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Santos-Sousa AL, Kayahara GM, Bastos DB, Sarafim-Silva BAM, Crivelini MM, Valente VB, Corrente JE, Xavier-Júnior JCC, Miyahara GI, Bernabé DG. Expression of β 1- and β 2-adrenergic receptors in oral squamous cell carcinoma and their association with psychological and clinical factors. Arch Oral Biol 2024; 162:105939. [PMID: 38490087 DOI: 10.1016/j.archoralbio.2024.105939] [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: 12/22/2023] [Revised: 02/22/2024] [Accepted: 02/25/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Psychological stressors have been related to tumor progression through the activation of beta-adrenergic receptors (β-AR) in several types of cancer. PURPOSE This study aimed to investigate the expressions of β1- and β2-AR and their association with psychological and clinicopathological variables in patients with oral squamous cell carcinoma. METHODS Tumor samples from 99 patients diagnosed with OSCC were subjected to immunohistochemical reaction to detect the expression of β1-AR and β2-AR. Anxiety and depression symptoms were assessed using the Beck Anxiety Inventory and Beck Depression Inventory (BDI), respectively. The Brunel Mood Scale was used for measuring affective mood states. RESULTS Univariate analyzes revealed that higher expression of β1-AR was associated with increased alcohol consumption (p = 0.032), higher education (p = 0.042), worse sleep quality (p = 0.044) and increased levels of pain related to the primary tumor (p < 0.001). Higher expression of β2-AR was related with regional metastasis (p = 0.014), increased levels of pain related to the primary tumor (p = 0.044), anxiety (p < 0.001) and depressive (p = 0.010) symptoms and higher mood scores of angry (p = 0.010) and fatigue (p = 0.010). Multivariate analysis identified that patients with advanced clinical stage had lower β1-AR expression (OR=0.145, 95% CI=0.025-0.828, p = 0.003). Higher anxiety symptoms and higher mood fatigue are independent factors for increased β2-AR expression (OR=4256, 95% CI=1439-12606, p = 0.009; OR=3816, 95% CI=1258-11,573, p = 0.018, respectively). CONCLUSION This study reveal that anxiety, fatigue symptoms, and clinical staging are associated with tumor expression of beta-adrenergic receptors in patients with oral cancer.
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Affiliation(s)
- Ana Lívia Santos-Sousa
- Psychosomatic Research Center, Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Giseli Mitsuy Kayahara
- Psychosomatic Research Center, Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil; Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Daniela Brito Bastos
- Psychosomatic Research Center, Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Bruna Amélia Moreira Sarafim-Silva
- Psychosomatic Research Center, Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Marcelo Macedo Crivelini
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Vítor Bonetti Valente
- Psychosomatic Research Center, Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil; Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - José Eduardo Corrente
- Research Support Office, Botucatu Medical School (UNESP), Botucatu, São Paulo, Brazil
| | | | - Glauco Issamu Miyahara
- Psychosomatic Research Center, Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil; Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Daniel Galera Bernabé
- Psychosomatic Research Center, Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil; Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil.
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Vitale E, Halemani K, Shetty A, Chang YC, Hu WY, Massafra R, Moretti A. Sex Differences in Anxiety and Depression Conditions among Cancer Patients: A Systematic Review and Meta-Analysis. Cancers (Basel) 2024; 16:1969. [PMID: 38893089 PMCID: PMC11171373 DOI: 10.3390/cancers16111969] [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: 04/12/2024] [Revised: 05/15/2024] [Accepted: 05/16/2024] [Indexed: 06/21/2024] Open
Abstract
(1) Background: Evidence suggested inconsistent results in anxiety and depression scores among female and male cancer patients. The present systematic review and meta-analysis aimed to assess how anxiety and depression conditions among cancer patients vary according to sex. (2) Methods: This systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). The protocol was registered in PROSPERO with id no. CRD42024512553. The search strategy involved combining keywords using Boolean operators, including "Anxiety", "Cancer", and "Depression", across several databases: Embase, PubMed, Scopus, and Web of Science. The outcomes were evaluated using the Hospital Anxiety and Depression Scale (HADS). (3) Results: Data were collected from five studies, enrolling a total of 6317 cancer patients, of whom 2961 were females and 3356 males. For each study, HADS-A and HADS-D scores were considered, also differentiating HADS scores according to cancer typology, and then three different meta-analyses were performed. Generally, females reported significantly higher levels of depression scores than males and, conversely, males reported significantly greater levels of anxiety than females. (4) Conclusions: Previous studies suggested higher rates of depression and anxiety conditions in females than in males, but the present data highlighted controversial findings, since males reported significantly higher levels of anxiety than females. In this scenario, the theoretical approach justified females being more open than males to expressing anxiety or depression conditions. It would be necessary for healthcare professionals to improve effective measures purposed at assessing and mitigating depressive symptoms in cases of advanced cancer, thereby improving their mental health, given the high rates of depression in advanced cancer patients, due to the difficulty level of performing their daily living activities, which deteriorate further over time.
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Affiliation(s)
- Elsa Vitale
- Scientific Directorate, IRCCS Istituto Tumori “Giovanni Paolo II”, 70124 Bari, Italy
| | - Kurvatteppa Halemani
- College of Nursing, All India Institute of Medical Sciences (AIIMS), Raebareli 229405, India;
| | - Asha Shetty
- College of Nursing, All India Institute of Medical Sciences (AIIMS), Bhubaneswar 751019, India;
| | - Yun-Chen Chang
- School of Nursing and Graduate Institute of Nursing, China Medical University, Taichung 406040, Taiwan;
- Nursing Department, China Medical University Hospital, Taichung 404328, Taiwan
| | - Wen-Yu Hu
- School of Nursing, College of Medicine, National Taiwan University, Taipei 106319, Taiwan;
- Department of Nursing, National Taiwan University Hospital, Taipei 100225, Taiwan
| | - Raffaella Massafra
- Laboratorio di Bioinformatica e Biostatistica, IRCCS Istituto Tumori “Giovanni Paolo II”, 70124 Bari, Italy;
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Bartzou E, Tsiloni E, Mantzoukas S, Dragioti E, Gouva M. Humor and Quality of Life in Adults With Chronic Diseases: A Systematic Review. Cureus 2024; 16:e55201. [PMID: 38562265 PMCID: PMC10983057 DOI: 10.7759/cureus.55201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2024] [Indexed: 04/04/2024] Open
Abstract
Individuals grappling with chronic ailments often undergo a deterioration in their overall quality of life (QoL), encompassing psychological, social, and physical dimensions of well-being. Acknowledging that humor has demonstrated the potential to engender favorable effects on QoL, this systematic review endeavors to investigate the correlation between humor and QoL among adults contending with chronic health conditions. A comprehensive review of quantitative data was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. PubMed/MEDLINE, PsycINFO, and Cumulative Index to Nursing & Allied Health (CINAHL) were comprehensively searched from the establishment of each database up to June 22, 2023. Furthermore, reference lists of the included datasets and pertinent review articles were scrutinized exhaustively. The Newcastle-Ottawa Scale (NOS) was employed to assess the quality of eligible studies. A total of 18 studies satisfied the inclusion criteria. These studies encompassed a diverse spectrum of chronic disease categories (including cardiovascular diseases, various types of cancer, etc.) and collectively involved a participant cohort comprising 4,325 individuals. Remarkable findings surfaced, indicating a noteworthy association between distinct facets of humor-such as one's sense of humor, coping humor, humor styles, and laughter-and psychological QoL. Nonetheless, the relationship between humor and physical QoL exhibited a more intricate pattern, characterized by mixed outcomes. Despite the limited and inconsistent evidence across studies, humor appears to exhibit a positive association with QoL.
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Affiliation(s)
- Eleni Bartzou
- Research Laboratory Psychology of Patients, Families & Health Professionals, University of Ioannina, Ioannina, GRC
| | - Evangelia Tsiloni
- Research Laboratory Psychology of Patients, Families & Health Professionals, University of Ioannina, Ioannina, GRC
| | - Stefanos Mantzoukas
- Research Laboratory Psychology of Patients, Families & Health Professionals,, University of Ioannina, Ioannina, GRC
| | - Elena Dragioti
- Research Laboratory Psychology of Patients, Families & Health Professionals, University of Ioannina, Ioannina, GRC
| | - Mary Gouva
- Research Laboratory Psychology of Patients, Families & Health Professionals, University of Ioannina, Ioannina, GRC
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Lu CH, Hung CY, Hsueh SW, Yeh KY, Hung YS, Chou WC. Frailty is an independent factor for health-related quality of life in patients with head and neck cancer receiving definitive concurrent chemoradiotherapy. Support Care Cancer 2024; 32:106. [PMID: 38221588 DOI: 10.1007/s00520-024-08313-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 01/08/2024] [Indexed: 01/16/2024]
Abstract
PURPOSE Health-related quality of life (HRQoL) is associated with treatment-related complications and poor survival in patients with head and neck cancer (HNC). We investigated the effects of frailty on HRQoL in patients with HNC receiving definitive concurrent chemoradiotherapy (CCRT). METHODS A total of 461 consecutive patients with locally advanced HNC who received CCRT between 2017 and 2018 at three medical centers in Taiwan were included. Frailty and HRQoL were assessed using the Comprehensive Geriatric Assessment and QLQ-H&N35 before CCRT. The sum score was calculated based on the first 30 questions of QLQ-H&N35. Multivariate analysis was performed to evaluate the impact of frailty on HRQoL. RESULTS The overall sum score was 39 (34-49). The sum scores of patients with impairments in 0, 1, 2, 3, and ≥ 4 frailty domains were 34 (32-38), 40 (34-47), 46 (36-55), 48 (41-64), and 56 (50-60), respectively. Patients with impairments in more frailty domains had a higher symptom burden (p for trend < 0.001). Frail patients tended to experience symptoms across all QLQ-H&N35 subscales. Sex, body mass index, tumor type, tumor stage, Eastern Cooperative Oncology Group performance status, and frailty were determinants of HRQoL in the univariate analysis. Frailty was an independent determinant of HRQoL in the multivariate analysis. CONCLUSION Routine frailty assessment may serve as a surrogate for the selection of patients with HNC with poor HRQoL before CCRT. Further studies are needed to determine whether appropriate interventions in frail patients would improve their HRQoL during CCRT.
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Affiliation(s)
- Chang-Hsien Lu
- Department of Hematology and Oncology, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan
| | - Chia-Yen Hung
- Department of Hematology and Oncology, Chang Gung Memorial Hospital at Linkou and College of Medicine, Chang Gung University, 5 Fu-Hsing Street, Kwei-Shan Shiang, Taoyuan, Taiwan
- Division of Hematology and Oncology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Shun-Wen Hsueh
- Department of Hematology and Oncology, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Kun-Yun Yeh
- Department of Hematology and Oncology, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Yu-Shin Hung
- Department of Hematology and Oncology, Chang Gung Memorial Hospital at Linkou and College of Medicine, Chang Gung University, 5 Fu-Hsing Street, Kwei-Shan Shiang, Taoyuan, Taiwan
| | - Wen-Chi Chou
- Department of Hematology and Oncology, Chang Gung Memorial Hospital at Linkou and College of Medicine, Chang Gung University, 5 Fu-Hsing Street, Kwei-Shan Shiang, Taoyuan, Taiwan.
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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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Figueira JA, Sarafim-Silva BAM, Gonçalves GM, Aranha LN, Lopes FL, Corrente JE, Biasoli ÉR, Miyahara GI, Bernabé DG. Predisposing factors for increased cortisol levels in oral cancer patients. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2022; 9:100110. [PMID: 35755918 PMCID: PMC9216328 DOI: 10.1016/j.cpnec.2022.100110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 01/03/2022] [Accepted: 01/03/2022] [Indexed: 12/24/2022] Open
Abstract
Cancer patients may have a dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and abnormal secretion of cortisol. Increased cortisol levels have been associated with worse prognosis in patients with different types of tumors. Although anxiety and depression can trigger an abnormal cortisol secretion, little is known regarding the influence of these emotional disorders on HPA axis dysregulation in cancer patients when evaluating together with demographic, clinicopathological and biobehavioral variables. This cross-sectional study analyzed the pre-treatment plasma cortisol levels of 133 patients with oral squamous cell carcinoma (OSCC) and its association with demographic, clinicopathological, biobehavioral and psychological variables. Plasma cortisol levels were measured by electrochemiluminescence, and anxiety and depression symptoms were assessed using Beck Anxiety Inventory (BAI) and Depression (BDI), respectively. Demographic, clinicopathological and biobehavioral data were collected from patients' medical records. Results from multivariate analysis showed that the occurrence of cancer-induced pain was predictive for higher cortisol levels (OR = 5.388, p = 0.003). Men with OSCC were 4.5 times more likely to have higher plasma cortisol levels than women (OR = 4.472, p = 0.018). The effect of sex on cortisol concentrations was lost in the adjusted model for clinical staging (OR = 2.945, p = 0.116). The absence of chronic alcohol consumption history was a protective factor for highest hormone concentrations in oral cancer patients (OR = 0.104, p = 0.004). Anxiety symptoms measured by BAI as “hands trembling” (OR = 0.192, p = 0.016) and being “nervous” (OR = 0.207, p = 0.0004) were associated with lower cortisol levels. In contrast, the feeling of “fear of losing control” was a risk factor for highest hormone concentrations (OR = 6.508, p = 0.0004). The global score and specific symptoms of depression measured by the BDI were not predictive for plasma hormone levels (p > 0.05). Together, our results show that pain, alcohol consumption and feeling fear are independent factors for increased systemic cortisol levels in patients with oral cancer. Therefore, psychological intervention, as well as control of pain and alcohol consumption, should be considered to prevent the negative effects of cortisol secretion dysregulation in cancer patients. Pain, alcoholism and fear increase cortisol levels in cancer patients. Different anxiety symptoms can inversely predict cortisol systemic levels. Management of pain, alcoholism, and fear could prevent HPA axis dysregulation.
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Affiliation(s)
- Jéssica Araújo Figueira
- Psychosomatic Research Center, Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, 15050-015, Brazil
| | - Bruna Amélia Moreira Sarafim-Silva
- Psychosomatic Research Center, Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, 15050-015, Brazil
| | - Gislene Maria Gonçalves
- Psychosomatic Research Center, Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, 15050-015, Brazil
| | | | - Flávia Lombardi Lopes
- Department of Production and Animal Health, São Paulo State University (UNESP), School of Veterinary Medicine, Araçatuba, São Paulo, 16050-680, Brazil
| | - José Eduardo Corrente
- Research Support Office, Botucatu Medical School (UNESP), Botucatu, São Paulo, 18618-687, Brazil
| | - Éder Ricardo Biasoli
- Psychosomatic Research Center, Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, 15050-015, Brazil
| | - Glauco Issamu Miyahara
- Psychosomatic Research Center, Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, 15050-015, Brazil
| | - Daniel Galera Bernabé
- Psychosomatic Research Center, Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, 15050-015, Brazil
- Corresponding author. Psychosomatic Research Center, Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, 1193 José Bonifácio St, SP 15050-015, Araçatuba, São Paulo, Brazil.
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Van der Elst S, Bardash Y, Wotman M, Kraus D, Tham T. The prognostic impact of depression or depressive symptoms on patients with head and neck cancer: A systematic review and meta-analysis. Head Neck 2021; 43:3608-3617. [PMID: 34525238 DOI: 10.1002/hed.26868] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 07/18/2021] [Accepted: 08/31/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND This systematic review and meta-analysis sought to assess the extent to which pretreatment depression or depressive symptoms are related to prognosis in patients with head and neck cancer (HNC). METHODS Medline, EMbase, Scopus, and The Cochrane Library databases were searched. A meta-analysis was done to generate a forest plot and pooled hazard ratio (HR) with 95% CI for overall survival (OS). RevMan 5.3 and Meta Essentials were used for statistical analysis. RESULTS Based on seven studies involving 1743 patients, the results showed that HNC patients with pretreatment depression or depressive symptoms had worse OS than patients without depression or depressive symptoms, with an HR of 1.33, 95% CI 1.16-1.52, p = <0.0001. There is heterogeneity in the pooled summary effect (I2 = 80%, p < 0.0001). CONCLUSIONS Pretreatment depression or depressive symptoms may indicate worse OS in patients with HNC. The pooled analysis demonstrated a statistically significant effect. These results were limited by mild heterogeneity.
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Affiliation(s)
- Sarah Van der Elst
- Department of Otolaryngology-Head and Neck Surgery, Donald & Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Yonatan Bardash
- Department of Otolaryngology-Head and Neck Surgery, Donald & Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Michael Wotman
- Department of Otolaryngology-Head and Neck Surgery, Donald & Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Dennis Kraus
- Department of Otolaryngology-Head and Neck Surgery, Donald & Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Tristan Tham
- Department of Otolaryngology-Head and Neck Surgery, Donald & Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
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8
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Speksnijder CM, Lankhorst PJM, de Bree R, de Haan AFJ, Koole R, Merkx MAW. Depression and related factors after oral oncological treatment: a 5-year prospective cohort study. Support Care Cancer 2020; 29:2907-2916. [PMID: 33001267 PMCID: PMC8062368 DOI: 10.1007/s00520-020-05795-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 09/22/2020] [Indexed: 11/29/2022]
Abstract
PURPOSES Being diagnosed with oral cancer is a life-threatening life event. It often induces social, emotional and psychological consequences and may cause depressive disorders. The primary aim of this study was to identify and quantify the personal and clinical characteristics involved in depression for patients who have been treated for oral cavity malignancies, with a 5-year follow-up period after treatment. The secondary aim of this study was to identify the clinical factors that increase a patient's risk of experiencing depression 5 years after treatment. METHODS Patients with primary oral cancer were assessed for up to 5 years after primary treatment. A mixed-model analysis was performed, with depression measured by the Center for Epidemiologic Studies Depression Scale as outcome measure. RESULTS A total of 141 patients were included in the study. Factors associated with depression were gender, tumour location and having an emotion-oriented coping style. The occurrence of depression within 5 years after treatment could be reliably predicted by a patient's gender, the location of their tumour and the extent to which they had an emotion-oriented coping style. CONCLUSIONS This study revealed that being female, having a maxillary tumour and having an emotion-oriented coping style are associated with higher levels of depressive symptoms in patients treated for oral cancer up to 5 years post-treatment. A substantial proportion of the patients with oral cancer experienced high levels of depression both before and after their treatment, suggesting that adequate diagnostics and care are needed to try to prevent severe depression in these patients.
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Affiliation(s)
- Caroline M Speksnijder
- Cancer Center, Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. .,Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands. .,Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, P.O. Box 85.500, 3508, GA, Utrecht, The Netherlands.
| | - Petra J M Lankhorst
- Department of Medical Oncology, Deventer Hospital, Deventer, The Netherlands
| | - Remco de Bree
- Cancer Center, Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Anton F J de Haan
- Department for Health Evidence, Section Biostatistics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ron Koole
- Department of Medical Oncology, Deventer Hospital, Deventer, The Netherlands
| | - Matthias A W Merkx
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
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9
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Korsten LHA, Jansen F, de Haan BJF, Sent D, Cuijpers P, Leemans CR, Verdonck-de Leeuw IM. Factors associated with depression over time in head and neck cancer patients: A systematic review. Psychooncology 2019; 28:1159-1183. [PMID: 30865357 PMCID: PMC6593868 DOI: 10.1002/pon.5058] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 03/05/2019] [Accepted: 03/07/2019] [Indexed: 11/22/2022]
Abstract
Objective To systematically review the literature on factors associated with a clinical diagnosis of depression or symptoms of depression (depression) among head and neck cancer (HNC) patients. Methods The search was conducted in PubMed, PsycINFO, and CINAHL. Studies were included if they investigated factors associated with depression among HNC patients, they were of prospective or longitudinal nature, and English full text was available. The search, data extraction, and quality assessment were performed by two authors. Based on the data extraction and quality assessment, the level of evidence was determined. Results In total, 35 studies were included: 21 on factors associated with depression at a single (later) time point, 10 on the course of depression, and four on both. In total, 77 sociodemographic, lifestyle, clinical, patient‐reported outcome measures, and inflammatory factors were extracted. Regarding depression at a single time point, there was strong evidence that depression at an earlier time point was significantly associated. For all other factors, evidence was inconclusive, although evidence suggests that age, marital status, education, ethnicity, hospital/region, sleep, smoking, alcohol, surgery, treatment, tumor location, and recurrence are not important associated factors. Regarding the course of depression, we found inconclusive evidence for all factors, although evidence suggests that gender, age, chemotherapy, pain, disease stage, treatment, and tumor location are not important associated factors. Conclusion Depression at an earlier time point is significantly associated with depression later on. Several sociodemographic and clinical factors seem not to be important factors associated with depression. For other factors, further research is warranted.
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Affiliation(s)
- Laura H A Korsten
- Department of Otolaryngology - Head and Neck Surgery, Cancer Center Amsterdam (CCA), Amsterdam Public Health Research Institute, Amsterdam UMC, location VUmc, Amsterdam
| | - Femke Jansen
- Department of Otolaryngology - Head and Neck Surgery, Cancer Center Amsterdam (CCA), Amsterdam Public Health Research Institute, Amsterdam UMC, location VUmc, Amsterdam.,Department of Clinical, Neuro and Development Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam
| | - Ben J F de Haan
- Department of Medical Informatics, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam
| | - Danielle Sent
- Department of Medical Informatics, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam
| | - Pim Cuijpers
- Department of Clinical, Neuro and Development Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam
| | - C René Leemans
- Department of Otolaryngology - Head and Neck Surgery, Cancer Center Amsterdam (CCA), Amsterdam Public Health Research Institute, Amsterdam UMC, location VUmc, Amsterdam
| | - Irma M Verdonck-de Leeuw
- Department of Otolaryngology - Head and Neck Surgery, Cancer Center Amsterdam (CCA), Amsterdam Public Health Research Institute, Amsterdam UMC, location VUmc, Amsterdam.,Department of Clinical, Neuro and Development Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam
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10
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Sarafim-Silva BAM, Duarte GD, Sundefeld MLMM, Biasoli ÉR, Miyahara GI, Bernabé DG. Childhood trauma is predictive for clinical staging, alcohol consumption, and emotional symptoms in patients with head and neck cancer. Cancer 2018; 124:3684-3692. [DOI: 10.1002/cncr.31597] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 05/18/2018] [Accepted: 05/22/2018] [Indexed: 12/21/2022]
Affiliation(s)
- Bruna Amélia M. Sarafim-Silva
- Psychosomatic Research Center, Oral Oncology Center, School of Dentistry; São Paulo State University - UNESP; Araçatuba São Paulo Brazil
| | - Gabrielle D. Duarte
- Psychosomatic Research Center, Oral Oncology Center, School of Dentistry; São Paulo State University - UNESP; Araçatuba São Paulo Brazil
| | - Maria Lúcia M. M. Sundefeld
- Psychosomatic Research Center, Oral Oncology Center, School of Dentistry; São Paulo State University - UNESP; Araçatuba São Paulo Brazil
| | - Éder Ricardo Biasoli
- Psychosomatic Research Center, Oral Oncology Center, School of Dentistry; São Paulo State University - UNESP; Araçatuba São Paulo Brazil
| | - Glauco I. Miyahara
- Psychosomatic Research Center, Oral Oncology Center, School of Dentistry; São Paulo State University - UNESP; Araçatuba São Paulo Brazil
| | - Daniel Galera Bernabé
- Psychosomatic Research Center, Oral Oncology Center, School of Dentistry; São Paulo State University - UNESP; Araçatuba São Paulo Brazil
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11
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Cook SA, Salmon P, Hayes G, Byrne A, Fisher PL. Predictors of emotional distress a year or more after diagnosis of cancer: A systematic review of the literature. Psychooncology 2018; 27:791-801. [PMID: 29318702 PMCID: PMC5873392 DOI: 10.1002/pon.4601] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 10/27/2017] [Accepted: 11/23/2017] [Indexed: 11/12/2022]
Abstract
Objective Why some people recover emotionally after diagnosis and treatment of cancer and others do not is poorly understood. To identify factors around the time of diagnosis that predict longer‐term distress is a necessary step in developing interventions to reduce patients' vulnerability. This review identified the demographic, clinical, social, and psychological factors available at or within 3 months of diagnosis that are reliable predictors of emotional distress at least 12 months later. Methods A systematic search of literature for prospective studies addressing our research question and predicting a range of distress outcomes was conducted. Thirty‐nine papers (reporting 36 studies) were subjected to narrative synthesis of the evidence. Results There was no consistent evidence that demographic, clinical, or social factors reliably predicted longer‐term distress. Of the psychological factors examined, only baseline distress (significant in 26 of 30 relevant papers; 24 of 28 studies) and neuroticism (significant in all 5 papers/studies that examined it) consistently predicted longer‐term distress. The heterogeneity of included studies, particularly in populations studied and methodology, precluded meta‐analytic techniques. Conclusions This review supports current clinical guidance advising early assessment of distress as a marker of vulnerability to persistent problems. Additionally, neuroticism is also indicated as a useful marker of vulnerability. However, the review also highlights that more sophisticated research designs, capable of identifying the psychological processes that underlie the association between these marker variables and persistent distress, are needed before more effective early interventions can be developed.
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Affiliation(s)
- Sharon A Cook
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Peter Salmon
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - Gemma Hayes
- The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - Angela Byrne
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - Peter L Fisher
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK.,Nidaros DPS, Østmarka University Hospital, Trondheim, Norway
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12
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Ringash J, Bernstein LJ, Devins G, Dunphy C, Giuliani M, Martino R, McEwen S. Head and Neck Cancer Survivorship: Learning the Needs, Meeting the Needs. Semin Radiat Oncol 2018; 28:64-74. [DOI: 10.1016/j.semradonc.2017.08.008] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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13
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Pynnonen MA, Gillespie MB, Roman B, Rosenfeld RM, Tunkel DE, Bontempo L, Brook I, Chick DA, Colandrea M, Finestone SA, Fowler JC, Griffith CC, Henson Z, Levine C, Mehta V, Salama A, Scharpf J, Shatzkes DR, Stern WB, Youngerman JS, Corrigan MD. Clinical Practice Guideline: Evaluation of the Neck Mass in Adults. Otolaryngol Head Neck Surg 2017; 157:S1-S30. [PMID: 28891406 DOI: 10.1177/0194599817722550] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Objective Neck masses are common in adults, but often the underlying etiology is not easily identifiable. While infections cause most of the neck masses in children, most persistent neck masses in adults are neoplasms. Malignant neoplasms far exceed any other etiology of adult neck mass. Importantly, an asymptomatic neck mass may be the initial or only clinically apparent manifestation of head and neck cancer, such as squamous cell carcinoma (HNSCC), lymphoma, thyroid, or salivary gland cancer. Evidence suggests that a neck mass in the adult patient should be considered malignant until proven otherwise. Timely diagnosis of a neck mass due to metastatic HNSCC is paramount because delayed diagnosis directly affects tumor stage and worsens prognosis. Unfortunately, despite substantial advances in testing modalities over the last few decades, diagnostic delays are common. Currently, there is only 1 evidence-based clinical practice guideline to assist clinicians in evaluating an adult with a neck mass. Additionally, much of the available information is fragmented, disorganized, or focused on specific etiologies. In addition, although there is literature related to the diagnostic accuracy of individual tests, there is little guidance about rational sequencing of tests in the course of clinical care. This guideline strives to bring a coherent, evidence-based, multidisciplinary perspective to the evaluation of the neck mass with the intention to facilitate prompt diagnosis and enhance patient outcomes. Purpose The primary purpose of this guideline is to promote the efficient, effective, and accurate diagnostic workup of neck masses to ensure that adults with potentially malignant disease receive prompt diagnosis and intervention to optimize outcomes. Specific goals include reducing delays in diagnosis of HNSCC; promoting appropriate testing, including imaging, pathologic evaluation, and empiric medical therapies; reducing inappropriate testing; and promoting appropriate physical examination when cancer is suspected. The target patient for this guideline is anyone ≥18 years old with a neck mass. The target clinician for this guideline is anyone who may be the first clinician whom a patient with a neck mass encounters. This includes clinicians in primary care, dentistry, and emergency medicine, as well as pathologists and radiologists who have a role in diagnosing neck masses. This guideline does not apply to children. This guideline addresses the initial broad differential diagnosis of a neck mass in an adult. However, the intention is only to assist the clinician with a basic understanding of the broad array of possible entities. The intention is not to direct management of a neck mass known to originate from thyroid, salivary gland, mandibular, or dental pathology as management recommendations for these etiologies already exist. This guideline also does not address the subsequent management of specific pathologic entities, as treatment recommendations for benign and malignant neck masses can be found elsewhere. Instead, this guideline is restricted to addressing the appropriate work-up of an adult patient with a neck mass that may be malignant in order to expedite diagnosis and referral to a head and neck cancer specialist. The Guideline Development Group sought to craft a set of actionable statements relevant to diagnostic decisions made by a clinician in the workup of an adult patient with a neck mass. Furthermore, where possible, the Guideline Development Group incorporated evidence to promote high-quality and cost-effective care. Action Statements The development group made a strong recommendation that clinicians should order a neck computed tomography (or magnetic resonance imaging) with contrast for patients with a neck mass deemed at increased risk for malignancy. The development group made the following recommendations: (1) Clinicians should identify patients with a neck mass who are at increased risk for malignancy because the patient lacks a history of infectious etiology and the mass has been present for ≥2 weeks without significant fluctuation or the mass is of uncertain duration. (2) Clinicians should identify patients with a neck mass who are at increased risk for malignancy based on ≥1 of these physical examination characteristics: fixation to adjacent tissues, firm consistency, size >1.5 cm, or ulceration of overlying skin. (3) Clinicians should conduct an initial history and physical examination for patients with a neck mass to identify those with other suspicious findings that represent an increased risk for malignancy. (4) For patients with a neck mass who are not at increased risk for malignancy, clinicians or their designees should advise patients of criteria that would trigger the need for additional evaluation. Clinicians or their designees should also document a plan for follow-up to assess resolution or final diagnosis. (5) For patients with a neck mass who are deemed at increased risk for malignancy, clinicians or their designees should explain to the patient the significance of being at increased risk and explain any recommended diagnostic tests. (6) Clinicians should perform, or refer the patient to a clinician who can perform, a targeted physical examination (including visualizing the mucosa of the larynx, base of tongue, and pharynx) for patients with a neck mass deemed at increased risk for malignancy. (7) Clinicians should perform fine-needle aspiration (FNA) instead of open biopsy, or refer the patient to someone who can perform FNA, for patients with a neck mass deemed at increased risk for malignancy when the diagnosis of the neck mass remains uncertain. (8) For patients with a neck mass deemed at increased risk for malignancy, clinicians should continue evaluation of patients with a cystic neck mass, as determined by FNA or imaging studies, until a diagnosis is obtained and should not assume that the mass is benign. (9) Clinicians should obtain additional ancillary tests based on the patient's history and physical examination when a patient with a neck mass is deemed at increased risk for malignancy who does not have a diagnosis after FNA and imaging. (10) Clinicians should recommend evaluation of the upper aerodigestive tract under anesthesia, before open biopsy, for patients with a neck mass deemed at increased risk for malignancy and without a diagnosis or primary site identified with FNA, imaging, and/or ancillary tests. The development group recommended against clinicians routinely prescribing antibiotic therapy for patients with a neck mass unless there are signs and symptoms of bacterial infection.
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Affiliation(s)
| | - M Boyd Gillespie
- 2 Universityy of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Benjamin Roman
- 3 Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Richard M Rosenfeld
- 4 SUNY Downstate Medical Center, Long Island College Hospital, New York, New York, USA
| | | | - Laura Bontempo
- 6 University of Maryland School of Medicine, Baltimore, Maryland, USA
| | | | | | - Maria Colandrea
- 8 Veterans Affairs Medical Center, Durham, North Carolina, USA.,9 Duke University School of Nursing, Durham, North Carolina, USA
| | - Sandra A Finestone
- 10 Consumers United for Evidence-Based Healthcare, Baltimore, Maryland, USA
| | | | | | - Zeb Henson
- 13 University of Mississippi Medical Center, Jackson, Mississippi, USA
| | | | - Vikas Mehta
- 15 Lousiana State University, Shreveport, Louisiana, USA
| | | | | | - Deborah R Shatzkes
- 18 Hofstra Northwell School of Medicine, Lenox Hill Hospital, New York, New York, USA
| | - Wendy B Stern
- 19 Southcoast Hospital, North Dartmouth, Massachusetts, USA
| | | | - Maureen D Corrigan
- 21 American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA
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14
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Astrup GL, Rustøen T, Hofsø K, Gran JM, Bjordal K. Symptom burden and patient characteristics: Association with quality of life in patients with head and neck cancer undergoing radiotherapy. Head Neck 2017; 39:2114-2126. [PMID: 28766791 DOI: 10.1002/hed.24875] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 05/09/2017] [Accepted: 05/30/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Patients with head and neck cancer (HNC) experience diminished quality of life (QOL) during and after treatment. This study examined which characteristics were associated with QOL over time. METHODS One hundred thirty-three patients with HNC from a study of 534 oncology patients rated physical and mental QOL using the Short Form-12 5 times from the initiation of radiotherapy (RT) through the following 6 months. Linear mixed model analyses examined changes over time and associated characteristics. RESULTS The QOL deteriorated during RT and gradually improved after completion. Less social support was negatively associated with both physical and mental QOL. Older age, more comorbidities, more psychological symptoms, and concomitant chemotherapy (CTX) were negatively associated with physical QOL. Male sex, less physical symptoms, surgery before RT, and concomitant chemotherapy were positively associated with mental QOL. CONCLUSION Clinicians can use knowledge on time course and associated characteristics to identify and inform patients at higher risk for diminished QOL.
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Affiliation(s)
- Guro Lindviksmoen Astrup
- Department of Oncology, Division of Cancer Medicine, Oslo University Hospital, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway
| | - Tone Rustøen
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Norway.,Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway
| | - Kristin Hofsø
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Norway.,Lovisenberg Diaconal University College, Oslo, Norway
| | - Jon Michael Gran
- Oslo Centre for Biostatistics and Epidemiology, Faculty of Medicine, University of Oslo and Oslo University Hospital, Norway
| | - Kristin Bjordal
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway.,Research Support Services, Oslo University Hospital, Norway
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15
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Batıoğlu-Karaaltın A, Binbay Z, Yiğit Ö, Dönmez Z. Evaluation of life quality, self-confidence and sexual functions in patients with total and partial laryngectomy. Auris Nasus Larynx 2017; 44:188-194. [DOI: 10.1016/j.anl.2016.03.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 03/26/2016] [Accepted: 03/28/2016] [Indexed: 10/21/2022]
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16
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van Deudekom FJ, Schimberg AS, Kallenberg MH, Slingerland M, van der Velden LA, Mooijaart SP. Functional and cognitive impairment, social environment, frailty and adverse health outcomes in older patients with head and neck cancer, a systematic review. Oral Oncol 2017; 64:27-36. [DOI: 10.1016/j.oraloncology.2016.11.013] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 10/24/2016] [Accepted: 11/24/2016] [Indexed: 12/13/2022]
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17
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Abstract
BACKGROUND Cancer patients with depression or anxiety have poor survival, and the interaction between mental and physical problems in older patients may exacerbate this problem. K-ras oncogene (KRAS) mutation may play a role in the development of psychosocial distress and may be associated with poor survival of metastatic colorectal cancer (mCRC) patients. This study investigated the association between KRAS gene mutations and psychosocial morbidity to explore the possible cancer/psychosis relationship in older mCRC patients. METHODS In this study, 62 newly diagnosed mCRC patients were recruited and completed the Hospital Anxiety and Depression Scale (HADS). Demographic data were also collected, and clinicopathological data were retrieved from medical records. KRAS mutations were assessed via PCR analysis of tissue specimens from the patients. RESULTS The results showed that 28 of the 62 participants (45.2%) had positive screens for possible depression, and 45 of the 62 participants (72.6%) had positive screens for anxiety. The KRAS mutation rate was 40.3% (25/62), and 19 of the 25 patients with KRAS mutations (76.0%) had probable depression, whereas only 24.3% of the patients with wild-type KRAS were probably depressed (p < 0.05). The KRAS mutation was associated with higher HADS depression scores, independent of gender and performance status (p < 0.05), but not with higher HADS anxiety or total scores. CONCLUSIONS KRAS mutations were associated with depression severity and higher rates of probable depression in older mCRC patients. Depression should be assessed and treated as early as possible in older mCRC patients with the KRAS mutation. Further studies are needed to verify our current findings using a larger sample size.
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18
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Pfeifer MP, Keeney C, Bumpous J, Schapmire TJ, Studts JL, Myers J, Head B. Impact of a telehealth intervention on quality of life and symptom distress in patients with head and neck cancer. JOURNAL OF COMMUNITY AND SUPPORTIVE ONCOLOGY 2016; 13:14-21. [PMID: 25839061 DOI: 10.12788/jcso.0101] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Patients undergoing treatment for head and neck cancer commonly experience signicant changes in quality of life (QoL) and levels of symptom distress. It is not known if a telehealth intervention would mitigate these changes. OBJECTIVE To evaluate the impact of a telehealth intervention on QoL and symptom burden in patients undergoing initial treatment for head and neck cancers. METHODS A randomized clinical trial comparing the impact on QoL and symptom distress of telehealth intervention and standard care was conducted with 80 patients (45 treatment, 35 control) who had been diagnosed with head or neck cancer and were receiving 1 or more treatment modalities. Treatment group participants responded daily to symptom management algorithms using a simple telehealth messaging device. QoL was evaluated by the Functional Assessment of Cancer Therapy-Head and Neck Scale (FACTHN) and symptom burden by the Memorial Symptom Assessment Scale (MSAS). Control group participants completed assessments while they received routine care. RESULTS In the posttreatment phase, the telehealth participants had signicantly better scores than the controls for physical well-being (20.6 vs 17.0, P = .02) and trial outcome index (59.9 vs. 50.2, P = .04) on the FACT-HN, and total scores on the MSAS (0.9 vs. 1.2, P = .04). LIMITATIONS The moderate sample size of 80 patients limits the power to measure more subtle impacts of the intervention. CONCLUSIONS Using telehealth to provide support to patients with head and neck cancer during the acute phase of treatment improved some aspects of posttreatment QoL and symptom burden.
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Affiliation(s)
- Mark P Pfeifer
- Department of Medicine, University of Louisville, Louisville, Kentucky, USA
| | - Cynthia Keeney
- Department of Medicine, University of Louisville, Louisville, Kentucky, USA. Ms Keeney is now with Big White Wall
| | - Jeffrey Bumpous
- Department of Surgery/Otolaryngology, University of Louisville, Louisville, Kentucky, USA
| | - Tara J Schapmire
- Department of Medicine, University of Louisville, Louisville, Kentucky, USA
| | - Jamie L Studts
- Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - John Myers
- Department of Pediatrics, School of Medicine, University of Louisville, Louisville, Kentucky, USA
| | - Barbara Head
- Department of Medicine, University of Louisville, Louisville, Kentucky, USA.
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19
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Moderators of the response to a nurse-led psychosocial intervention to reduce depressive symptoms in head and neck cancer patients. Support Care Cancer 2015; 23:2417-26. [PMID: 25612795 PMCID: PMC4483179 DOI: 10.1007/s00520-015-2603-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 01/05/2015] [Indexed: 11/26/2022]
Abstract
Purpose Little is known about the variables that moderate the response to psychosocial interventions to decrease depressive symptoms in cancer patients. The purpose of this study was to determine whether variables associated with depressive symptoms in cancer patients in general moderate the response to a nurse-led psychosocial intervention in patients with head and neck cancer. Methods This study is a secondary analysis of a randomized controlled trial evaluating the effect of the nurse counseling and after intervention (NUCAI) on depressive symptoms 12 months after cancer treatment in patients with head and neck cancer. Of 205 patients, 103 received the NUCAI and 102 care as usual. Twenty-one variables were selected for analysis and a linear regression analyses including interaction terms was performed for each variable separately. Significant moderators were post hoc probed. Results Four moderators were found: marital status, global quality of life, emotional functioning, and social functioning. Patients who were married/living together or had low scores for global quality of life, and emotional or social functioning at baseline benefited more from the NUCAI than patients who were single or with high scores for global quality of life and emotional or social functioning. Conclusions Marital status, global quality of life, and emotional and social functioning of head and neck cancer patients should be evaluated to determine whether they might benefit from a psychosocial intervention to combat depressive symptoms. Further research is necessary to replicate results and to contribute to the knowledge needed to make screening and personalized patient care possible.
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20
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Moubayed SP, Sampalis JS, Ayad T, Guertin L, Bissada E, Gologan OE, Soulières D, Lambert L, Filion E, Nguyen-Tan PF, Christopoulos A. Predicting depression and quality of life among long-term head and neck cancer survivors. Otolaryngol Head Neck Surg 2014; 152:91-7. [PMID: 25395572 DOI: 10.1177/0194599814557772] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The aim of this study is to identify clinical factors that are predictive of depression and quality of life (QOL) among long-term survivors of head and neck squamous cell carcinoma and to develop predictive scores using these factors. STUDY DESIGN Cohort study SETTING Tertiary referral center. SUBJECTS AND METHODS A total of 209 posttreatment (median follow-up, 38.7 months) head and neck cancer patients were prospectively evaluated using the Hospital Anxiety Depression Scale (HADS), the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30, and the EORTC Quality of Life Questionnaire Head and Neck 35, and pretreatment patient-related, tumor-related, and treatment-related predictors were identified using chart review. Bivariate (χ(2) and t test) and multivariate (linear regression) analyses were used to construct predictive models. RESULTS Significant pretreatment predictors of depression were identified on multivariate analysis as smoking at diagnosis, >14 alcoholic drinks per week, T3 or T4 status, and >3 medications (P < .001). Two or more of these factors yielded an 82.3% sensitivity in detecting significant depressive symptoms (defined as a HADS cutoff score of 5). Significant predictors of fatigue, global health/QOL, social contact, speech, pain, swallowing, and xerostomia were also identified. CONCLUSION Pretreatment predictors of long-term depression and QOL have been defined using multivariate models, and an easily applicable predictive score of long-term depression is proposed. Potential eventual clinical applications include prophylactic intervention in at-risk patients.
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Affiliation(s)
- Sami P Moubayed
- Otolaryngology-Head and Neck Surgery Service, Université de Montréal Hospital Center, Montreal, Canada Division of Surgical Research, Department of Surgery, McGill University, Montreal, Canada
| | - John S Sampalis
- Division of Surgical Research, Department of Surgery, McGill University, Montreal, Canada
| | - Tareck Ayad
- Otolaryngology-Head and Neck Surgery Service, Université de Montréal Hospital Center, Montreal, Canada
| | - Louis Guertin
- Otolaryngology-Head and Neck Surgery Service, Université de Montréal Hospital Center, Montreal, Canada
| | - Eric Bissada
- Otolaryngology-Head and Neck Surgery Service, Université de Montréal Hospital Center, Montreal, Canada
| | - Olguta E Gologan
- Department of Pathology, Université de Montréal Hospital Center, Montreal, Canada
| | - Denis Soulières
- Medical Oncology Service, Université de Montréal Hospital Center, Montreal, Canada
| | - Louise Lambert
- Department of Radiation Oncology, Université de Montréal Hospital Center, Montreal, Canada
| | - Edith Filion
- Department of Radiation Oncology, Université de Montréal Hospital Center, Montreal, Canada
| | - Phuc Felix Nguyen-Tan
- Department of Radiation Oncology, Université de Montréal Hospital Center, Montreal, Canada
| | - Apostolos Christopoulos
- Otolaryngology-Head and Neck Surgery Service, Université de Montréal Hospital Center, Montreal, Canada
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21
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Hanna EY, Mendoza TR, Rosenthal DI, Gunn GB, Sehra P, Yucel E, Cleeland CS. The symptom burden of treatment-naive patients with head and neck cancer. Cancer 2014; 121:766-73. [PMID: 25369213 DOI: 10.1002/cncr.29097] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 08/28/2014] [Accepted: 09/02/2014] [Indexed: 11/12/2022]
Abstract
BACKGROUND The treatment of head and neck cancer (HNC) may cause substantial local and systemic symptomatic morbidities, but many patients have high symptom levels before treatment begins. Knowledge of disease-related (treatment-naive) symptom status would aid in the evaluation of the symptomatic benefit or burden of HNC therapies. METHODS The authors retrospectively examined symptoms, quality of life, and health status reported by patients with HNC who were naive to any treatment. Symptoms were explored by anatomical site and disease factors were correlated with symptom severity and interference. A clustering algorithm was used to identify a subset of highly symptomatic patients, and the effects of disease site, tumor stage, and demographic variables on membership in this high-symptom group were examined. RESULTS A total of 748 treatment-naive patients with mucosal (434 patients), nonmucosal (272 patients), or skull base (42 patients) tumors were identified who had rated their symptoms using the MD Anderson Symptom Inventory. The majority of patients were white non-Hispanic (82%) and male (68%), with a median age of 59 years. Approximately one-third the patients had a high pretreatment symptom burden. Pain, fatigue, distress, and disturbed sleep were the most severe symptoms reported, regardless of tumor stage or site. Symptom burden was found to be higher among patients with more advanced disease. Predictors of a high symptom burden included having a mucosal tumor and being female. CONCLUSIONS The high prevalence of moderate to severe symptoms found in the current study demonstrates the importance of assessing patient-reported symptoms routinely before treatment is initiated and emphasizes the need for symptom management in parallel with disease treatment. Baseline characterization of symptom status should be incorporated into clinical trials that may affect symptom burden.
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Affiliation(s)
- Ehab Y Hanna
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
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22
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Abstract
UNLABELLED Head and neck cancer (HNC) constitutes approximately 3% of all cancers in the UK, with in excess of 8500 new cases annually. Management of HNC depends on site, extent, histology, previous medical history and patient choice. A multidisciplinary approach is required to optimize patient wellbeing, owing to the significant functional and psychosocial implications that can impact on quality of life. Members of the dental team, to include the general dental practitioner, have a key role in patient care; therefore the dental team should be knowledgeable in the short-term and longer-term implications and how this impacts on quality of life. CLINICAL RELEVANCE This article offers the dental team with an overview of how HNC and the various treatments, such as surgery, radiotherapy and chemotherapy, impact upon quality of life, both in the short-term and longer-term.
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23
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Fang CY, Egleston BL, Ridge JA, Lango MN, Bovbjerg DH, Studts JL, Burtness BA, Einarson MB, Klein-Szanto AJP. Psychosocial functioning and vascular endothelial growth factor in patients with head and neck cancer. Head Neck 2013; 36:1113-9. [PMID: 23804308 DOI: 10.1002/hed.23421] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Revised: 03/27/2013] [Accepted: 06/10/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Psychosocial functioning is associated with vascular endothelial growth factor (VEGF) in various patient populations. This study examined whether psychosocial functioning in patients with head and neck squamous cell carcinoma (HNSCC) is associated with tumor VEGF expression, a protein that stimulates angiogenesis and is associated with poor prognosis. METHODS Forty-two newly diagnosed patients completed assessments of psychosocial functioning (ie, depressive symptoms, perceived stress, anxiety, social support) before surgery. Tumor samples were obtained for VEGF analysis and human papillomavirus (HPV)-typing. RESULTS Poorer psychosocial functioning was associated with greater VEGF expression controlling for disease stage (odds ratio [OR], 4.55; 95% confidence interval [CI], 1.72-12.0; p < .01). When examined by HPV status, the association between psychosocial functioning and VEGF remained significant among patients who were HPV negative (OR, 5.50; 95% CI, 1.68-17.3; p < .01), but not among patients who were HPV positive. CONCLUSION These findings inform our understanding of the biobehavioral pathways that may contribute to poor outcomes in non-HPV-associated HNSCCs.
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Affiliation(s)
- Carolyn Y Fang
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania
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24
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McGarvey A, Osmotherly P, Hoffman G, Chiarelli P. Lymphoedema following treatment for head and neck cancer: impact on patients, and beliefs of health professionals. Eur J Cancer Care (Engl) 2013; 23:317-27. [DOI: 10.1111/ecc.12134] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2013] [Indexed: 11/27/2022]
Affiliation(s)
- A.C. McGarvey
- Physiotherapy Department; The Calvary Mater Newcastle Hospital; Waratah NSW Australia
- Faculty of Health Sciences; University of Newcastle; Callaghan NSW Australia
| | - P.G. Osmotherly
- Faculty of Health Sciences; University of Newcastle; Callaghan NSW Australia
| | - G.R. Hoffman
- Department of Maxillofacial Surgery; John Hunter Hospital; New Lambton NSW Australia
| | - P.E. Chiarelli
- Faculty of Health Sciences; University of Newcastle; Callaghan NSW Australia
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25
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Aarstad AKH, Beisland E, Aarstad HJ. Personality, choice of coping and T stage predict level of distress in head and neck cancer patients during follow-up. Eur Arch Otorhinolaryngol 2011; 269:2121-8. [PMID: 22200985 DOI: 10.1007/s00405-011-1884-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Accepted: 12/09/2011] [Indexed: 01/23/2023]
Abstract
The aim of the present study was to investigate to what extent TNM stage, treatment level, personality, choice of coping, mood and health-related quality of life (HRQoL) scores predicted distress as measured by general health questionnaire (GHQ) in successfully treated head and neck squamous cell carcinoma (HNSCC) patients. All patients younger than 80 years who had been diagnosed with HNSCC in western Norway in the period from 1992 to 1997, and who had survived until 1999, were sampled. Ninety-six patients (90% response rate) were included 48 ± 2 months after diagnosis. We determined personality by the Eysenck personality inventory, coping by the COPE questionnaire; HRQoL by EORTC QLQ questionnaire; and mood by Beck depression inventory (BDI). Fifty-five of 58 eligible patients were interviewed a second time 47 ± 1 months after the first interview where neuroticism and GHQ-30 questionnaires were answered. Both HRQoL [explained variance (EV), 9-40%] and BDI (EV 26-30%) scores predicted the GHQ scores. Numerical T stage was inversely associated with GHQ scores (EV ~10%). High neuroticism generally predicted high GHQ scores (EV 16-28%). Avoidance focused, problem focused, drinking to cope predicted GHQ scores (EV 8-14%) and high alcohol consumption (EV ~8%) predicted GHQ scores. The present association pattern could still be shown when adjusted for gender, age and educational level when studied by multiple regression analyses. In conclusion, lowered HRQoL, low mood, a high T stage, high alcohol consumption, high neuroticism, coping by avoidance and coping by problem solving directly predicted worse distress as measured by high GHQ scores, whereas neuroticism was also associated with GHQ through choice of coping.
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Affiliation(s)
- Anne K H Aarstad
- Department of Surgical Sciences, Faculty of Medicine, University of Bergen, 5021 Bergen, Norway.
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Williamson JS, Ingrams D, Jones H. Quality of life after treatment of laryngeal carcinoma: a single centre cross-sectional study. Ann R Coll Surg Engl 2011; 93:591-5. [PMID: 22041234 DOI: 10.1308/147870811x13137608455253] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Laryngeal cancer treatment inherently affects life's most basic functions and significantly affects quality of life (QOL). We aimed to identify which aspects of QOL and which patients are most affected by the various treatment options. METHODS The University of Washington Quality of Life (UW-QOL) questionnaire was administered to all patients with laryngeal cancer treated at a single institution over a seven-year period (2003-2010). RESULTS In total, 41 patients responded. All had been treated for squamous cell carcinoma of the larynx. Questionnaires were completed at a median of 18.5 months after treatment. The overall quality of life was 81.1/100 as assessed by the UW-QOL scale, with only 4.9% reporting 'poor' or worse QOL. Neither patient age nor time after treatment significantly affected any aspect of QOL. Patients undergoing primary radiotherapy reported the best QOL. Those undergoing chemoradiotherapy or combined surgical treatment and chemoradiotherapy reported the worst QOL, particularly in terms of social eating, taste and saliva production. Patients with a T stage ≥2 and those with nodal metastases reported a significantly worse QOL. CONCLUSIONS Overall, QOL in our patients was good. This study highlights the aspects of QOL most affected by various treatments for laryngeal cancer and identifies areas in which therapeutic intervention may be focused. It also provides information to guide clinicians when assisting patients to make informed decisions regarding treatment of their head and neck cancer.
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Affiliation(s)
- J S Williamson
- Department of ENT, Royal Gwent hospital, Cardiff Road, Newport, NP20 2UB, UK.
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Variability and stability of coping in women with breast cancer. Support Care Cancer 2011; 20:2277-85. [DOI: 10.1007/s00520-011-1334-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2011] [Accepted: 11/11/2011] [Indexed: 11/26/2022]
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Head BA, Heitz L, Keeney C, Myers J, Appana SN, Studts JL, Bumpous J, Pfeifer M. The relationship between weight loss and health-related quality of life in persons treated for head and neck cancer. Support Care Cancer 2011; 19:1511-8. [PMID: 20730547 PMCID: PMC4177674 DOI: 10.1007/s00520-010-0975-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Accepted: 07/29/2010] [Indexed: 11/27/2022]
Abstract
PURPOSE This study explores the relationship between weight loss, health-related quality of life (HRQOL), and symptom burden in patients treated for head and neck cancers. METHODS Participants completed the Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N) and the Memorial Symptom Assessment Scale (MSAS) pre-treatment, mid-treatment, and post-treatment. Weights were recorded prior to treatment and at the post-treatment follow-up visit, and percentage weight loss was tabulated. Relationships between weight loss, HRQOL, and symptom burden were evaluated using the nonparametric Spearman rho. A simple linear regression model was developed to examine the influence weight loss has on HRQOL in a predictive manner. RESULTS Average weight loss per patient was 12 lb with a modal value of 19. Weight loss was found to be significantly correlated with decreases in physical well-being, functional well-being, the Head and Neck specific subscale, and composite QOL scores. No significant correlations were found between weight loss and symptom burden as measured by the MSAS. Linear regression suggested that a 10% decrease in baseline weight resulted in a 19% decrease in the FACT-H&N score. CONCLUSION The strong association between weight loss and HRQOL supports the importance of efforts to prevent weight loss via patient education, aggressive monitoring, and immediate intervention to stop or reverse weight loss during treatment. New approaches to the weight loss and wasting experienced by patients should be developed and tested.
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Affiliation(s)
- Barbara A Head
- University of Louisville School of Medicine, MDR Bldg., Suite 110, 511 South Floyd St., Ste. 110, Louisville, KY 40202, USA.
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Aarstad AKH, Lode K, Larsen JP, Bru E, Aarstad HJ. Choice of psychological coping in laryngectomized, head and neck squamous cell carcinoma patients versus multiple sclerosis patients. Eur Arch Otorhinolaryngol 2011; 268:907-15. [PMID: 21085978 PMCID: PMC3087083 DOI: 10.1007/s00405-010-1417-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2010] [Accepted: 10/25/2010] [Indexed: 11/26/2022]
Abstract
To be treated for cancer must be a frightening experience. Yet quality of life (QoL) of successfully treated cancer patients seems to be relatively similar in comparison with QoL of a general population, with psychological coping partly responsible for this finding. When measuring choice of coping, the nature of coping score levels constituting appropriate scores, and whether score levels rely on the context of the disease has not been settled. We have studied the COPE coping responses as related to disease in successfully treated head and neck squamous cell carcinoma (HNSCC) patient groups (general and laryngectomized), as well as compared to multiple sclerosis (MS) patients. The COPE response patterns have also been compared to the Beck depression inventory (BDI) scores. Age and gender of patients were not directly associated with choice of coping. Within the problem-focused coping indexes, the coping index "active coping" was reported to be most utilized among HNSCC patients, whereas "coping by suppression" and "coping by social support" were most utilized among MS patients. Emotional-focused coping was most prevalent among HNSCC patients and lowest among the MS patients. Level of avoidance coping was similar between the groups. The coping of the general HNSCC patients differed most from the MS patients. An association was shown between increased coping efforts and lowered mood. In particular, avoidance coping was associated with lowered mood. These associations were stronger among the MS patients than HNSCC patients. Drinking to cope was most prevalent among the laryngectomized group, and was correlated with BDI scores in all groups. Furthermore, adequate coping seems to be to limit avoidance coping and promote coping by acceptance. The response pattern of the COPE inventory seems to be valid among HNSCC and MS patients.
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Affiliation(s)
- A K H Aarstad
- Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, 5021 Bergen, Norway.
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Aarstad AKH, Beisland E, Osthus AA, Aarstad HJ. Distress, quality of life, neuroticism and psychological coping are related in head and neck cancer patients during follow-up. Acta Oncol 2011; 50:390-8. [PMID: 20843173 DOI: 10.3109/0284186x.2010.504227] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
UNLABELLED The aim of the present study was to study the relation between distress, quality of life (QoL), personality and choice of coping in successfully treated head and neck squamous cell carcinoma (HNSCC) patients, and to study whether distress could be regarded as a QoL variable. MATERIAL AND METHODS We determined present distress by the general health questionnaire (GHQ), QoL by the European Organization for Research and Treatment of Cancer Quality of life Questionnaire (EORTC-QLQ) C30/H&N35, personality by the Eysenck Personality Inventory and coping by the COPE questionnaire. All patients younger than 80 years who had been diagnosed with HNSCC in Western Norway in the period from 1992 to October 2001, and who had survived at least 12 months without evidence of disease were interviewed. In addition, treatment level, TNM stage, alcohol consumption level as well as smoking level were determined. One hundred and thirty-nine patients (96.5% response rate) were included. RESULTS Distress and QoL indexes were scored with a common variance (CV) between 20% and 35%. The measured variables account for 40-48% of the variance of the QoL/GHQ scores. Between 3% and 10% of the GHQ/general QoL scores and 10% of the variance of the H&N35 QoL scores were predicted by the TNM stage. The measured psychological factors accounted for 20% of the H&N35 QoL scores and 40% of the measured variance of the general QoL and GHQ responses. High neuroticism (CV≈20-35%), present avoidance coping (CV≈10-30%) and coping by suppression of competing activity (CV≈10-20%) were associated with low QoL and high distress. CONCLUSION GHQ and QoL scores are scored similar, and are to some extent predicted by treatment related factors, but between 2.5 and 10 times more closely associated with psychological factors. Distress may possibly also be regarded as a QoL variable.
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Affiliation(s)
- Anne K H Aarstad
- Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway.
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Merz EL, Malcarne VL, Hansdottir I, Furst DE, Clements PJ, Weisman MH. A longitudinal analysis of humor coping and quality of life in systemic sclerosis. PSYCHOL HEALTH MED 2009; 14:553-66. [DOI: 10.1080/13548500903111798] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Oliffe JL, Ogrodniczuk J, Bottorff JL, Hislop TG, Halpin M. Connecting humor, health, and masculinities at prostate cancer support groups. Psychooncology 2009; 18:916-26. [DOI: 10.1002/pon.1415] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Hahm BJ, Min SU, Yoon MY, Shin YW, Kim JS, Jung JY, Suh DH. Changes of psychiatric parameters and their relationships by oral isotretinoin in acne patients. J Dermatol 2009; 36:255-61. [PMID: 19382995 DOI: 10.1111/j.1346-8138.2009.00635.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Oral isotretinoin is a highly effective agent for the treatment of moderate to severe acne, but ever since oral isotretinoin was introduced as a modality for acne, the relationship between oral isotretinoin therapy and psychiatric problems, especially depression, has been controversial. The purposes of this study were to know the acute effects of oral isotretinoin therapy on psychiatric symptoms and to investigate the relationships among them, which have not been reported in the published work. This cohort study included 38 acne patients who started oral isotretinoin therapy. Individual patients were examined before administering oral isotretinoin and 2 and 8 weeks after commencement. Acne severity was graded using the Leeds revised acne grading system. Acute psychiatric effects of oral isotretinoin were assessed using a questionnaire authorized by two psychiatrists. This questionnaire included assessments of acne-related quality of life (Assessment of the Psychological and Social Effects of Acne [APSEA]), depression (Beck's depression inventory [BDI]), anxiety (Beck's anxiety inventory [BAI]) and psychopathology (Symptomchecklist-90-revised [SCL-90-R]). Acne grading and APSEA showed similar change patterns. Both improved after 8 weeks of oral isotretinoin treatment. On the other hand, the severity of depression decreased after 2 weeks of treatment. A significant correlation was found between BDI and APSEA, but no correlation was found between BDI and acne grade. These results indicate that oral isotretinoin therapy alleviates depressive symptoms. Improvements in depression are directly related to acne-related life quality improvements rather than to improvement in acne grade.
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Affiliation(s)
- Bong Jin Hahm
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
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Aarstad AKH, Aarstad HJ, Olofsson J. Personality and choice of coping predict quality of life in head and neck cancer patients during follow-up. Acta Oncol 2009; 47:879-90. [PMID: 18568484 DOI: 10.1080/02841860701798858] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION The aim of the present study was to investigate to what extent personality and choice of coping predicted self-reported quality of life (QoL) in successfully treated head and neck squamous cell carcinoma (HNSCC) patients. MATERIALS AND METHODS We determined QoL by the European Organization for Research and Treatment of Cancer Quality of life Questionnaire (EORTC-QLQ) C30/H&N35, personality by the Eysenck Personality Inventory and coping by the COPE questionnaire. All patients younger than 80 years who had been diagnosed with HNSCC in Western Norway in the period from 1992 to1997, and who had survived until 1999, were sampled. Ninety-six patients (90% response rate) were included 48+/-2 months after diagnosis. Fifty-five of 58 eligible patients were interviewed a second time 47+/-1 months after the first interview where neuroticism and QoL questionnaires were answered. RESULTS Numerical T stage was inversely associated with the second QoL scores (CV: 10-24%). High neuroticism generally predicted low secondary QoL scores both directly (common variance: 17-25%) and adjusted by the QoL values measured simultaneously as the neuroticism (CV: 11-25%). Avoidance focused, problem focused, drinking to cope and coping by humor all predicted QoL scores (CV: 8.5-15%). The present association pattern could still be shown when adjusted for gender, age and educational level when studied by multiple regression analyses. CONCLUSION In conclusion, a high T stage, high neuroticism, coping by humor and coping by problem solving directly predicted low QoL whereas neuroticism was also associated with QoL through avoidance coping.
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Gurney TA, Eisele DW, Orloff LA, Wang SJ. Predictors of quality of life after treatment for oral cavity and oropharyngeal carcinoma. Otolaryngol Head Neck Surg 2008; 139:262-7. [DOI: 10.1016/j.otohns.2008.05.024] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2007] [Revised: 04/11/2008] [Accepted: 05/15/2008] [Indexed: 11/30/2022]
Abstract
BACKGROUND: Treatment for head and neck cancer, including surgery, radiation, and chemotherapy, can impact quality of life. DESIGN: Patients seen at an academic institution and treated for oral cavity and oropharyngeal carcinoma were asked to participate. The standardized University of Michigan Head and Neck Specific Quality of Life questionnaire was distributed. RESULTS: Eighty-seven patients completed the questionnaire. The majority had squamous cell carcinoma (94%), stage III or IV disease (53%), and a history of tobacco or alcohol dependence (59%), and were male (62%). Eighteen percent had free-tissue transfer (fibula free flap in 8% and radial forearm free flap in 10%). Predictors of worse quality of life included advanced stage, gastrostomy-tube dependence, complication, or recurrence. CONCLUSION: Stage, gastrostomy-tube dependence, complication, recurrence, and treatment modality influence quality of life. A better understanding of the impact of oral cavity and oropharyngeal cancer treatment on quality of life will enable us to better advise our patients.
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Affiliation(s)
- Theresa A. Gurney
- Department of Otolaryngology–Head and Neck Surgery, University of California, San Francisco, San Francisco, CA
| | - David W. Eisele
- Department of Otolaryngology–Head and Neck Surgery, University of California, San Francisco, San Francisco, CA
| | - Lisa A. Orloff
- Department of Otolaryngology–Head and Neck Surgery, University of California, San Francisco, San Francisco, CA
| | - Steven J. Wang
- Department of Otolaryngology–Head and Neck Surgery, University of California, San Francisco, San Francisco, CA
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Mehanna HM, De Boer MF, Morton RP. The association of psycho-social factors and survival in head and neck cancer. Clin Otolaryngol 2008; 33:83-9. [PMID: 18429854 DOI: 10.1111/j.1749-4486.2008.01666.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Update a previous review examining associations between psycho-social factors and survival in head and neck cancer patients. DATA SOURCES Searched Cochrane, Psych info and Embase for the period from 1 January 1995 to 1 June 2007, as well as personal and article reference lists and article archives. STUDY SELECTION Identified articles assessed by consensus for eligibility using following criteria: survival as outcome measure; psycho-social factors as prognostic indicators; results specifically for head and neck cancer patients, not including oesophageal or thyroid cancer. Seven of 64 articles fulfilled criteria. DATA EXTRACTION Data abstracted independently by two reviewers using pre-determined proformas. Quality also rated using Scottish Intercollegiate Guidelines Network 50 tool. DATA SYNTHESIS At baseline, expression of intense psycho-social complaints, higher self-perceived physical ability and self-reported high physical functioning were significantly associated with increased survival. Uncertainty about the diagnosis and treatment was found to be a negative prognostic indicator, as was being single, poor cognitive function, baseline fatigue and alcoholism. Overall quality of life and head and neck pain 12 months after date of diagnosis were found to be significantly associated with survival in one study. However, overall quality of life and depression at the time of diagnosis were not. CONCLUSIONS There appears to be some association between selected psycho-social factors and long-term survival from head and neck cancer. However this relationship is currently neither strong nor proven, requiring examination by multi centred trials with standardisation of research definitions and methodologies, and examination of post-treatment psycho-social factors.
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Affiliation(s)
- H M Mehanna
- Institute of Head and Neck Studies and Education, Department of Otolaryngology, University Hospitals Coventry and Warwick NHS Trust, Coventry, UK.
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Bergquist H, Ruth M, Hammerlid E. Psychiatric morbidity among patients with cancer of the esophagus or the gastro-esophageal junction: a prospective, longitudinal evaluation. Dis Esophagus 2007; 20:523-9. [PMID: 17958729 DOI: 10.1111/j.1442-2050.2007.00741.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Cancer of the esophagus is often diagnosed at a late stage and is related to severe morbidity and a low 5-year survival rate. Previous studies have reported low health-related quality of life and high suicide rates for these patients. The occurrence of psychiatric morbidity and thus the potential need for psychological support may vary over time after diagnosis. This has not been adequately studied in patients with newly diagnosed cancer of the esophagus or gastro-esophageal junction. The present study therefore aimed to prospectively evaluate the prevalence of psychiatric morbidity in 94 consecutive patients (median age 66, range 45-88 years) with all stages of disease. Psychiatric morbidity was evaluated with the Hospital Anxiety and Depression Scale (HADS) questionnaire at inclusion and 1, 2, 3, 6 and 12 months later. At inclusion, 42% of the patients had HADS scores indicating possible or probable anxiety disorder and/or depression. At all follow-ups except at 3 months, proportions of patients with possible/probable anxiety disorder were significantly lower than at inclusion. Among patients with a duration of tumor-specific symptoms exceeding 6 months pre-diagnosis, larger proportions of patients with a possible/probable anxiety disorder were found at the 1- and 6-month follow ups. The prevalence of possible/probable depression was greater among patients treated with a palliative intent than among those with a curative intent at inclusion. Patients who died during the study period scored worse for depression compared to the survivors. Apart from this, the proportion of patients with possible/probable psychiatric morbidity (anxiety and/or depression) was relatively stable over time and was unrelated to patient characteristics or clinical background, including the treatment regime. In conclusion, psychiatric morbidity is common among esophageal cancer patients, both at inclusion and over time, regardless of the cancer therapy given. The findings stress the importance of monitoring the patients' mental health and of offering adequate psychological care when needed.
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Affiliation(s)
- H Bergquist
- Department of Otorhinolaryngology, Sahlgrenska University Hospital, Gothenburg, Sweden.
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Rogers SN, Ahad SA, Murphy AP. A structured review and theme analysis of papers published on ‘quality of life’ in head and neck cancer: 2000–2005. Oral Oncol 2007; 43:843-68. [PMID: 17600755 DOI: 10.1016/j.oraloncology.2007.02.006] [Citation(s) in RCA: 183] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2006] [Revised: 02/25/2007] [Accepted: 02/26/2007] [Indexed: 11/18/2022]
Abstract
Over the past 10 years, quality of life (QOL) has been increasingly recognised as an important outcome parameter in head and neck cancer. Validated questionnaires have emerged and there has been an increase in the number of papers published each year. The aim of this article is to review the literature over the past five years (2000-2005 inclusive), to identify papers reporting outcomes using patient self-competed questionnaires and group these into themes. The tabulated summary allows for the areas of health related quality of life research to be identified and to explore issues that are perhaps deficit in the literature. The three authors independently searched the literature published in the English language using the ISI search engine with cross-reference using Pub Med and Ovid. The search terms were; quality of life, questionnaire, and head and neck cancer. Studies were placed in to one of five themes. There were 165 studies identified. The numbers in each theme were predictors of QOL [Hassanein KA, Musgrove BT, Bradbury E. Functional status of patients with oral cancer and its relation to style of coping, social support and psychological status. Br J Oral Maxillofac Surg 2001;39:340-5.], functional outcome [Klug C, Neuburg J, Glaser C, Schwarz B, Kermer C, Millesi W. Quality of life 2-10 years after combined treatment for advanced oral and oropharyngeal cancer. Int J Oral Maxillofac Surg 2002;31:664-9.], questionnaire development [Hanna E, Sherman A, Cash D, Adams D, Vural E, Fan CY, et al. Quality of life for patients following total laryngectomy vs chemoradiation for laryngeal preservation. Arch Otolaryngol Head Neck Surg 2004;130:875-9.], randomised clinical trials [Kanatas AN, Rogers SN. A national survey of health-related quality of life questionnaires in head and neck oncology. Ann R Coll Surg Engl 2004;86:6-10.], and reviews [Kanatas AN, Rogers SN. A national survey of health-related quality of life questionnaires in head and neck oncology. Ann R Coll Surg Engl 2004;86:6-10.]. Although many facets of HRQOL following head and neck cancer have been explored over the last five years the paper identifies issues where research is still lacking.
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Affiliation(s)
- S N Rogers
- Regional Maxillofacial Unit, University Hospital Aintree, Aintree Trust, Liverpool L9 7AL, UK.
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Kerawala CJ, Newlands C, Coombes D. Follow-up after treatment of squamous cell carcinoma of the oral cavity: Current maxillofacial practice in the United Kingdom. Br J Oral Maxillofac Surg 2007; 45:361-3. [DOI: 10.1016/j.bjoms.2006.09.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2006] [Indexed: 10/23/2022]
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Omoro SAO, Fann JR, Weymuller EA, Macharia IM, Yueh B. Swahili translation and validation of the Patient Health Questionnaire-9 depression scale in the Kenyan head and neck cancer patient population. Int J Psychiatry Med 2007; 36:367-81. [PMID: 17236703 DOI: 10.2190/8w7y-0tpm-jvgv-qw6m] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Depression is an important predictor of post therapy quality of life (QOL) in head and neck (H&N) cancer patients. In addition, depression rates may vary among cultures. OBJECTIVE As part of a larger cross cultural study on post therapy QOL differences in H&N cancer patients, the goal of this project was to translate a well-validated English language depression scale into Swahili, and then validate this scale in Kenyan H&N cancer patients. METHODS, SETTINGS AND SUBJECTS: In Part 1 of the study, we translated the Patient Health Questionnaire-9 (PHQ-9) into Swahili, adhering to established International Quality of Life Association (IQOLA) guidelines. In Part 2, we psychometrically validated the newly translated scale using a prospective study of 48 patients at the Kenyatta National Hospital ENT clinic in Nairobi, Kenya. RESULTS The Swahili PHQ-9 had good test retest reliability (Intraclass correlation coefficient, 0.71) and internal consistency (Cronbach's alpha = 0.80). It also had good construct validity, as scores correlated strongly with TNM stage (Chi square = 123, p < 0.05), and with the compositeand global scores of an H&N cancer specific QOL scale (UW-QOL, r = -0.87, p < 0.05). CONCLUSION The Swahili version of the PHQ-9 is a reliable scale in Kenyan H&N cancer patients, and is a valuable tool in screening for and monitoring of depression as a function of QOL in this population.
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Affiliation(s)
- S A O Omoro
- University of Washington, Department Of Otolaryngology-Head and Neck Surgery, USA.
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Walter M, Hänni B, Haug M, Amrhein I, Krebs-Roubicek E, Müller-Spahn F, Savaskan E. Humour therapy in patients with late-life depression or Alzheimer's disease: a pilot study. Int J Geriatr Psychiatry 2007; 22:77-83. [PMID: 16977676 DOI: 10.1002/gps.1658] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Of the disabling disorders of the elderly, depression is the most common affective disorder and Alzheimer's disease (AD) the most common neurodegenerative disorder. Pharmacological treatment strategies for these disorders are often accompanied with severe side effects. Therefore non-pharmacological treatment strategies are of great importance. The aim of the present study was to investigate the impact of humour therapy on quality of life in patients with depression or AD. METHODS Twenty patients with late-life depression and 20 patients with AD were evaluated. Ten patients in each group underwent a humour therapy group (HT) once in two weeks for 60 min in addition to standard pharmacotherapy, which was given as usual to the other group as standard therapy (ST). All patients completed a psychometric test battery at admission and before discharge from the clinic. RESULTS The quality of life scores improved both in HT and ST groups for depressive patients but not for patients with AD irrespective of the therapy group. Depressive patients receiving HT showed the highest quality of life after treatment. In addition, patients with depression in both therapy groups showed improvements in mood, depression score, and instrumental activities of daily living. CONCLUSIONS Although there was no significant effect of humour therapy comparing with standard therapy on quality of life, these findings suggest that humour therapy can provide an additional therapeutic tool. Further studies with higher frequently humour groups are required in order to investigate the impact of humour therapy in gerontopsychiatric treatment.
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Affiliation(s)
- Marc Walter
- Psychiatric University Clinics, University of Basel, Basel, Switzerland.
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Aarstad AKH, Aarstad HJ, Bru E, Olofsson J. Psychological coping style versus disease extent, tumour treatment and quality of life in successfully treated head and neck squamous cell carcinoma patients. Clin Otolaryngol 2006; 30:530-8. [PMID: 16402979 DOI: 10.1111/j.1749-4486.2005.01114.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To study self-reported coping style by the COPE questionnaire and the association to tumour node distant metastasis (TNM) stage, received treatment and health-related quality of life (HRQoL) in a population of successfully treated head and neck squamous cell carcinoma (HNSCC) patients. DESIGN Disease free HNSCC patients were interviewed during a regular outpatient visit to the Department. SETTING All patients <80 years who had been diagnosed with HNSCC, in Western Norway, in the period from 1992 to 1997 and who were disease free in the year 2000 were included. MAIN OUTCOME MEASURES The HNSCC patients were studied by the European organization for research and treatment of cancer quality of life (QoL) questionnaire and by the COPE questionnaire from which coping styles profiles were extracted. Clinical and socio-demographic variables were also gathered. RESULTS Level of problem focused coping style was associated with the T stage and whether or not the patient was given neck radiotherapy. An avoidance-focused coping style was generally associated with lowered HRQoL. Employment of emotional focused coping was associated with low HRQoL among the patients treated with surgery only, and associated with increased HRQoL among patients treated with radiation therapy only. The associations between HRQoL and coping style levels were stronger for HRQoL indexes reflecting cognitive/emotional function than for HRQoL indexes reflecting physical function. CONCLUSIONS In former HNSCC patients, level of problem focused coping style was associated with the T stage and if given neck radiotherapy. Level of avoidance coping was inversely associated with the HRQoL, and level of emotional coping was associated with HRQoL in a complex manner.
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Affiliation(s)
- A K H Aarstad
- Department of Surgical Sciences, Section of Otolaryngology/Head and Neck Surgery, Faculty of Medicine, University of Bergen, Bergen, Norway
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Humphris GM, Ozakinci G. Psychological responses and support needs of patients following head and neck cancer. Int J Surg 2006; 4:37-44. [PMID: 17462312 DOI: 10.1016/j.ijsu.2005.12.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2005] [Revised: 12/19/2005] [Accepted: 12/21/2005] [Indexed: 10/25/2022]
Abstract
The patient with head and neck (H&N) cancer is prone to psychological distress immediately following diagnosis and during the treatment phase. Lowered mood is typical and tends to extend beyond the treatment phase. There is little evidence for a specific treatment method predicting a characteristic psychological response. Rather, patients' reactions vary widely according to fears of recurrence, health beliefs, personality, coping and available support. Patient reports of quality of life show a return to pre-treatment status after a year but are determined to some degree by initial depression levels and dispositional factors such as optimism. Information provided to patients (e.g. leaflets, booklets of written guidance) by specialist treatment centres about the disease and its management require sustained effort in their design and distribution. Our understanding of patient responses to this disease has improved and has assisted in the development of psychological interventions. Controlled trials will provide important evidence of the components, effects and sustainability of these experimental programmes, and improve overall care plans for this often neglected patient group.
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Affiliation(s)
- Gerry M Humphris
- Bute Medical School, University of St Andrews, Queen's Terrace, St Andrews KY16 9TS, UK.
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Aarstad HJ, Aarstad AKH, Lybak S, Monge O, Haugen DF, Olofsson J. The amount of treatment versus quality of life in patients formerly treated for head and neck squamous cell carcinomas. Eur Arch Otorhinolaryngol 2005; 263:9-15. [PMID: 16205902 DOI: 10.1007/s00405-005-0961-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2004] [Accepted: 02/21/2005] [Indexed: 11/29/2022]
Abstract
The aim of the present study was to investigate the association between the self-reported quality of life (QoL) versus the initial TNM stage and amount of primary and recurrent tumor therapy given in a population of formerly treated head and neck squamous cell carcinoma (HNSCC) patients. We determined QoL by the European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire (EORTC-QLQ) C30/H&N35 by structured interview. One hundred and twenty-two patients less than 80 years old, who had been diagnosed with HNSCC in western Norway in the period from 1992 to1997, and who had survived until 2000, were identified. Of these patients, 106 were eligible to be included. Ninety-six of these patients agreed to be interviewed. For TNM stage as well as the type of therapy given (local surgery, neck dissection or radiation therapy), T stage predicted the general QoL scores. Both increased TNM stage and all given tumor therapy seemingly caused lower H&N symptom QoL scores. Of the various tumor treatments employed, neck radiation therapy and neck dissection were indicated to be the most closely associated with the H&N QoL scores. Having neck dissection performed seemingly caused impairment beyond what was explained by the initial TNM stage. In conclusion, tumor therapy to HNSCC should not be restricted due to general QoL considerations. Further study of how and when to perform neck treatment is suggested in order to avoid unnecessary reduced H&N QoL.
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Affiliation(s)
- H J Aarstad
- Section of Otolaryngology/Head and Neck Surgery, Department of Surgical Sciences, University of Bergen, Bergen, Norway.
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