| | - Christopher W Noel
- Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre and Michael Garron Hospital.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto
| | - Jullie Hallet
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto.,Division of Surgical Oncology, Odette Cancer Centre-Sunnybrook Health Sciences Centre, Toronto, Ontario.,Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Antoine Eskander
- Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre and Michael Garron Hospital.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto
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5
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Lines LM, Barch DH, Zabala D, Halpern MT, Jacobsen PB, Mollica MA. Associations between Mental Health and Care Experiences among Older Adults with Cancer. Psychooncology 2022; 31:1491-1501. [DOI: 10.1002/pon.5966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 05/02/2022] [Accepted: 05/08/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Lisa M. Lines
- RTI International 3040 E. Cornwallis Rd Research Triangle Park NC27709 United States
- University of Massachusetts Medical School 55 Lake Ave. North Worcester MA01655 United States
| | - Daniel H. Barch
- RTI International 3040 E. Cornwallis Rd Research Triangle Park NC27709 United States
- Tufts University Psychology Department Medford MA United States
| | - Diana Zabala
- RTI International 3040 E. Cornwallis Rd Research Triangle Park NC27709 United States
| | - Michael T. Halpern
- National Cancer Institute Division of Cancer Control and Population Sciences Healthcare Delivery Research Program Bethesda United States
| | - Paul B. Jacobsen
- National Cancer Institute Division of Cancer Control and Population Sciences Healthcare Delivery Research Program Bethesda United States
| | - Michelle A. Mollica
- National Cancer Institute Division of Cancer Control and Population Sciences Healthcare Delivery Research Program Bethesda United States
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Lenze NR, Bensen JT, Yarbrough WG, Shuman AG. Characteristics and outcomes associated with anxiety and depression in a head and neck cancer survivorship cohort. Am J Otolaryngol 2022; 43:103442. [PMID: 35405498 DOI: 10.1016/j.amjoto.2022.103442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 04/03/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE To assess the prevalence and predictors of mental health disorders (MDHs) among head and neck squamous cell carcinoma (HNSCC) survivors, and the association with health-related quality of life (HRQOL), pain, and survival outcomes. MATERIALS AND METHODS This was a retrospective, cross-sectional study of HNSCC survivors surveyed at an outpatient oncology clinic from May 2012 through July 2016. RESULTS Among 198 HNSCC survivors, 21% reported a MHD. Female sex (OR 6.60, 95% CI 2.08 to 20.98; p = 0.001) and Medicare insurance status (OR 4.95, 95% CI 1.52 to 16.11; p = 0.008) were significant predictors of reporting a MHD in the fully adjusted model. Patients reporting a MHD reported significantly worse pain (p < 0001) and worse HRQOL on the PROMIS Physical (p < 0.001), PROMIS Mental (p < 0.001), and FACT-GP (p < 0.026) questionnaires. Diagnosis of a MHD was not correlated with 5-year OS (74% vs. 84%; p = 0.087). CONCLUSION Initiatives for early identification and intervention of MHDs as part of survivorship initiatives may engender clinically meaningful outcomes in head and neck cancer.
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Affiliation(s)
- Nicholas R Lenze
- Department of Otolaryngology-Head & Neck Surgery, University of Michigan, Ann Arbor, MI, United States.
| | - Jeannette T Bensen
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Wendell G Yarbrough
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, NC, United States; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Department of Pathology, University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - Andrew G Shuman
- Department of Otolaryngology-Head & Neck Surgery, University of Michigan, Ann Arbor, MI, United States
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7
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Emotional distress among survivors of Adolescent and Young Adult cancer or adult cancer. Ann Epidemiol 2022; 72:48-56. [DOI: 10.1016/j.annepidem.2022.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 03/16/2022] [Accepted: 03/28/2022] [Indexed: 11/21/2022]
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Bhanja D, Ba D, Tuohy K, Wilding H, Trifoi M, Padmanaban V, Liu G, Sughrue M, Zacharia B, Leslie D, Mansouri A. Association of Low-Grade Glioma Diagnosis and Management Approach with Mental Health Disorders: A MarketScan Analysis 2005-2014. Cancers (Basel) 2022; 14:cancers14061376. [PMID: 35326529 PMCID: PMC8946211 DOI: 10.3390/cancers14061376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/27/2022] [Accepted: 03/04/2022] [Indexed: 12/04/2022] Open
Abstract
Simple Summary Low-grade gliomas (LGGs) comprise 13–16% of glial tumors. As survival for LGG patients has been improving, it is important to consider the effects of diagnosis and treatment on mental health. The aims of this retrospective cohort study were to determine the incidence, prevalence, and risk factors of mental health disorders (MHD) in LGG patients. In our analysis including 20,432 LGG patients, we identified an MHD prevalence of 60.9%. Of those with no history of prior MHD, 16.9% of LGG patients developed a new onset of MHD within 12 months of LGG diagnosis. Risk factors included female gender, ages 35–54, presence of seizures, and first-line surgical treatment. Therefore, proactive surveillance and counseling surrounding MHDs are recommended among LGG patients. Impact of surgery on brain networks affecting mood should also be considered. Abstract Low-grade gliomas (LGGs) comprise 13–16% of glial tumors. As survival for LGG patients has been gradually improving, it is essential that the effects of diagnosis and disease progression on mental health be considered. This retrospective cohort study queried the IBM Watson Health MarketScan® Database to describe the incidence and prevalence of mental health disorders (MHDs) among LGG patients and identify associated risk factors. Among the 20,432 LGG patients identified, 12,436 (60.9%) had at least one MHD. Of those who never had a prior MHD, as documented in the claims record, 1915 (16.7%) had their first, newly diagnosed MHD within 12 months after LGG diagnosis. Patients who were female (odds ratio (OR), 1.14, 95% confidence intervals (CI), 1.03–1.26), aged 35–44 (OR, 1.20, 95% CI, 1.03–1.39), and experienced glioma-related seizures (OR, 2.19, 95% CI, 1.95–2.47) were significantly associated with MHD incidence. Patients who underwent resection (OR, 2.58, 95% CI, 2.19–3.04) or biopsy (OR, 2.17, 95% CI, 1.68–2.79) were also more likely to develop a MHD compared to patients who did not undergo a first-line surgical treatment. These data support the need for active surveillance, proactive counseling, and management of MHDs in patients with LGG. Impact of surgery on brain networks affecting mood should also be considered.
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Affiliation(s)
- Debarati Bhanja
- Penn State College of Medicine, Hershey, PA 17033, USA; (D.B.); (K.T.); (H.W.); (M.T.)
| | - Djibril Ba
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA; (D.B.); (G.L.); (D.L.)
| | - Kyle Tuohy
- Penn State College of Medicine, Hershey, PA 17033, USA; (D.B.); (K.T.); (H.W.); (M.T.)
| | - Hannah Wilding
- Penn State College of Medicine, Hershey, PA 17033, USA; (D.B.); (K.T.); (H.W.); (M.T.)
| | - Mara Trifoi
- Penn State College of Medicine, Hershey, PA 17033, USA; (D.B.); (K.T.); (H.W.); (M.T.)
| | - Varun Padmanaban
- Department of Neurosurgery, Penn State College of Medicine, Hershey, PA 17033, USA; (V.P.); (B.Z.)
| | - Guodong Liu
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA; (D.B.); (G.L.); (D.L.)
| | - Michael Sughrue
- Centre for Minimally Invasive Neurosurgery, Prince of Wales Private Hospital, Randwick, NSW 2031, Australia;
| | - Brad Zacharia
- Department of Neurosurgery, Penn State College of Medicine, Hershey, PA 17033, USA; (V.P.); (B.Z.)
- Penn State Cancer Institute, Hershey, PA 17033, USA
| | - Douglas Leslie
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA; (D.B.); (G.L.); (D.L.)
| | - Alireza Mansouri
- Department of Neurosurgery, Penn State College of Medicine, Hershey, PA 17033, USA; (V.P.); (B.Z.)
- Penn State Cancer Institute, Hershey, PA 17033, USA
- Correspondence:
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Gavidia R, Dunietz GL, O'Brien LM, Schütz SG, Spector ME, Swiecicki PL, Chervin RD. Risk of obstructive sleep apnea after treatment of head and neck squamous cell carcinoma: a cross-sectional study. J Clin Sleep Med 2022; 18:1681-1686. [PMID: 35236549 DOI: 10.5664/jcsm.9954] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Head and neck squamous cell carcinoma (HNSCC) or its treatment may be associated with an increased risk of obstructive sleep apnea (OSA). However, reported relationships between OSA risk factors and HNSCC are inconsistent. This study examined associations between tumor variables and risk of OSA at least one year after completion of treatment for HNSCC. METHODS This cross-sectional study included HNSCC patients of a large academic medical center. Inclusion criteria were age ≥18 years, cancer free for at least one year, with absence of tracheostomy or mental impairment. The STOP-BANG questionnaire, with a threshold ≥3, was used to classify HNSCC patients into elevated and low OSA risk. Tumor characteristics and treatment types were obtained from medical records. Descriptive statistics were used to compare characteristics between OSA risk groups. Unadjusted and age-adjusted logistic and linear regression models were used to explore associations between exposures and OSA risk. RESULTS Among 67 participants, 85% were males, mean age was 62.0 years (8.0 SD), mean body mass index was 28.7 kg/m2 (4.6 SD), and mean neck circumference was 16.3 inches (1.2 SD). Three-quarters of participants received chemoradiation only. Elevated OSA risk was observed in 60% of the participants. Tumor location, tumor stage, and type of cancer treatment were not different between OSA risk groups. Hyperlipidemia was more common in the elevated OSA risk group vs. the low risk (n=16, 40% vs. n=2, 7%, p=0.004). Age-adjusted analysis showed a trend toward twofold increased odds of elevated OSA risk in patients with tumors at the base of the tongue in comparison to other locations (OR=2.3, 95% CI 0.9, 6.4). No associations between tumor stage, cancer treatment, and elevated OSA risk were observed. CONCLUSIONS Elevated OSA risk was common after HNSCC treatment. However, measured HNSCC characteristics generally were not different between elevated and low OSA risk groups. Given the high frequency of OSA that appears likely to exist in HNSCC patients, clinicians should inquire about OSA features in patients with a history of HNSCC.
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Affiliation(s)
- Ronald Gavidia
- Department of Neurology, Division of Sleep Medicine, University of Michigan, Ann Arbor, Michigan
| | - Galit Levi Dunietz
- Department of Neurology, Division of Sleep Medicine, University of Michigan, Ann Arbor, Michigan
| | - Louise M O'Brien
- Department of Neurology, Division of Sleep Medicine, University of Michigan, Ann Arbor, Michigan
| | - Sonja G Schütz
- Department of Neurology, Division of Sleep Medicine, University of Michigan, Ann Arbor, Michigan
| | - Matthew E Spector
- Department of Otolaryngology and Head and Neck Surgery, University of Michigan, Ann Arbor
| | - Paul L Swiecicki
- Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, Michigan
| | - Ronald D Chervin
- Department of Neurology, Division of Sleep Medicine, University of Michigan, Ann Arbor, Michigan
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Multi-domain analysis of non-surgical risk factors amenable to pre-operative optimization in microvascular head and neck surgery. Am J Otolaryngol 2022; 43:103346. [PMID: 35016097 DOI: 10.1016/j.amjoto.2021.103346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/22/2021] [Accepted: 12/13/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE The goal of this study was to conduct a multi-domain, organ system-based analysis of non-surgical comorbidities amenable to pre-operative optimization in patients undergoing free tissue transfer, in order to better understand factors that influence patient outcomes. STUDY DESIGN Retrospective review. SETTINGS Tertiary academic center. MATERIALS AND METHODS A retrospective analysis of 546 patients in a prospectively maintained database who underwent free tissue transfer reconstruction between 2007 and 2016 was performed. Analysis of the relationship between binary-coded system-based domains and log-transformed length of stay (LOS), rehabilitation requirement, 30-day readmission, and post-operative complications was conducted with multiple linear regression or logistic regression models. RESULTS Poor nutritional status and the presence of anxiety/depression independently increased median hospital LOS. Endocrine and metabolic deficits, poor nutrition status, and psychiatric comorbidities were significant predictors for rehabilitation facility requirement upon discharge. CONCLUSION Interventions targeted to patient psychiatric and nutritional health may yield substantially improved outcomes in the head and neck cancer population receiving free tissue transfer surgery.
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Nehlsen AD, Sindhu KK, Jones BM, Lehrer EJ, Rowley JP, Bakst RL. Moving beyond Definitive Therapy: Increasing Physical Activity in Survivors of Cancers of the Head and Neck. Curr Oncol 2022; 29:1213-1222. [PMID: 35200602 PMCID: PMC8870667 DOI: 10.3390/curroncol29020103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/29/2022] [Accepted: 02/10/2022] [Indexed: 11/16/2022] Open
Abstract
As chemotherapeutic, radiation, and surgical techniques have improved, there has been a dramatic improvement in survival in patients diagnosed with cancers of the head and neck. As a result, a heightened focus on survivorship by clinicians will increasingly prove necessary. In particular, medical care teams will have to pay special attention to mitigating the long-term sequelae of definitive cancer treatments, many of which act as barriers to exercise. This is unfortunate, as the benefits of exercise in patients with cancer have become increasingly recognized. In this review, we discuss the potential benefits of and barriers to exercise in survivors of cancers of the head and neck. We also review existing exercise guidelines and strategies by which clinicians can promote exercise in this unique patient population.
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Flach S, Howarth K, Hackinger S, Pipinikas C, Ellis P, McLay K, Marsico G, Forshew T, Walz C, Reichel CA, Gires O, Canis M, Baumeister P. Liquid BIOpsy for MiNimal RESidual DiSease Detection in Head and Neck Squamous Cell Carcinoma (LIONESS)-a personalised circulating tumour DNA analysis in head and neck squamous cell carcinoma. Br J Cancer 2022; 126:1186-1195. [PMID: 35132238 PMCID: PMC9023460 DOI: 10.1038/s41416-022-01716-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 12/11/2021] [Accepted: 01/21/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Head and neck squamous cell carcinoma (HNSCC) remain a substantial burden to global health. Cell-free circulating tumour DNA (ctDNA) is an emerging biomarker but has not been studied sufficiently in HNSCC. METHODS We conducted a single-centre prospective cohort study to investigate ctDNA in patients with p16-negative HNSCC who received curative-intent primary surgical treatment. Whole-exome sequencing was performed on formalin-fixed paraffin-embedded (FFPE) tumour tissue. We utilised RaDaRTM, a highly sensitive personalised assay using deep sequencing for tumour-specific variants, to analyse serial pre- and post-operative plasma samples for evidence of minimal residual disease and recurrence. RESULTS In 17 patients analysed, personalised panels were designed to detect 34 to 52 somatic variants. Data show ctDNA detection in baseline samples taken prior to surgery in 17 of 17 patients. In post-surgery samples, ctDNA could be detected at levels as low as 0.0006% variant allele frequency. In all cases with clinical recurrence to date, ctDNA was detected prior to progression, with lead times ranging from 108 to 253 days. CONCLUSIONS This study illustrates the potential of ctDNA as a biomarker for detecting minimal residual disease and recurrence in HNSCC and demonstrates the feasibility of personalised ctDNA assays for the detection of disease prior to clinical recurrence.
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Affiliation(s)
- Susanne Flach
- Department of Otorhinolaryngology, Head and Neck Surgery, Hospital of the Ludwig-Maximilians-University (LMU) of Munich, Marchioninistrasse 15, 81377, Munich, Germany.
| | | | | | | | - Pete Ellis
- Inivata Ltd, Babraham Research Park, Cambridge, UK
| | | | | | - Tim Forshew
- Inivata Ltd, Babraham Research Park, Cambridge, UK
| | - Christoph Walz
- Institute of Pathology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Christoph A Reichel
- Department of Otorhinolaryngology, Head and Neck Surgery, Hospital of the Ludwig-Maximilians-University (LMU) of Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Olivier Gires
- Department of Otorhinolaryngology, Head and Neck Surgery, Hospital of the Ludwig-Maximilians-University (LMU) of Munich, Marchioninistrasse 15, 81377, Munich, Germany.,Clinical Cooperation Group "Personalised Radiotherapy in Head and Neck Cancer", German Research Centre for Environmental Health GmbH, Neuherberg, Munich, Germany
| | - Martin Canis
- Department of Otorhinolaryngology, Head and Neck Surgery, Hospital of the Ludwig-Maximilians-University (LMU) of Munich, Marchioninistrasse 15, 81377, Munich, Germany.,Clinical Cooperation Group "Personalised Radiotherapy in Head and Neck Cancer", German Research Centre for Environmental Health GmbH, Neuherberg, Munich, Germany
| | - Philipp Baumeister
- Department of Otorhinolaryngology, Head and Neck Surgery, Hospital of the Ludwig-Maximilians-University (LMU) of Munich, Marchioninistrasse 15, 81377, Munich, Germany.,Clinical Cooperation Group "Personalised Radiotherapy in Head and Neck Cancer", German Research Centre for Environmental Health GmbH, Neuherberg, Munich, Germany
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13
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Maurer R, McNutt S, Daggubati LC, Ba DM, Liu G, Leslie D, Goyal N, Zacharia BE. Mental health disorders in newly diagnosed non-functional pitutary adenoma under initial observation: an observational cohort study using the nationwide MarketScan database. Pituitary 2022; 25:85-91. [PMID: 34269977 DOI: 10.1007/s11102-021-01172-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/05/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Nonfunctioning pituitary adenomas account for 15-30% of pituitary tumors. Studies exploring the role of an intracranial tumor diagnosis, specifically nonfunctioning pituitary adenomas, on mental health disorders (MHDs) in patients have been limited. We characterize the incidence and factors affecting the development of MHDs in untreated pituitary adenomas. METHODS Utilizing a large-scale private payor database, MarketScan, we performed a retrospective study of patients with an untreated pituitary adenomas and corresponding MHD. RESULTS We found that in patients diagnosed with an untreated pituitary adenomas, approximately 15% were newly diagnosed with a MHD within 1 year of the pituitary adenoma diagnosis. Independent risk factors included female gender and substance abuse. Headaches, visual symptoms, and higher Charlson Co-morbidity indexes were also independently associated with a subsequent diagnosis of MHD. On multivariable analysis, patients in the pituitary tumor cohort were more likely to be diagnosed with a MHD than those in the matched cohort (aOR: 1.31, CI: 1.19-1.44). CONCLUSION By identifying risk factors, advanced screening can focus on non-operative pituitary adenoma patients at high-risk for the development of MHD.
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Affiliation(s)
- Robert Maurer
- College of Medicine, The Pennsylvania State University, 500 University Dr., Hershey, PA, 17033, USA
- Department of Neurosurgery, Penn State Hershey Medical Center, 30 Hope Drive, Hershey, PA, 17033, USA
| | - Sarah McNutt
- College of Medicine, The Pennsylvania State University, 500 University Dr., Hershey, PA, 17033, USA
- Department of Neurosurgery, Penn State Hershey Medical Center, 30 Hope Drive, Hershey, PA, 17033, USA
| | - Lekhaj C Daggubati
- College of Medicine, The Pennsylvania State University, 500 University Dr., Hershey, PA, 17033, USA
- Department of Neurosurgery, Penn State Hershey Medical Center, 30 Hope Drive, Hershey, PA, 17033, USA
| | - Djibril M Ba
- College of Medicine, The Pennsylvania State University, 500 University Dr., Hershey, PA, 17033, USA
- Department of Otolaryngology-Head and Neck Surgery, Penn State Hershey Medical Center, 500 University Dr., MC H091, Hershey, PA, 17033, USA
- Department of Public Health Sciences, University Park, PA, 16802, USA
| | - Guodong Liu
- College of Medicine, The Pennsylvania State University, 500 University Dr., Hershey, PA, 17033, USA
- Department of Otolaryngology-Head and Neck Surgery, Penn State Hershey Medical Center, 500 University Dr., MC H091, Hershey, PA, 17033, USA
- Department of Public Health Sciences, University Park, PA, 16802, USA
| | - Douglas Leslie
- College of Medicine, The Pennsylvania State University, 500 University Dr., Hershey, PA, 17033, USA
- Department of Otolaryngology-Head and Neck Surgery, Penn State Hershey Medical Center, 500 University Dr., MC H091, Hershey, PA, 17033, USA
- Department of Public Health Sciences, University Park, PA, 16802, USA
| | - Neerav Goyal
- College of Medicine, The Pennsylvania State University, 500 University Dr., Hershey, PA, 17033, USA
- Department of Neurosurgery, Penn State Hershey Medical Center, 30 Hope Drive, Hershey, PA, 17033, USA
- Department of Otolaryngology-Head and Neck Surgery, Penn State Hershey Medical Center, 500 University Dr., MC H091, Hershey, PA, 17033, USA
- Department of Public Health Sciences, University Park, PA, 16802, USA
| | - Brad E Zacharia
- College of Medicine, The Pennsylvania State University, 500 University Dr., Hershey, PA, 17033, USA.
- Department of Neurosurgery, Penn State Hershey Medical Center, 30 Hope Drive, Hershey, PA, 17033, USA.
- Department of Otolaryngology-Head and Neck Surgery, Penn State Hershey Medical Center, 500 University Dr., MC H091, Hershey, PA, 17033, USA.
- Department of Public Health Sciences, University Park, PA, 16802, USA.
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14
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Osazuwa-Peters N, Barnes JM, Okafor SI, Taylor DB, Hussaini AS, Adjei Boakye E, Simpson MC, Graboyes EM, Lee WT. Incidence and Risk of Suicide Among Patients With Head and Neck Cancer in Rural, Urban, and Metropolitan Areas. JAMA Otolaryngol Head Neck Surg 2021; 147:1045-1052. [PMID: 34297790 PMCID: PMC8304170 DOI: 10.1001/jamaoto.2021.1728] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 06/09/2021] [Indexed: 01/13/2023]
Abstract
Importance Patients with head and neck cancer (HNC) are known to be at increased risk of suicide compared with the general population, but there has been insufficient research on whether this risk differs based on patients' rural, urban, or metropolitan residence status. Objective To evaluate whether the risk of suicide among patients with HNC differs by rural vs urban or metropolitan residence status. Design, Setting, and Participants This cross-sectional study uses data from the Surveillance, Epidemiology, and End Results database on patients aged 18 to 74 years who received a diagnosis of HNC from January 1, 2000, to December 31, 2016. Statistical analysis was conducted from November 27, 2020, to June 3, 2021. Exposures Residence status, assessed using 2013 Rural Urban Continuum Codes. Main Outcomes and Measures Death due to suicide was assessed by International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes (U03, X60-X84, and Y87.0) and the cause of death recode (50220). Standardized mortality ratios (SMRs) of suicide, assessing the suicide risk among patients with HNC compared with the general population, were calculated. Suicide risk by residence status was compared using Fine-Gray proportional hazards regression models. Results Data from 134 510 patients with HNC (101 142 men [75.2%]; mean [SE] age, 57.7 [10.3] years) were analyzed, and 405 suicides were identified. Metropolitan residents composed 86.6% of the sample, urban residents composed 11.7%, and rural residents composed 1.7%. The mortality rate of suicide was 59.2 per 100 000 person-years in metropolitan counties, 64.0 per 100 000 person-years in urban counties, and 126.7 per 100 000 person-years in rural counties. Compared with the general population, the risk of suicide was markedly higher among patients with HNC in metropolitan (SMR, 2.78; 95% CI, 2.49-3.09), urban (SMR, 2.84; 95% CI, 2.13-3.71), and rural (SMR, 5.47; 95% CI, 3.06-9.02) areas. In Fine-Gray competing-risk analyses that adjusted for other covariates, there was no meaningful difference in suicide risk among urban vs metropolitan residents. However, compared with rural residents, residents of urban (subdistribution hazard ratio, 0.52; 95% CI, 0.29-0.94) and metropolitan counties (subdistribution hazard ratio, 0.55; 95% CI, 0.32-0.94) had greatly lower risk of suicide. Conclusions and Relevance The findings of this cross-sectional study suggest that suicide risk is elevated in general among patients with HNC but is significantly higher for patients residing in rural areas. Effective suicide prevention strategies in the population of patients with HNC need to account for rural health owing to the high risk of suicide among residents with HNC in rural areas.
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Affiliation(s)
- Nosayaba Osazuwa-Peters
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina
- Duke Cancer Institute, Durham, North Carolina
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
- Editorial Board Member, JAMA Otolaryngology–Head & Neck Surgery
| | - Justin M. Barnes
- Department of Radiation Oncology, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Somtochi I. Okafor
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina
| | | | - Adnan S. Hussaini
- Department of Otolaryngology–Head and Neck Surgery, Georgetown University Medical Center, Washington, DC
| | - Eric Adjei Boakye
- Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield
- Simmons Cancer Institute, Springfield, Illinois
| | - Matthew C. Simpson
- Department of Otolaryngology–Head and Neck Surgery, St Louis University School of Medicine, St Louis, Missouri
- Advanced Health Data Research Institute, St Louis University, St Louis, Missouri
| | - Evan M. Graboyes
- Editorial Board Member, JAMA Otolaryngology–Head & Neck Surgery
- Department of Otolaryngology–Head and Neck Surgery, Medical University of South Carolina, Charleston
- Hollings Cancer Center, Medical University of South Carolina, Charleston
| | - Walter T. Lee
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina
- Duke Cancer Institute, Durham, North Carolina
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15
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Nallani R, Smith JB, Penn JP, Bur AM, Kakarala K, Shnayder Y, Villwock MR, Sykes KJ. Decision regret 3 and 6 months after treatment for head and neck cancer: An observational study of associations with clinicodemographics, anxiety, and quality of life. Head Neck 2021; 44:59-70. [PMID: 34704319 DOI: 10.1002/hed.26911] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/26/2021] [Accepted: 10/05/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND While quality of life (QOL), psychosocial health, and adverse treatment outcomes have been studied in head and neck cancer (HNC) patients, decision regret is an important and understudied complication that can negatively impact future health care decision making. METHODS Data collected using a HNC patient registry with questionnaires administered at initial consultation visits plus 3 and 6 months after treatment completion was retrospectively analyzed. A visual analog anxiety scale and the University of Washington Quality of Life were given at clinic visits. Decision regret was determined using a validated scale. Demographic and clinical variables were collected retrospectively and at baseline. RESULTS Patients with higher anxiety and lower self-reported QOL had higher concurrent regret at 3-month (n = 140) and at 6-month (n = 82) post-treatment. Later disease stage at presentation, nonprimary surgical treatment, and lower health literacy were associated with greater regret. CONCLUSIONS Decision regret was highest in HNC patients with high anxiety, low QOL, and more advanced disease.
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Affiliation(s)
- Rohit Nallani
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Joshua B Smith
- Department of Otolaryngology-Head and Neck Surgery, Saint Louis University, St. Louis, Missouri, USA
| | - Joseph P Penn
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Andres M Bur
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Kiran Kakarala
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Yelizaveta Shnayder
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Mark R Villwock
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Kevin J Sykes
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
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16
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Balachandra S, Eary RL, Lee R, Wynings EM, Sher DJ, Sura T, Liu Y, Tillman BN, Sumer BD, Arnold EM, Tiro JA, Lee SC, Day AT. Substance use and mental health burden in head and neck and other cancer survivors: A National Health Interview Survey analysis. Cancer 2021; 128:112-121. [PMID: 34499355 DOI: 10.1002/cncr.33881] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/17/2021] [Accepted: 02/13/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Tobacco dependence, alcohol abuse, depression, distress, and other adverse patient-level influences are common in head and neck cancer (HNC) survivors. Their interrelatedness and precise burden in comparison with survivors of other cancers are poorly understood. METHODS National Health Interview Survey data from 1997 to 2016 were pooled. The prevalence of adverse patient-level influences among HNC survivors and matched survivors of other cancers were compared using descriptive statistics. Multivariable logistic regressions evaluating covariate associations with the primary study outcomes were performed. These included 1) current cigarette smoking and/or heavy alcohol use (>14 drinks per week) and 2) high mental health burden (severe psychological distress [Kessler Index ≥ 13] and/or frequent depressive/anxiety symptoms). RESULTS In all, 918 HNC survivors and 3672 matched survivors of other cancers were identified. Compared with other cancer survivors, more HNC survivors were current smokers and/or heavy drinkers (24.6% [95% CI, 21.5%-27.7%] vs 18.0% [95% CI, 16.6%-19.4%]) and exhibited a high mental health burden (18.6% [95% CI, 15.7%-21.5%] vs 13.0% [95% CI, 11.7%-14.3%]). In multivariable analyses, 1) a high mental health burden predicted for smoking and/or heavy drinking (odds ratio [OR], 1.4; 95% CI, 1.0-1.9), and 2) current cigarette smoking predicted for a high mental health burden (OR, 1.7; 95% CI, 1.2-2.3). Furthermore, nonpartnered marital status and uninsured/Medicaid insurance status were significantly associated with both cigarette smoking and/or heavy alcohol use (ORs, 1.9 [95% CI, 1.4-2.5] and 1.5 [95% CI, 1.0-2.1], respectively) and a high mental health burden (ORs, 1.4 [95% CI, 1.1 -1.8] and 3.0 [95% CI, 2.2-4.2], respectively). CONCLUSIONS Stakeholders should allocate greater supportive care resources to HNC survivors. The interdependence of substance abuse, adverse mental health symptoms, and other adverse patient-level influences requires development of novel, multimodal survivorship care interventions.
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Affiliation(s)
- Sanjana Balachandra
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Rebecca L Eary
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Rebecca Lee
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Erin M Wynings
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - David J Sher
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Teena Sura
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Yulun Liu
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Brittny N Tillman
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Baran D Sumer
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Elizabeth Mayfield Arnold
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Jasmin A Tiro
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas.,Simmons Comprehensive Cancer Center, Population Science and Cancer Control Program, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Simon C Lee
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas.,Simmons Comprehensive Cancer Center, Population Science and Cancer Control Program, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Andrew T Day
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.,Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas.,Simmons Comprehensive Cancer Center, Population Science and Cancer Control Program, University of Texas Southwestern Medical Center, Dallas, Texas
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17
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Gao J, Tseng CC, Barinsky GL, Povolotskiy R, Grube JG, Baredes S, Park RCW. Exploratory analysis on the association of mental health disorders with in-hospital postoperative complications and mortality in head and neck cancer surgery. Head Neck 2021; 43:3022-3031. [PMID: 34180571 DOI: 10.1002/hed.26791] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 05/16/2021] [Accepted: 06/10/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The objective was to assess the association of mental health disorders with in-hospital complication and mortality rates in patients undergoing head and neck cancer surgery. METHODS In this exploratory retrospective study, the Nationwide Inpatient Sample was queried from 2003 to 2014 for all patients with a diagnosis of head and neck cancer who underwent surgery. Univariate cross-tabulation, logistic regression, and propensity score matching (PSM) were used to compare demographics, procedure-related variables, and in-hospital postoperative complications and mortality between patients with and without selected comorbid mental health disorders. RESULTS Of 39 600 included patients, 3390 (8.6%) had a selected comorbid mental health disorder diagnosis. After PSM, patients with selected mental health disorders had increased risk of overall medical complications on multivariable analysis (OR 1.28 [CI 1.12-1.46], P < 0.001) but not overall surgical complications or mortality. CONCLUSIONS Patients with a mental health disorder diagnosis have increased risk of in-hospital medical, certain surgical, and total complications.
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Affiliation(s)
- Jeff Gao
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Christopher C Tseng
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Gregory L Barinsky
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Roman Povolotskiy
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Jordon G Grube
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Soly Baredes
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.,Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Richard Chan Woo Park
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
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18
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Maurer R, Daggubati L, Ba DM, Liu G, Leslie D, Goyal N, Zacharia BE. Mental health disorders in patients with untreated meningiomas: an observational cohort study using the nationwide MarketScan database. Neurooncol Pract 2020; 7:507-513. [PMID: 33014391 DOI: 10.1093/nop/npaa025] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Meningiomas are the most common primary tumor of the CNS. Studies investigating the impact of a brain tumor diagnosis on mental health disorders (MHDs) in patients have been limited. The objective of this work is to characterize the incidence and factors affecting the presence of MHDs in untreated meningiomas. Methods Using a large-scale private payer database, MarketScan, we performed a retrospective study of patients with an untreated meningioma and corresponding MHD. Results We found that in patients diagnosed with an untreated meningioma, approximately 16% were diagnosed with an MHD within 1 year of the diagnosis of the meningioma. Conclusion By identifying risk factors, appropriate screening can focus on patients at high-risk for the development of MHD.
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Affiliation(s)
- Robert Maurer
- The Pennsylvania State University, College of Medicine.,Department of Neurosurgery, Penn State Hershey Medical Center
| | - Lekhaj Daggubati
- The Pennsylvania State University, College of Medicine.,Department of Neurosurgery, Penn State Hershey Medical Center
| | - Djibril M Ba
- The Pennsylvania State University, College of Medicine.,Department of Otolaryngology-Head and Neck Surgery, Penn State Hershey Medical Center.,Department of Public Health Sciences, Penn State University, State College, Pennsylvania
| | - Guodong Liu
- The Pennsylvania State University, College of Medicine.,Department of Otolaryngology-Head and Neck Surgery, Penn State Hershey Medical Center.,Department of Public Health Sciences, Penn State University, State College, Pennsylvania
| | - Douglas Leslie
- The Pennsylvania State University, College of Medicine.,Department of Otolaryngology-Head and Neck Surgery, Penn State Hershey Medical Center.,Department of Public Health Sciences, Penn State University, State College, Pennsylvania
| | - Neerav Goyal
- The Pennsylvania State University, College of Medicine.,Department of Neurosurgery, Penn State Hershey Medical Center
| | - Brad E Zacharia
- The Pennsylvania State University, College of Medicine.,Department of Neurosurgery, Penn State Hershey Medical Center
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19
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Huang VW, Imam SA, Nguyen SA. Head and neck survivorship care in the times of the SARS-CoV-2 pandemic. Head Neck 2020; 42:1664-1667. [PMID: 32358880 PMCID: PMC7267631 DOI: 10.1002/hed.26235] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 04/24/2020] [Indexed: 12/31/2022] Open
Abstract
With the arrival of the coronavirus disease (SARS‐CoV‐2) in the United States, care practice paradigms have drastically changed. Data from China suggest that the new virus poses additional risks as case fatality of patients with cancer was higher at 5.6% compared to 2.3% of the general population. There are three proposed major strategies to address care for patients with cancer in this SARS‐CoV‐2 pandemic with postponing treatment for those with stable cancer, increasing personal protection provisions for patients with cancer, and increasing monitoring if a patient becomes infected with SARS‐CoV‐2. In this present commentary, we discuss the unique mental health challenges and burdens of patients with head and neck cancer in the times of the SARS‐CoV‐2 pandemic and approaches to mitigate these stressors through telemedicine to reduce future burdens to the patient and the health care system.
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Affiliation(s)
- Victoria W Huang
- College of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Sarah A Imam
- Department of Health and Human Performance, The Citadel, Charleston, South Carolina, USA
| | - Shaun A Nguyen
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
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20
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Dawson C, Roe J, Starmer H, Brady G, Nund R, Coffey M, Govender R, Patterson JM, Nankivell P, Topping A, Sharma N, Parmar S, Elkington C, Merrit M, Stanbury D, Pracy P. Patient advocacy in head and neck cancer: Realities, challenges and the role of the multi‐disciplinary team. Clin Otolaryngol 2020; 45:437-444. [DOI: 10.1111/coa.13508] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 01/12/2020] [Indexed: 12/17/2022]
Affiliation(s)
| | - Justin Roe
- Department of Speech & Language Therapy The Royal Marsden NHS Foundation Trust London UK
- Department of Surgery and Cancer Imperial College Healthcare NHS Trust London UK
- National Centre for Airway ReconstructionImperial College Healthcare Trust London UK
| | - Heather Starmer
- Department of Otolaryngology and Head and Neck Cancer Speech and Swallowing Rehabilitation Stanford Cancer Center CA USA
| | - Grainne Brady
- Department of Speech and Language Therapy The Royal Marsden NHS Foundation Trust London UK
| | - Rebecca Nund
- School of Health and Rehabilitation Sciences The University of Queensland Brisbane Qld. Australia
| | | | - Roganie Govender
- University College London Hospital NHS Foundation Trust London UK
| | | | | | | | - Neil Sharma
- Queen Elizabeth Hospital Birmingham Birmingham UK
| | - Sat Parmar
- Queen Elizabeth Hospital Birmingham Birmingham UK
| | | | | | | | - Paul Pracy
- Queen Elizabeth Hospital Birmingham Birmingham UK
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