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Humbert M, Lequesne J, Licaj I, Bon-Mardion N, Bouhnik AD, Huyghe E, Dugue J, Babin E, Rhamati L. Sexual health at 5 years after diagnosis of head and neck cancer. Support Care Cancer 2023; 31:535. [PMID: 37615815 DOI: 10.1007/s00520-023-07949-3] [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: 03/28/2023] [Accepted: 07/13/2023] [Indexed: 08/25/2023]
Abstract
PURPOSE Sexual health (SH) is an emerging concern in the assessment of quality of life in patients surviving head and neck cancer (HNC). Using data from the French National Prospective VICAN Survey, this study aimed to assess SH deterioration five years after HNC diagnosis and related factors. METHODS Using univariate and multivariate analyses were performed in the 241 HNC survivors. We studied the factors associated between the sexuality and intimate life of these patients with demographic and medical data from the national epidemiological survey VICAN 5. RESULTS Sexuality and body image were altered in 78.8% for men and 79.2% for women. This alteration in sexual quality of life affects both men and women. Dissatisfaction with the frequency of sexual intercourse was associated with being treated with radiotherapy (p=0.024), as well as decrease of sexual desire in patients treated with chemotherapy (p=0.044). Fatigue (p=0.002), impaired physical health (p=0.049), and high disease stage (p=0.001) remained significantly associated, after multivariate analysis, with decreased sexual desire. Among these 3 factors negatively influencing sexual quality of life, two are treatable with appropriate management. CONCLUSION Five years after the diagnosis of HNC, a decrease in sexuality and body image are frequent and significantly impact the quality of life of survivors. These observations imply an adaptation of the management of the professionals involved.
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Affiliation(s)
- M Humbert
- Department of Otorhinolaryngology Head and Neck Surgery, Normandie Univ, UNICAEN, CHU de Caen Normandie, Caen, France.
- INSERM 1086 ANTICIPE, Caen University, Caen, France.
| | - J Lequesne
- Clinical Research Department, Centre François Baclesse, Caen, France
| | - I Licaj
- Clinical Research Department, Centre François Baclesse, Caen, France
- Department of Community Medicine, The UiT Arctic University of Norway, Tromsø, Norway
| | - N Bon-Mardion
- Department of Otorhinolaryngology Head and Neck Surgery, Mathilde Clinic, 76100, Rouen, France
| | - A D Bouhnik
- Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, Aix Marseille Univ, Inserm, IRD, Marseille, France
| | - E Huyghe
- Department of Urology, 36760 University of Toulouse, Toulouse, France
| | - J Dugue
- Department of Otorhinolaryngology Head and Neck Surgery, Normandie Univ, UNICAEN, CHU de Caen Normandie, Caen, France
| | - E Babin
- Department of Otorhinolaryngology Head and Neck Surgery, Normandie Univ, UNICAEN, CHU de Caen Normandie, Caen, France
- INSERM 1086 ANTICIPE, Caen University, Caen, France
| | - L Rhamati
- Department of Otorhinolaryngology Head and Neck Surgery, Hopital du Pays Salonais, 13300, Salon de Provence, France
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Babin E, Heutte N, Humbert M, Laccourreye O. Sex-related quality of life after total laryngectomy for cancer. Eur Ann Otorhinolaryngol Head Neck Dis 2023; 140:121-126. [PMID: 37142505 DOI: 10.1016/j.anorl.2023.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
OBJECTIVES Analysis of the quality of sexual life after total laryngectomy (TL) for cancer. MATERIAL AND METHODS The Cochrane, PubMed, Embase, ClinicalKey and Science Direct databases were searched using the keywords: "total laryngectomy, sexual function, sexual behavior, sexual complications, sexual dysfunction, sexuality, intimacy". The abstracts of 69 articles were read by two of the authors and 24 articles were selected. The main endpoint was the impact of impairment of quality of sexual life after TL for cancer and the methods used to assess this. The secondary endpoints were the type of sexual impairment, associated variables and their treatment. RESULTS The study population consisted of 1511 TL patients aged 21 to 90 years, with a male/female sex ratio of 7.49. One of the 7 validated Likert scales was used in 79% of the articles to evaluate impairment of sexual quality of life. Impaired quality of sexual life was reported by 47% of patients on average (range, 5-90%). Erectile and ejaculatory function and ejaculatory behavior of male patients decreased after TL. Other impairments comprised decreases in libido, frequency of sexual intercourse and satisfaction. Tracheostomy, advanced disease stage, young age and associated depression were factors for impairment. In all, 23% of patients reported lack of postoperative support in this area. CONCLUSION The quality of sexual life is severely impacted by TL for cancer. The present data are a source of information and should be taken into account before carrying out TL. A common information tool needs to be developed. There is patient demand for improved management of sexuality.
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Affiliation(s)
- E Babin
- Service d'otorhinolaryngologie et de chirurgie cervicofaciale, laboratoire ANTICIPE, université de Caen, CHU de Côte-de-Nacre, 14000 Caen, France.
| | - N Heutte
- CETAPS UR3832, université de Rouen, boulevard Siegfried, 76821 Mont-Saint-Aignan cedex, France; Service de recherche clinique, CLCC François-Baclessec, Caen, France
| | - M Humbert
- Service d'otorhinolaryngologie et de chirurgie cervicofaciale, laboratoire ANTICIPE, université de Caen, CHU de Côte-de-Nacre, 14000 Caen, France
| | - O Laccourreye
- Service d'otorhinolaryngologie et de chirurgie cervicofaciale, HEGP, université de Paris-Cité, AP-HP, 20-40, rue Leblanc, 75015 Paris, France
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Laksar Klarić Ž, Danic Hadzibegovic A, Včeva A, Karadža Lapić L, Babler D, Kralik K, Bonetti A, Benšić A. Validation and Cross-Cultural Adaptation of Croatian Self-Evaluation of Communication Experiences after Laryngectomy Questionnaire. Folia Phoniatr Logop 2023; 75:273-283. [PMID: 36808105 DOI: 10.1159/000529771] [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: 07/26/2022] [Accepted: 02/08/2023] [Indexed: 02/19/2023] Open
Abstract
INTRODUCTION The Self-Evaluation of Communication Experiences after Laryngectomy (SECEL) is a 35-item patient-reported questionnaire developed to address the communication needs of patients with laryngectomies. The aim was to translate, cross-culturally adapt, and validate the Croatian version. METHODS The SECEL was translated from English by two independent translators and back-translated by a native speaker, after which it was approved by an expert committee. The Croatian version of the Self-Evaluation of Communication Experiences after Laryngectomy questionnaire (SECEL:HR) was filled in by 50 laryngectomised patients who had completed their oncological treatment a year prior to inclusion in the study. Patients also filled in the Voice Handicap Index (VHI) and the Short Form Health Survey (SF-36) on the same day. All patients completed the SECEL:HR twice, the second time being 2 weeks after the initial test. Maximum phonation time and diadochokinesis of articulation organs were used for objective assessment. RESULTS Among the Croatian patients, the questionnaire was well-accepted and demonstrated good test-retest reliability and internal consistency for two out of three subscales. The correlations between VHI, SF-36, and SECEL:HR were moderate to strong. There were no significant differences between patients who are using oesophageal speech, tracheoesophageal speech, or the electrolarynx based on the SECEL:HR. CONCLUSION Preliminary findings of the research indicate that the Croatian version of the SECEL has sufficient psychometric qualities, high reliability, and good internal consistency, with a Cronbach's alpha of 0.89 for the total score. The Croatian version of SECEL can be recommended as a reliable and clinically valid measure for the assessment of substitution voices in Croatian-speaking patients.
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Affiliation(s)
- Željka Laksar Klarić
- Faculty of Medicine, J.J. Strossmayer University, Osijek, Croatia
- Clinical Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Centre Osijek, Osijek, Croatia
| | - Ana Danic Hadzibegovic
- Clinical Department of Otorhinolaryngology and Head and Neck Surgery, Clinical Hospital Centre Zagreb, Zagreb, Croatia
- Faculty of Dental Medicine and Health, J.J. Strossmayer University of Osijek, Osijek, Croatia
- School of Medicine, Zagreb University, Zagreb, Croatia
- Faculty of Education and Rehabilitation Sciences, University of Zagreb, Zagreb, Croatia
| | - Andrijana Včeva
- Faculty of Medicine, J.J. Strossmayer University, Osijek, Croatia
- Clinical Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Centre Osijek, Osijek, Croatia
| | | | - Danijela Babler
- Department of ENT and Head and Neck Surgery, "Dr Josip Benčević" General Hospital, Slavonski Brod, Croatia
| | - Kristina Kralik
- Department of Medical Statistics and Informatics, Faculty of Medicine, J.J. Strossmayer University, Osijek, Croatia
| | - Ana Bonetti
- Faculty of Education and Rehabilitation Sciences, University of Zagreb, Zagreb, Croatia
| | - Anja Benšić
- Department of Audiology and Phoniatrics, Clinical Hospital Centre Rijeka, Rijeka, Croatia
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Zhu X, Liu D, Zong M, Wang J. Effect of swallowing training combined with nutritional intervention on the nutritional status and quality of life of laryngeal cancer patients with dysphagia after operation and radiotherapy. J Oral Rehabil 2022; 49:729-733. [PMID: 35352383 DOI: 10.1111/joor.13328] [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] [Received: 06/24/2021] [Revised: 01/06/2022] [Accepted: 03/24/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Dysphagia is a common complication in patients with laryngeal cancer after surgery and radiotherapy. OBJECTIVES To explore the effect of swallowing training administered in combination with nutritional intervention on the nutritional status and quality of life of laryngeal cancer patients with dysphagia after surgery and radiotherapy. METHODS Sixty-six patients with laryngeal cancer who developed dysphagia were randomly divided into control group and intervention group (n=33 in each group). Patients in both groups received total laryngectomy and prophylactic radiotherapy and were provided routine health counseling and swallowing training. Patients in the intervention group were additionally provided with nutritional intervention. All patients were evaluated using video fluoroscopic swallowing examination (VFSE), Patient-Generated Subjective Global Assessment on nutritional status (PG-SGA) score, and Quality of Life Questionnaire-core 30 (QLQ-c30) score immediately after radiotherapy and three months later. RESULTS Prior to swallowing training, there was no significant between-group difference with respect to VFSE evaluation, PG-SGA score, or QLQ-c30 score. Both groups showed improvement in these measures at three months after radiotherapy; however, the improvement in the intervention group was significantly better than that in the control group. CONCLUSIONS Swallowing training combined with nutritional intervention can improve swallowing function, nutritional status, and the quality of life of laryngeal cancer patients with dysphagia after operation and radiotherapy.
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Affiliation(s)
- Xuewei Zhu
- Department of otolaryngology head and neck surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Dahai Liu
- Department of Lymph and Vascular Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Minru Zong
- Department of Rehabilitation, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Jianfeng Wang
- Department of Radiotherapy, China-Japan Union Hospital of Jilin University, Changchun, China
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Verdonck-de Leeuw IM, Melissant H, Lissenberg-Witte BI, Baatenburg de Jong RJ, den Heijer M, Langendijk JA, René Leemans C, Smit JH, Takes RP, Terhaard CHJ, Jansen F, Laan E. Associations between testosterone and patient reported sexual outcomes among male and female head and neck cancer patients before and six months after treatment: A pilot study. Oral Oncol 2021; 121:105505. [PMID: 34461364 DOI: 10.1016/j.oraloncology.2021.105505] [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: 05/07/2021] [Revised: 07/30/2021] [Accepted: 08/18/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To investigate associations between testosterone and patient reported sexual problems and need for sexual care in head and neck cancer patients at time of diagnosis and 6 months after treatment. PATIENTS AND METHODS Data and samples were used of 40 patients (20 men, 20 women) before and 6 months after treatment. Outcome measures were total testosterone level (TT) and free testosterone index (FTI), testosterone insufficiency (TI), the EORTC QLQ-HN35 Sexuality subscale, the subscales of the International Index of Erectile Function (IIEF), Female Sexual Function Index (FSFI), and the Sexuality subscale of the Short-Form Supportive Care Needs Survey (SCNS-SF34). RESULTS In men, higher FTI before treatment was significantly associated with better IIEF Orgasm (p = 0.020) and at 6 months follow-up with IIEF Desire (p = 0.019). Before treatment, insufficient testosterone was present in 5 males (25%) and in 3 at follow-up (15%) (2 patients who had TI before treatment plus one). In women, higher TT at follow-up was significantly associated with better EORTC Sexuality (p = 0.031) and FSFI Satisfaction (p = 0.020); FTI at follow-up was associated with FSFI Satisfaction (p = 0.012). Before treatment, TI was present in 2 women (10%) and in 3 (15%) at follow-up (the same 2 patients plus one). CONCLUSION This pilot study showed that testosterone seems to be associated with patient reported sexual outcomes among male and female head and neck cancer patients. It is estimated that 10-25% of HNC patients may have testosterone insufficiency before treatment and/or at 6 months after treatment.
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Affiliation(s)
- Irma M Verdonck-de Leeuw
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Otolaryngology - Head and Neck Surgery, Amsterdam, the Netherlands; Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences & Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Cancer Center Amsterdam Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Heleen Melissant
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Otolaryngology - Head and Neck Surgery, Amsterdam, the Netherlands; Cancer Center Amsterdam Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Birgit I Lissenberg-Witte
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam, the Netherlands
| | - Robert J Baatenburg de Jong
- Department of Otolaryngology and Head and Neck Surgery, Erasmus Cancer Institute, Erasmus MC, Rotterdam, the Netherlands
| | - Martin den Heijer
- Department of Internal Medicine, AmsterdamUMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Johannes A Langendijk
- Department of Radiation Oncology, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - C René Leemans
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Otolaryngology - Head and Neck Surgery, Amsterdam, the Netherlands; Cancer Center Amsterdam Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Johannes H Smit
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health, Amsterdam, the Netherlands
| | - Robert P Takes
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Otorhinolaryngology and Head and Neck Surgery, Nijmegen, the Netherlands
| | - Chris H J Terhaard
- Department of Radiotherapy, University Medical Center, Utrecht, the Netherlands
| | - Femke Jansen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Otolaryngology - Head and Neck Surgery, Amsterdam, the Netherlands; Cancer Center Amsterdam Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Ellen Laan
- Department of Sexology and Psychosomatic OBGYN, Amsterdam Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
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Schutte LER, Melissant HC, Jansen F, Lissenberg-Witte BI, Leemans CR, Sprangers MAG, Vergeer MR, Verdonck-de Leeuw IM, Laan ETM. Effect of Stepped Care on Sexual Interest and Enjoyment in Distressed Patients with Head and Neck Cancer: A Randomized Controlled Trial. Sex Med 2021; 9:100304. [PMID: 33460907 PMCID: PMC7930858 DOI: 10.1016/j.esxm.2020.100304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 12/01/2020] [Accepted: 12/01/2020] [Indexed: 01/24/2023] Open
Abstract
Introduction A recent randomized controlled trial (RCT) in patients with head and neck cancer (HNC) with psychological distress showed that a stepped care (SC) program targeting psychological distress compared with care as usual (CAU), is (cost)effective in reducing psychological distress. Aim The aim of the present study was to investigate whether SC can coalleviate problems with sexual interest and enjoyment. A secondary aim was to investigate whether the presence of an unmet sexual health need and having a psychiatric disorder (depression or anxiety) at baseline moderated any effect of SC on these sexual variables until 1-year follow-up. Methods HNC survivors (N = 134), randomized to SC or CAU, were assessed regarding their sexual interest and enjoyment before and after the intervention and at 3, 6, 9, and 12 months follow-up. Linear mixed models were used to evaluate differences in the course of sexual interest and enjoyment between SC and CAU. Main Outcome Measure The “sexuality” symptom subscale, part of the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire, Head and Neck Cancer–specific module. Results Of all patients, 76.1% had an unmet sexual need at baseline, 24.6% had a psychiatric disorder (anxiety or depression). SC did not reduce problems with sexual interest and enjoyment at any of the follow-up measurements compared with CAU (P = .85). This was neither moderated by an unmet sexual health need at baseline (P = .64) nor by the presence of a psychiatric disorder at baseline (P = .59). Conclusion A substantial number of patients with HNC have unmet sexual health needs. SC targeting psychological distress does not reduce problems with sexuality in these patients. Interventions specifically targeting sexuality are recommended. Schutte LER, Melissant HC, Jansen F, et al. Effect of Stepped Care on Sexual Interest and Enjoyment in Distressed Patients with Head and Neck Cancer: A Randomized Controlled Trial. Sex Med 2021;9:100304.
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Affiliation(s)
- Laura E R Schutte
- Department of Sexology and Psychosomatic Gynaecology, Amsterdam University Medical Centers, Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Heleen C Melissant
- Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Femke Jansen
- Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Department of Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam, Amsterdam University Medical Centers, Location VUmc, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Birgit I Lissenberg-Witte
- Department of Epidemiology and Biostatistics, Amsterdam University Medical Centers, Location VUmc, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - C René Leemans
- Department of Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam, Amsterdam University Medical Centers, Location VUmc, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Mirjam A G Sprangers
- Department of Medical Psychology, Amsterdam University Medical Centers, Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marije R Vergeer
- Department of Radiation Oncology, Amsterdam University Medical Centers, Location VUmc, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Department of Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam, Amsterdam University Medical Centers, Location VUmc, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ellen T M Laan
- Department of Sexology and Psychosomatic Gynaecology, Amsterdam University Medical Centers, Location AMC, University of Amsterdam, Amsterdam, The Netherlands.
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Tong JY, Pasick LJ, Benito DA, Sataloff RT. Complications associated with tracheoesophageal voice prostheses from 2010 to 2020: A MAUDE study. Am J Otolaryngol 2020; 41:102652. [PMID: 32711236 DOI: 10.1016/j.amjoto.2020.102652] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 07/04/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Tracheoesophageal puncture with voice prosthesis placement remains the gold standard for voice restoration following total laryngectomy, but may cause various complications. This study aims to summarize patient-related and device-related adverse events associated with tracheoesophageal puncture and voice prosthesis placement. MATERIALS AND METHODS The U.S. Food and Drug Administration's Manufacturer and User Facility Device Experience database was queried for reports of adverse events related to tracheoesophageal puncture with voice prosthesis placement from January 1, 2010, to April 30, 2020. Data were extracted from reports pertaining to tracheoesophageal prostheses. RESULTS Seventy-seven reports involving tracheoesophageal voice prostheses were identified, from which 111 adverse events were extracted. Of these, 58 (52.3%) were patient-related, while 53 (47.7%) were device-related. The most frequently reported patient-related adverse events were aspirated prosthesis (24 [41.4%]), foreign body during placement (11 [19.0%]), aspiration pneumonia (9 [15.5%]), and aspirated brush tip (8 [13.8%]). The most common device-related adverse events were detached brush tip (15 [28.3%]), leak (14 [26.4%]), and torn esophageal flange (11 [20.8%]). CONCLUSIONS While tracheoesophageal puncture with voice prosthesis placement has revolutionized voice rehabilitation following total laryngectomy, the procedure may be associated with adverse events both at the time of placement and later. Interventions aimed at improving both physician and patient education may help reduce adverse events attributed to improper use. Further research is needed to clarify optimal approaches to education.
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Wulff NB, Højager A, Wessel I, Dalton SO, Homøe P. Health-Related Quality of Life Following Total Laryngectomy: A Systematic Review. Laryngoscope 2020; 131:820-831. [PMID: 32866284 DOI: 10.1002/lary.29027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 06/13/2020] [Accepted: 07/25/2020] [Indexed: 01/16/2023]
Abstract
OBJECTIVE Treatment of advanced laryngeal and hypopharyngeal cancer has shifted from total laryngectomy (TL) toward laryngeal-preserving therapies due to a general perception that TL has a significantly negative impact on the individual's life. However, whether the physical impairments related to TL translate to a reduced health-related quality of life (HRQoL) has not yet been determined. Therefore, the objective of this systematic review was to determine how HRQoL is affected following TL. METHODS Systematic searches were conducted in PubMed, Embase, and Cochrane. Inclusion criteria were original studies describing quality of life following TL after larynx/hypopharynx cancer using a formally developed patient-reported questionnaire. Study quality assessment was carried out with the tool developed by the National Heart, Lung, and Blood Institute. RESULTS Forty-six studies using 12 different questionnaires were included. The majority were cross-sectional (85%), and study quality was rated poor in 30%, fair in 30%, and good in 39% of studies. When comparing results from the four most frequently used questionnaires with normative data, we found that in more than 60% of studies, differences to the reference population were of clinical importance, with only few exceptions. CONCLUSIONS In general, we found that people who received TL have a worse HRQoL than the male normative reference population. However, even though TL patients experience a clinically important difference in many domains when compared with normative data, their burden of symptoms is generally mild. The current review also makes it evident that despite the relatively large number of studies conducted, the strength of evidence remains weak. Laryngoscope, 131:820-831, 2021.
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Affiliation(s)
- Nille B Wulff
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark
| | - Anna Højager
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark
| | - Irene Wessel
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Susanne O Dalton
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Naestved, Denmark
| | - Preben Homøe
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Rhoten BA, Davis AJ, Baraff BN, Holler KH, Dietrich MS. Priorities and Preferences of Patients With Head and Neck Cancer for Discussing and Receiving Information About Sexuality and Perception of Self-Report Measures. J Sex Med 2020; 17:1529-1537. [PMID: 32417203 PMCID: PMC7664992 DOI: 10.1016/j.jsxm.2020.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 03/20/2020] [Accepted: 04/03/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Head and neck cancer and its treatment can cause impairment in survivors' sexuality. Previous studies show a need for education and psychological support. AIM To examine patients' priorities and preferences for discussing and receiving information about sexuality and to examine patient perceptions of existing self-report measures used in research. METHODS This descriptive, cross-sectional, Web-based study recruited adults with a current or previous diagnosis of head and neck cancer. Participants answered questions about their priority and preference for receiving information about sexuality and reviewed 4 self-report measures commonly used in the research of this population. RESULTS More than 80% (n = 61) of participants reported that it was important to receive information about sexual issues. Participants chose "at the time of diagnosis" as the most frequent answer for preferred time to receive this information. Half of the participants (n = 35) indicated that they prefer discussing sexual issues with a health-care provider. The most frequent answer for the method of receiving information was through discussions. Participants endorsed 4 themes not addressed by self-report surveys: (i) elicitation of important information, (ii) symptom burden issues, (iii) psychological issues, and (iv) physical barriers. CLINICAL IMPLICATIONS Providers, regardless of specialty, must attempt or facilitate discussions around these issues at various times within the treatment and recovery phases. STRENGTHS & LIMITATIONS Although limited by sample representation and cross-sectional design, this study addresses an important patient-centered issue that is a critical aspect of quality of life. CONCLUSIONS Patients prefer to discuss sexual issues in person with their health-care providers at the time of diagnosis. Participants reacted positively to the self-report measures, but they felt that important issues faced by patients with head and neck cancer were not fully addressed. Rhoten BA, Davis AJ, Baraff BN, et al. Priorities and Preferences of Patients With Head and Neck Cancer for Discussing and Receiving Information About Sexuality and Perception of Self-Report Measures. J Sex Med 2020;17:1529-1537.
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Affiliation(s)
| | - Amanda J Davis
- Vanderbilt University School of Nursing, Nashville, TN, USA
| | | | - Kelly H Holler
- Vanderbilt University School of Nursing, Nashville, TN, USA
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Gür H, Çayan S, Akbay E, Dölek EK, Özcan C, Görür K. The effect of partial and total laryngectomy on couples’ sexual functions in men with larynx cancer. Eur Arch Otorhinolaryngol 2020; 277:3397-3402. [DOI: 10.1007/s00405-020-06167-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 06/21/2020] [Indexed: 01/07/2023]
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Matev B, Asenov A, Stoyanov GS, Nikiforova LT, Sapundzhiev NR. Losing One's Voice to Save One's Life: A Brief History of Laryngectomy. Cureus 2020; 12:e8804. [PMID: 32724750 PMCID: PMC7381876 DOI: 10.7759/cureus.8804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Laryngectomy is a surgical procedure that involves the surgical removal of the laryngeal complex, thereby separating the upper from the lower respiratory tracts, resulting in a tracheostomy. In this way, respiration is achieved at the expense of the patient’s voice. A neopharynx is formed, serving only as a digestive passage between the mouth and the esophagus. Until the introduction of the procedure, patients with laryngeal cancer were considered terminally ill. Most often, the title of “First recorded laryngectomy” is held by Theodor Billroth in 1873; however, the outcome of the operation itself was doubtful, with later attempts having a 50% mortality rate. The first major leap in reducing patient mortality rates was the introduction of the two-step laryngectomy, performed by Themistocles Gluck in 1881. This achievement, along with the general advancements in the field of surgery at the time allowed his student Johannes Sørensen to perfect the method and further develop it into a modified single-stage laryngectomy. This procedure is the basis of contemporary methods.
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Affiliation(s)
- Boyko Matev
- Medicine, Medical University of Varna, Varna, BGR
| | - Asen Asenov
- Department of Otolaryngology, Head and Neck Surgery, Medical University of Plovdiv, Plovdiv, BGR
| | - George S Stoyanov
- General and Clinical Pathology/Forensic Medicine and Deontology, Medical University of Varna, Varna, BGR
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Goiato MC, Amoroso AP, Silva B, Dos Santos EG, Caxias FPD, Bitencourt SB, Moreno A, Dos Santos DM. The Impact of Surgery and Radiotherapy on Health-Related Quality of Life of Individuals with Oral and Oropharyngeal Carcinoma and Short-Term Follow up after Treatment. Asian Pac J Cancer Prev 2020; 21:1227-1234. [PMID: 32458626 PMCID: PMC7541871 DOI: 10.31557/apjcp.2020.21.5.1227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Indexed: 11/25/2022] Open
Abstract
Objective: This study aimed to evaluate the quality of life of patients with oral or oropharyngeal cancer by using specific questionnaires (QLQ-C30 and QLQ-HandN35), varying according to the location of the tumor (oral cavity or oropharynx) and the treatment performed (only surgery or surgery associated with radiotherapy). Methods: Fifty patients were enrolled in this study and answered the EORTC QLQ-C30 and EORTC HandN35 questionnaires, before (baseline), at 1 week, and 3 months after treatment. Internal consistency reliability was calculated with the Cronbach coefficient. The Kruskal-Wallis and Wilcoxon tests were applied and P<.05 was considered significant. Results: Some aspects showed significant difference (P<.05) between tumor location (oral/oropharyngeal) and treatment performed (surgery or surgery plus radiotherapy) only for the baseline and 1 week after treatment periods. Conclusion: Quality of life is a factor that affected patients with head and neck cancer. The time elapsed after treatment, whether surgical or surgical plus radiotherapy, influenced patient quality of life. The period of greatest morbidity was 1 week after treatment.
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Affiliation(s)
- Marcelo Coelho Goiato
- Oral Oncology Center and Department of Dental Materials and Prosthodontics, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Andressa Paschoal Amoroso
- Oral Oncology Center and Department of Dental Materials and Prosthodontics, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Bruna Silva
- Oral Oncology Center and Department of Dental Materials and Prosthodontics, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Emerson Gomes Dos Santos
- Department of Business, Paulista School of Politics, Economics and Business, Universidade Federal de São Paulo (UNIFESP), Osasco, Brazil
| | - Fernanda Pereira De Caxias
- Oral Oncology Center and Department of Dental Materials and Prosthodontics, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Sandro Basso Bitencourt
- Oral Oncology Center and Department of Dental Materials and Prosthodontics, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Amalia Moreno
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Daniela Micheline Dos Santos
- Oral Oncology Center and Department of Dental Materials and Prosthodontics, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
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13
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Elnazer HY, Baldwin DS. Structured review of the use of the Arizona sexual experiences scale in clinical settings. Hum Psychopharmacol 2020; 35:e2730. [PMID: 32236977 DOI: 10.1002/hup.2730] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 03/04/2020] [Accepted: 03/04/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND Approximately 40% of women and 30% of men describe sexual dysfunction, although recognition in medical settings is suboptimal, due to problems in reporting and eliciting concerns relating to sexual function and satisfaction. Screening questionnaires may help to support this aspect of clinical practice. The Arizona sexual experiences scale (ASEX) includes items that quantify sex drive, arousal, vaginal lubrication or penile erection, ability to reach orgasm, and satisfaction from orgasm. METHOD We investigated the validity and other psychometric properties of the ASEX, and the findings from the populations in which it has been employed, by searching MEDLINE, EMBASE, and Google Scholar using the terms, Arizona sexual experiences scale, Arizona Sexual Experience Questionnaire, and ASEX. We eliminated duplications, letters, and papers not available in English, and grouped the remaining papers into the categories of psychometric, epidemiological, and outcome-based studies. RESULTS After elimination of letters and duplicates, papers not in English, and preclinical and irrelevant studies, 104 papers were analyzed. The ASEX has excellent internal consistency, scale reliability and strong test-retest reliability. Analyses of variance reveal significant differences in total ASEX scores between patients and controls and between females and males. ASEX appears to be useful in a range of clinical situations including patients with primary sexual dysfunction, specific psychiatric disorders, specific physical illnesses, and treatment emergent sexual dysfunction. DISCUSSION The ASEX appears to be a reliable instrument for identifying and quantifying sexual dysfunction across a range of populations in various clinical settings. Little is known about its utility in patients with anxiety disorders or relationships between ASEX scores and biological parameters.
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Affiliation(s)
- Hesham Y Elnazer
- Faculty of Medicine, Clinical and Experimental Sciences (CNS and Psychiatry). Academic Department, University of Southampton, Southampton, UK
| | - David S Baldwin
- Faculty of Medicine, Clinical and Experimental Sciences (CNS and Psychiatry). Academic Department, University of Southampton, Southampton, UK
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14
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Pizzorni N, Crosetti E, Santambrogio E, de Cillis G, Bertolin A, Rizzotto G, Fantini M, Succo G, Schindler A. The Penetration-Aspiration Scale: Adaptation to Open Partial Laryngectomy and Reliability Analysis. Dysphagia 2019; 35:261-271. [PMID: 31161405 DOI: 10.1007/s00455-019-10025-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 05/06/2019] [Accepted: 05/25/2019] [Indexed: 11/25/2022]
Abstract
A standard for assessing swallowing function after open partial horizontal laryngectomy (OPHL) is still not established. The variability in the measures used to investigate swallowing functional outcomes after OPHL limits the communication among clinicians and the possibility to compare and combine results from different studies. The study aims to adapt the PAS to the altered anatomy after OPHLs using fiberoptic endoscopic evaluation of swallowing (FEES) and to test its reliability. To adapt the PAS, two landmarks were identified: the entry of the laryngeal vestibule and the neoglottis. Ninety patients who underwent an OPHL were recruited (27 type I, 31 type II and 32 type III). FEES was performed and video-recorded. Two speech and language therapists (SLTs) independently rated each FEES using the PAS adapted for OPHL (OPHL-PAS). FEES recordings were rated for a second time by both SLTs at least 15 days from the first video analysis. Inter- and intra-rater agreement was assessed using unweighted Cohen's kappa. Overall, inter-rater agreement of the OPHL-PAS was k = 0.863, while intra-rater agreement was k = 0.854. Concerning different OPHL types, inter- and intra-rater agreement were k = 0.924 and k = 0.914 for type I, k = 0.865 and k = 0.790 for type II, and k = 0.808 and k = 0.858 for type III, respectively. The OPHL-PAS is a reliable scale to assess the invasion of lower airway during swallowing in patients with OPHL using FEES. The study represents the first attempt to define standard tools to assess swallowing functional outcome in this population.
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Affiliation(s)
- Nicole Pizzorni
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy.
| | - Erika Crosetti
- Head and Neck Oncology Service, Candiolo Cancer Institute-FPO IRCCS, Candiolo, Italy
| | - Elena Santambrogio
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - Giada de Cillis
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - Andy Bertolin
- Department of Otorhinolaryngology, Ospedale Civile of Vittorio Veneto, Belluno, Italy
| | - Giuseppe Rizzotto
- Department of Otorhinolaryngology, Ospedale Civile of Vittorio Veneto, Belluno, Italy
| | - Marco Fantini
- Head and Neck Oncology Service, Candiolo Cancer Institute-FPO IRCCS, Candiolo, Italy
| | - Giovanni Succo
- Head and Neck Oncology Service, Candiolo Cancer Institute-FPO IRCCS, Candiolo, Italy
| | - Antonio Schindler
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
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15
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Relationship between swallowing-related quality of life and fiberoptic endoscopic evaluation of swallowing in patients who underwent open partial horizontal laryngectomy. Eur Arch Otorhinolaryngol 2018; 275:973-985. [DOI: 10.1007/s00405-018-4888-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 01/24/2018] [Indexed: 10/18/2022]
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16
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Cheraghlou S, Kuo P, Mehra S, Yarbrough WG, Judson BL. Salvage Surgery after Radiation Failure in T1/T2 Larynx Cancer: Outcomes following Total versus Conservation Surgery. Otolaryngol Head Neck Surg 2018; 158:497-504. [DOI: 10.1177/0194599817742596] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective After radiation failure for early T-stage larynx cancer, national guidelines recommend salvage surgery. Total laryngectomy and conservation laryngeal surgery with an open or endoscopic approach are both used. Beyond single-institution studies, there is a lack of evidence concerning the outcomes of these procedures. We aim to study whether treatment with conservation laryngeal surgery is associated with poorer outcomes than treatment with total laryngectomy as salvage surgery after radiation failure for T1/T2 larynx cancers. Study Design A retrospective study was conducted of adult squamous cell larynx cancer cases in the National Cancer Database diagnosed from 2004 to 2012. Setting Commission on Cancer cancer programs in the United States. Methods Demographic, facility, tumor, and survival variables were included in the analyses. Multivariate survival regressions as well as univariate Kaplan-Meier analyses were conducted. Results Slightly more than 7% of patients receiving radiotherapy for T1/T2 larynx cancers later received salvage surgery. Salvage with partial laryngectomy was not associated with diminished survival as compared with total laryngectomy. However, positive surgical margins were associated with worse outcomes (hazard ratio, 1.782; P = .001), and a larger percentage of patients receiving partial laryngectomy had positive margins than those receiving total laryngectomy. Facility characteristics were not associated with differences in salvage surgery type or outcomes. Conclusion In recognition of the inherent selection bias, patients who experienced recurrences after radiation for T1/T2 larynx cancer and underwent conservation salvage laryngeal surgery demonstrated clinical outcomes similar to those of patients undergoing salvage total laryngectomy. Increased rates of positive surgical margins were observed among patients undergoing salvage conservation surgery.
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Affiliation(s)
- Shayan Cheraghlou
- Division of Otolaryngology, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - Phoebe Kuo
- Division of Otolaryngology, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - Saral Mehra
- Division of Otolaryngology, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
- Yale Cancer Center, New Haven, Connecticut, USA
| | - Wendell G. Yarbrough
- Division of Otolaryngology, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
- Yale Cancer Center, New Haven, Connecticut, USA
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Benjamin L. Judson
- Division of Otolaryngology, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
- Yale Cancer Center, New Haven, Connecticut, USA
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Raol N, Lilley E, Cooper Z, Dowdall J, Morris MA. Preoperative Counseling in Salvage Total Laryngectomy: Content Analysis of Electronic Medical Records. Otolaryngol Head Neck Surg 2017; 157:641-647. [DOI: 10.1177/0194599817726769] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Objective To study preoperative counseling in patients undergoing salvage total laryngectomy (STL). Study Design Case series with chart review. Setting Tertiary care academic hospital. Subjects and Methods We reviewed charts of patients ≥18 years undergoing STL between 2005 and 2015. Fifty-eight patients were identified. Notes written within 2 months prior to surgery by head and neck surgical oncologists, radiation oncologists, medical oncologists, speech-language pathologists, social workers, and nurse practitioners were extracted and coded into 4 categories. Coded content was then analyzed using a simple tally within content areas. Results Nonphysicians documented patient values and priorities, exclusive of treatment desires, more frequently. These topics included apprehension about family obligations, fear about communication, questions regarding quality of life, and anxiety regarding job continuation. Physician notes documented priorities regarding preferences for surgical treatment. No patients were seen by palliative care preoperatively, and only 14% (n = 8) patients had documentation of an end-of-life discussion. Conclusions Preoperative counseling for STL patients that included nonphysicians had a higher frequency of discussion of patients’ priorities. This suggests including these types of providers may lead to more patient-centered care. A prospective study evaluating patient and physician perceptions of preoperative counseling can better identify where discrepancies exists and help conceptualize a framework for preoperative counseling in STL patients and other patients undergoing high-risk surgery.
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Affiliation(s)
- Nikhila Raol
- Center for Surgery and Public Health, Harvard Medical School and Harvard T.H. Chan School of Public Health, Department of Surgery, Brigham & Women’s Hospital, Boston, Massachusetts, USA
- Department of Otolaryngology, Emory University, Atlanta, Georgia, USA
| | - Elizabeth Lilley
- Center for Surgery and Public Health, Harvard Medical School and Harvard T.H. Chan School of Public Health, Department of Surgery, Brigham & Women’s Hospital, Boston, Massachusetts, USA
| | - Zara Cooper
- Center for Surgery and Public Health, Harvard Medical School and Harvard T.H. Chan School of Public Health, Department of Surgery, Brigham & Women’s Hospital, Boston, Massachusetts, USA
| | - Jayme Dowdall
- Division of Otolaryngology, Department of Surgery, Brigham & Women’s Hospital, Boston, Massachusetts, USA
- Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, USA
| | - Megan A. Morris
- Department of Community and Behavioral Health, Colorado School of Public Health, Denver, Colorado, USA
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Taberna M, Inglehart RC, Pickard RKL, Fakhry C, Agrawal A, Katz ML, Gillison ML. Significant changes in sexual behavior after a diagnosis of human papillomavirus-positive and human papillomavirus-negative oral cancer. Cancer 2017; 123:1156-1165. [PMID: 28195638 DOI: 10.1002/cncr.30564] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 11/09/2016] [Accepted: 11/10/2016] [Indexed: 12/18/2022]
Abstract
BACKGROUND Sexual behavior and oral human papillomavirus (HPV) infection are risk factors for oral squamous cell carcinoma (OSCC). The effects of OSCC diagnosis and treatment on subsequent relationship stress and sexual behavior are unknown. METHODS Incident cases of HPV-positive or HPV-negative OSCC in patients who had a partnered relationship and partners of patients with oropharyngeal cancer were eligible for a study in which surveys were administered at diagnosis and at the 6-month follow-up time point to assess relationship distress, HPV transmission and concerns about health consequences, and sexual behavior. The frequency distributions of responses, stratified by tumor HPV status, were compared at baseline and follow-up. RESULTS In total, 262 patients with OSCC and 81 partners were enrolled. Among the patients, 142 (54.2%) had HPV-positive OSCC, and 120 (45.8%) had HPV-negative OSCC. Relationship distress was infrequently reported, and 69% of patients felt that their relationship had strengthened since the cancer diagnosis. Both HPV-positive patients (25%) and their partners (14%) reported feelings of guilt or responsibility for the diagnosis of an HPV-caused cancer. Concern over sexual, but not nonsexual, HPV transmission to partners was reported by 50%. Significant declines in the frequency of vaginal and oral sexual behaviors were reported at follow-up, regardless of tumor HPV status. From baseline to 6 months, significant increases in abstinence from vaginal sex (from 10% to 34%; P < .01) and oral sex (from 25% to 80%; P < .01) were reported. CONCLUSIONS Diagnosis and treatment of OSCC are associated with significant declines in the frequency of vaginal and oral sex, regardless of tumor HPV status. Sexual behavior is an important quality-of-life outcome to assess within clinical trials. [See related editorial on pages 000-000, this issue.] Cancer 2017. © 2017 American Cancer Society. Cancer 2017;123:1156-1165. © 2016 American Cancer Society.
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Affiliation(s)
- Miren Taberna
- Department of Medical Oncology, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute, L'Hospitalet de Llobregat, Barcelona, Spain.,Cancer Epidemiology Research Program, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute, L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Ronald C Inglehart
- Medical Scientist Training Program, The Ohio State University College of Medicine, Columbus, Ohio
| | | | - Carole Fakhry
- Department of Otolaryngology, Head and Neck Surgery, Johns Hopkins School of Medicine, Johns Hopkins Outpatient Center, Baltimore, Maryland
| | - Amit Agrawal
- Department of Otolaryngology, Head and Neck Surgery, The Ohio State University, Columbus, Ohio
| | - Mira L Katz
- Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio.,Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, Ohio
| | - Maura L Gillison
- Department of Medicine, The Ohio State University, Columbus, Ohio
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