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Jehn P, Linsen SS, Zeller AN, Eckstein FM, Neuhaus MT, Gellrich NC, Krüskemper G, Lentge F, Spalthoff S, Korn P. Gender-specific differences concerning psychosocial aspects and functional impairments that influence quality of life in oral cancer treatment. Support Care Cancer 2022; 30:4905-4915. [PMID: 35171323 DOI: 10.1007/s00520-022-06907-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 02/09/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE Patients with oral cancer have gender-specific differences with respect to health-related quality of life (HRQoL) and psychosocial variables (PV). The aim of the present study was to evaluate HRQoL and PV outcomes in patients treated for oral squamous cell carcinoma. METHODS Data of 1234 patients were collected from a multicenter rehabilitation study of the German-Austrian-Swiss Cooperative Group on Tumours of the Maxillofacial Region (DÖSAK). Patient characteristics, oncological variables, post-treatment impairments, general quality of life (QoL), and PV (coping strategies, control beliefs, personal traits, perceived social support, depression, anxiety, and fear of tumor recurrence) were recorded. RESULTS After treatment, HRQoL was similar between genders concerning general QoL, but men experienced significantly more treatment-related functional impairments influencing HRQoL. PV revealed gender-specific coping strategies, with women reporting significantly more "depressive coping," "religiosity," "fatalistic externality," and higher "social burden." Owing to their religious coping strategies, fatalistic attitude, and perceived higher social integration, women demonstrated superior disease acceptance, despite higher depression, anxiety, and lower psychosocial resilience. Conversely, men reported more introverted personal traits and lower social integration. CONCLUSION Interventions during oral cancer treatment should address PV and have gender-specific elements to improve HRQoL after therapy.
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Affiliation(s)
- Philipp Jehn
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany.
| | - Sabine Swantje Linsen
- Department of Prosthodontics; Preclinical Education and Dental Material Science, University Hospital Bonn, Welschnonnenstr. 17, 53111, Bonn, Germany
| | - Alexander-Nicolai Zeller
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
| | - Fabian Matthias Eckstein
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
| | - Michael-Tobias Neuhaus
- Department of Oral, Craniomaxillofacial and Facial Plastic Surgery, University Hospital of Leipzig, Liebigstr. 12, Leipzig, 04103, Germany
| | - Nils-Claudius Gellrich
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
| | - Gertrud Krüskemper
- Department of Medical Psychology, Ruhr University of Bochum, Universitätsstr. 150, Building MA 0/145, 44780, Bochum, Germany
| | - Fritjof Lentge
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
| | - Simon Spalthoff
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
| | - Philippe Korn
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
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Sjeltoft JR, Donsel PO, Vad H, Larsen MK, Missel M. A radical change: A qualitative study of patients' experiences of eating and daily living through the first year after oesophageal resection. Eur J Oncol Nurs 2020; 48:101800. [PMID: 32746000 DOI: 10.1016/j.ejon.2020.101800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/29/2020] [Accepted: 07/06/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE The purpose of this study is to explore the lived experiences of patients in terms of eating and consequences in everyday life in the first year after oesophageal cancer surgery. METHODS Thirteen patients participated in qualitative interviews one year after surgery for oesophageal cancer. Descriptions capturing the meaning of the lived experiences of patients were then derived from subsequent analysis and interpretation of the interviews. A phenomenological hermeneutical approach comprised the epistemological stance, and theoretical perspectives were drawn from Schutz' theory of everyday life. RESULTS Patient descriptions of their experiences with food, eating and everyday life in the first year after oesophageal cancer surgery fell into four themes: Adjusting to a different anatomy - food and eating as a dominant and difficult activity; changed body - food and eating as an underlying shadow; feeling different - social consequences of changed eating; a nutritional jungle - guidance and support in an uncertain time. CONCLUSION The physical and social consequences of oesophageal cancer resection upend everyday structures, requiring patients to adopt a new, conscious and reflexive approach to food and eating as a social activity. Continuous support from healthcare professionals and patient-to-patient interaction can help redefine everyday life.
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Affiliation(s)
| | - Pernille Orloff Donsel
- Department of Cardiothoracic Surgery, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark.
| | - Henrik Vad
- Department of Cardiothoracic Surgery, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark.
| | - Malene Kaas Larsen
- Department of Surgery, Odense University Hospital, Sdr. Boulevard, 5000, Odense, Denmark; Institute of Regional Health Research, University of Southern Denmark, Campusvej 55, 5000, Odense, Denmark.
| | - Malene Missel
- Department of Cardiothoracic Surgery, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark.
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Rupel K, Ottaviani G, Gobbo M, Poropat A, Zoi V, Zacchigna S, Di Lenarda R, Biasotto M. Campaign to Increase Awareness of Oral Cancer Risk Factors Among Preadolescents. J Cancer Educ 2020; 35:616-620. [PMID: 30835060 DOI: 10.1007/s13187-019-01504-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Oral squamous cell carcinoma (OSCC) represents one of the most common but scarcely known malignancies worldwide. The etiology of OSCC is strongly related to lifestyle habits and behavior, especially tobacco smoking and alcohol abuse. The mean age of individuals who start smoking and drinking alcohol is decreasing; thus, the aim of our campaign was to test the awareness and increase knowledge of oral cancer and its risk factors among young preadolescents. Six schools with 460 students aged 12-14 years were included in the campaign. A lecture about carcinogenesis and oral cancer was provided. Anonymous questionnaires were submitted to the students before and after the lecture, to test their knowledge, awareness, and understanding. Before the lecture, the students showed very little awareness of oral cancer (26.8%), although almost all of them identified tobacco smoking as a risk factor (92.2%). After the lecture, the students showed a significant understanding of the provided information, thus increasing their awareness. On scales of 1-10, the students rated the appropriateness of the campaign at 8.9 and their overall appreciation at 8.7. Social campaigns, especially among young students, seem to be appreciated and may represent a powerful strategy for increasing knowledge about cancer risk factors, especially when they are highly related to lifestyle habits and behavior.
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Affiliation(s)
- Katia Rupel
- Division of Oral Medicine, Department of Medical, Surgical and Health Sciences, University of Trieste, Piazza Ospitale 1, Trieste, Italy.
| | - Giulia Ottaviani
- Division of Oral Medicine, Department of Medical, Surgical and Health Sciences, University of Trieste, Piazza Ospitale 1, Trieste, Italy
| | - Margherita Gobbo
- Division of Oral Medicine, Department of Medical, Surgical and Health Sciences, University of Trieste, Piazza Ospitale 1, Trieste, Italy
| | - Augusto Poropat
- Division of Oral Medicine, Department of Medical, Surgical and Health Sciences, University of Trieste, Piazza Ospitale 1, Trieste, Italy
| | - Valentina Zoi
- Division of Oral Medicine, Department of Medical, Surgical and Health Sciences, University of Trieste, Piazza Ospitale 1, Trieste, Italy
| | - Serena Zacchigna
- Division of Oral Medicine, Department of Medical, Surgical and Health Sciences, University of Trieste, Piazza Ospitale 1, Trieste, Italy
- International Centre for Genetic Engineering and Biotechnology (ICGEB), 34149, Trieste, Italy
| | - Roberto Di Lenarda
- Division of Oral Medicine, Department of Medical, Surgical and Health Sciences, University of Trieste, Piazza Ospitale 1, Trieste, Italy
| | - Matteo Biasotto
- Division of Oral Medicine, Department of Medical, Surgical and Health Sciences, University of Trieste, Piazza Ospitale 1, Trieste, Italy
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Răducu L, Avino A, Purnichescu Purtan R, Balcangiu-Stroescu AE, Bălan DG, Timofte D, Ionescu D, Jecan CR. Quality of Life in Patients with Surgically Removed Skin Tumors. Medicina (Kaunas) 2020; 56:E66. [PMID: 32050413 PMCID: PMC7074335 DOI: 10.3390/medicina56020066] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 01/31/2020] [Accepted: 02/02/2020] [Indexed: 12/11/2022]
Abstract
Background and Objectives: Skin cancer is one of the most frequently diagnosed malignancies. The main goal of the therapeutic management is total excision with the prevention of recurrence and metastasis. The quality of life of the patients with skin cancer is affected by the morbidity risk, surgery, and cosmetic or functional aspects. The aim of this study was to evaluate the quality of life of patients with skin cancer prior to and post surgical intervention. Material and methods: We performed a prospective study on 247 patients with skin tumors. Quality of life was evaluated through an initial questionnaire that was given to all consenting patients. This was used to determine patients' mobility, selfcare, normal activities, pain, and despair, using a five-point Likert scale. The general autoperceived health state was also recorded using a 100-point scale. The study included the responses of all patients at hospital admission, after one month of surgery, and after one year of surgery. Results: In patients with squamous cell carcinoma (SCC), the general health state indicator statistically significantly decreased one month after surgery and increased at one-year follow-up. In malignant melanoma (MM) patients, mobility, selfcare, normal activities, and discomfort presented a decrease in values one year after surgery, compared to the values registered at hospital admission. In patients with basal cell carcinoma (BCC), all indicators of quality of life presented an impaired value one year after surgery, after a decreasing trend. The general health state indicator statistically significantly increased one month after surgery and after one year. Conclusions: Surgery is one of the main steps in treating skin cancer. It has a great impact on patients' quality of life because of pain andthe effect on mobility and normal activities. Skin cancers influence the quality of life of patients both psychologicallyand physically.
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Affiliation(s)
- Laura Răducu
- Department of Plastic and Reconstructive Surgery, Clinical Emergency Hospital “Prof. Dr. Agrippa Ionescu”, 011356 Bucharest, Romania; (L.R.); (C.-R.J.)
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Adelaida Avino
- Department of Plastic and Reconstructive Surgery, Clinical Emergency Hospital “Prof. Dr. Agrippa Ionescu”, 011356 Bucharest, Romania; (L.R.); (C.-R.J.)
| | - Raluca Purnichescu Purtan
- Department of Mathematical Methods and Models, Faculty of Applied Sciences, University Politehnica of Bucharest, 060042 Bucharest, Romania;
| | - Andra-Elena Balcangiu-Stroescu
- Department of Dialysis, Emergency University Hospital Bucharest, 050098 Bucharest, Romania; (A.-E.B.-S.); (D.T.)
- Discipline of Physiology, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, 020021 Bucharest, Romania;
| | - Daniela Gabriela Bălan
- Discipline of Physiology, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, 020021 Bucharest, Romania;
| | - Delia Timofte
- Department of Dialysis, Emergency University Hospital Bucharest, 050098 Bucharest, Romania; (A.-E.B.-S.); (D.T.)
| | - Dorin Ionescu
- Discipline of Internal Medicine I and Nephrology, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Nephrology, Emergency University Hospital Bucharest, 050098 Bucharest, Romania
| | - Cristian-Radu Jecan
- Department of Plastic and Reconstructive Surgery, Clinical Emergency Hospital “Prof. Dr. Agrippa Ionescu”, 011356 Bucharest, Romania; (L.R.); (C.-R.J.)
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
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Waalboer-Spuij R, Hollestein LM, Nijsten TEC, Group LV. Satisfaction with Information Provision and Health-related Quality of Life in Basal and Squamous Cell Carcinoma Patients: A Cross-sectional Population-based Study. Acta Derm Venereol 2019; 99:933-934. [PMID: 31120545 DOI: 10.2340/00015555-3226] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Rick Waalboer-Spuij
- Department of Dermatology, Erasmus MC University Medical Centre, Postbus 2040, NL-3000 CA Rotterdam, The Netherlands.
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Abedini R, Nasimi M, Noormohammad Pour P, Moghtadaie A, Tohidinik HR. Quality of Life in Patients with Non-melanoma Skin Cancer: Implications for Healthcare Education Services and Supports. J Cancer Educ 2019; 34:755-759. [PMID: 29705894 DOI: 10.1007/s13187-018-1368-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Non-melanoma skin cancer (NMSC) is the most prevalent type of cancer among Caucasian populations worldwide. The purpose of this work was to measure quality of life (QOL) of the patients with diagnosis of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) who were referred to our cancer clinic. During 1 year, 95 patients were selected and asked to complete Dermatology Life Quality Index (DLQI) questionnaires. Ninety-five patients with NMSC (74 men and 21 women) with mean age of 64.6 ± 12.5 participated in this cross-sectional study. From 95 patients, 75 had BCC, 15 had SCC, and 5 patients had both SCC and BCC. The total DLQI scores of the all participants were between 0 and 16; the mean was 4.1 ± 4.25 and median was 2. Variables which were associated with impaired QOL were marital status (P = 0.03) and tumor location (P = 0.02). By using general dermatology QOL questionnaire, it had been demonstrated that patients with NMSC faced with minimal QOL impairment; also, this handicap was more pronounced in younger patients and singles and patients with tumors located in exposed areas. Our findings demonstrated a need to educate our patients to improve patients' knowledge about different aspects of disease.
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Affiliation(s)
- Robabeh Abedini
- Autoimmune Bullous Disease Research Center, Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Razi Hospital-Vahdate Eslami Street, Tehran, 1199663911, Iran
| | - Maryam Nasimi
- Autoimmune Bullous Disease Research Center, Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Razi Hospital-Vahdate Eslami Street, Tehran, 1199663911, Iran.
| | - Pedram Noormohammad Pour
- Autoimmune Bullous Disease Research Center, Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Razi Hospital-Vahdate Eslami Street, Tehran, 1199663911, Iran
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Barazzetti DO, Barazzetti PHO, Cavalheiro BT, Ely JB, Nunes DH, Stamm AMNDF. Quality of life and clinical and demographic characteristics of patients with cutaneous squamous cell carcinoma submitted to tumor resection by double-bladed scalpel. An Bras Dermatol 2019; 94:304-312. [PMID: 31365659 PMCID: PMC6668942 DOI: 10.1590/abd1806-4841.20197842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 06/03/2018] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Non-melanoma skin cancer accounts for a third of all malignancies registered in Brazil, with squamous cell carcinoma (SCC) being one of its subtypes. It develops in photo-exposed areas, affecting social habits and causing negative influence on quality of life (QoL). OBJECTIVES To evaluate QoL in patients with primary cutaneous SCC. METHODS A cross-sectional study was performed in patients with clinical diagnosis of SCC, corroborated by dermoscopy and confirmed by histopathology; prior to resection of the tumor using the double-blade scalpel technique, a questionnaire on the Dermatology Life Quality Index (DLQI) was applied. RESULTS Among the 46 evaluated patients, mean age was 67.1 ± 16.0 years, with a predominance of males, low educational level and socioeconomic status, Fitzpatrick II phototype, history of outdoor work, and tumor location in exposed photo areas. Mean DLQI was 4.02 ± 0.63, and in the categorization, 11 (23.9%) had a moderate to severe negative effect on QoL. The skin tumor had a negative impact on daily activities (33% of cases), treatment effects (30%), and symptoms and feelings (29%). Study limitations: There is no gold standard instrument for assessing QoL in dermatological patients. CONCLUSION In the study sample, one-fourth of patients with SCC had a moderate to severe negative effect on quality of life.
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Affiliation(s)
| | | | | | - Jorge Bins Ely
- Department of Operating Technique and Experimental Surgery,
Universidade Federal de Santa Catarina (SC), Brazil
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Abstract
INTRODUCTION "Sociability" is defined as the range of experiences linking the subject to others. This is the first study to focus specifically on the impact of head and neck cancer on the sociability of patients' partners. METHOD Data were collected via a dedicated questionnaire sent to patients' partners. The main endpoint was partner's self-assessment of the impact of the patient's disease on the partner's everyday life. The impact on sociability was analyzed with respect to: the circle of friends (friendship environment), unknown environment, known outside environment, necessary environment, and solitary activities. RESULTS Two hundred and seventy partners responded. Their everyday activities were impacted by the patient's disease in 71.5% of cases. The friendship environment was badly affected in 46.4% of cases. The unknown environment was affected in 44.0% of cases. Social practices related to the known outside environment were affected in 67.8% of cases, and the necessary environment in 26.0%; the number of solitary activities increased in 35.6% of cases. Social impact on patients' partners was thus considerable.
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Affiliation(s)
- G Grandazzi
- Inserm/Université de Caen U1086, cancers et préventions, 14000 Caen, France
| | - L-M Roussel
- Inserm/Université de Caen U1086, cancers et préventions, 14000 Caen, France; CHU de Caen, service ORL et chirurgie cervico-faciale, 14000 Caen, France.
| | - F Cuny
- CHU de Caen, service ORL et chirurgie cervico-faciale, 14000 Caen, France
| | - F Morlais
- Inserm/Université de Caen U1086, cancers et préventions, 14000 Caen, France
| | - L Launay
- Inserm/Université de Caen U1086, cancers et préventions, 14000 Caen, France
| | - E Babin
- Inserm/Université de Caen U1086, cancers et préventions, 14000 Caen, France; CHU de Caen, service ORL et chirurgie cervico-faciale, 14000 Caen, France
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Huang CC, Kuo HP, Lin YE, Chen SC. Effects of a Web-based Health Education Program on Quality of Life and Symptom Distress of Initially Diagnosed Advanced Non-Small Cell Lung Cancer Patients: A Randomized Controlled Trial. J Cancer Educ 2019; 34:41-49. [PMID: 28780685 DOI: 10.1007/s13187-017-1263-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Advanced non-small cell lung cancer (NSCLC) patients treated with chemotherapy experience functional decline and decreased quality of life. The purpose of this study was to evaluate the effects of a web-based health education program on global quality of life, quality of life-related functional dimensions, and symptom distress of initially diagnosed advanced non-small cell lung cancer patients. This study used a randomized, pre- and post-repeated measures design. A total of 55 participants were randomly assigned to an experimental group (n = 27) and a control group (n = 28). The experimental group participated in a web-based health education program, and the control group received usual care. Patients were assessed at 4 time points: baseline assessment (T0), and then 1, 2, and 3 months (T1, T2, and T3) after participating in the web-based health education program or receiving usual care. Patients in the experimental group had significantly greater global quality of life and emotional function, and significantly less top ten significant symptom distresses compared to those in the control group. There were no differences between the groups and within groups with respect to physical function, role function, cognitive function, and social function. The web-based health education can improve global quality of life, emotional function, and top ten significant symptom distresses in patients receiving chemotherapy during the first 3 months after initial diagnosis of advanced NSCLC. Web-based health education can improve quality of life and lessen distress of initially diagnosed NSCLC patients treated with chemotherapy.
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Affiliation(s)
- Chi-Chin Huang
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Han-Pin Kuo
- Department of Chest Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yueh-E Lin
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Nursing, College of Nursing, Chang Gung University of Science and Technology, 261, Wen-Hua 1st Road, Kweishan, Taoyuan, 333, Taiwan
| | - Shu-Ching Chen
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
- Department of Nursing, College of Nursing, Chang Gung University of Science and Technology, 261, Wen-Hua 1st Road, Kweishan, Taoyuan, 333, Taiwan.
- Department of Radiation Oncology, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Proton and Radiation Therapy Center, Taoyuan, Taiwan.
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Janz TA, Momin SR, Sterba KR, Kato MG, Armeson KE, Day TA. Comparison of psychosocial factors over time among HPV+ oropharyngeal cancer and tobacco-related oral cavity cancer patients. Am J Otolaryngol 2019; 40:40-45. [PMID: 30322742 DOI: 10.1016/j.amjoto.2018.08.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 08/29/2018] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The role of human papilloma virus (HPV) in the pathogenesis of oropharyngeal squamous cell carcinoma (OPSCC) is well documented, as is the excellent prognosis of patients with HPV-associated disease; in contrast, oral cavity squamous cell carcinoma (OCSCC) is associated with tobacco and alcohol use and has a worse prognosis. While causative factors, staging, and treatment guidelines differ between these cancer subsets, few studies have compared psychosocial factors in these groups. OBJECTIVE To explore differences in psychosocial factors between HPV+ OPSCC patients versus OCSCC smokers. METHODS A prospective cohort study at a single multidisciplinary, tertiary care HNC center was completed with recruitment from 2010 to 2013 using self-administered questionnaires before treatment and at 12 months. Patients were included with a diagnosis of HPV+ OPSCC or OCSCC with a smoking history. 38 (21 HPV+ OPSCC/17 OCSCC) met criteria. The main outcomes included self-efficacy, symptom severity, cancer worry, and depression. RESULTS A total of 38 (21 HPV+ OPSCC/17 OCSCC) patients (mean age: 57 [32-76], 73.7% male, 78.9% Caucasian, 71% stage IV) met inclusion criteria. OPSCC patients tended to be of male sex, Caucasian race, and single. Furthermore, OPSCC patients were more likely than OCSCC patients to have private insurance, be employed, and use alcohol and tobacco less frequently. Regarding psychosocial factors, HPV+ OPSCC patients reported lower symptom severity (2.7 versus 3.3), depression (12.0 versus 14.0) and cancer worry (2.8 versus 3.2) at baseline compared to OCSCC patients. Depression decreased significantly over time in OPSCC patients (12.0 to 9.9; effect size: -3.2 (95% CI: -5.9 to -0.4)). Although not statistically significant, cancer worry decreased in both groups (2.8 to 2.4 and 3.2 to 2.7, respectively, effect sizes: -0.3 (95% CI: -0.7-0.08) and -0.6 (95% CI: -1.2-0.05), respectively). No statistically significant differences in patterns of change over time were noted between groups. CONCLUSIONS AND RELEVANCE This pilot study highlighted a pattern of reduced quality of life parameters in OCSCC patients at baseline with similar improvements over time compared to the OPSCC cohort. Although different in cancer etiology and treatment plans, HPV+ OPSCC and tobacco-related OCSCC patients both require multidisciplinary cancer care plans that address psychosocial concerns. LEVEL OF EVIDENCE 2B.
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Affiliation(s)
- Tyler A Janz
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, United States of America; University of Central Florida College of Medicine, Orlando, FL, United States of America.
| | - Suhael R Momin
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, United States of America; Department of Otolaryngology - Head and Neck Surgery, Henry Ford Health System, Detroit, MI, United States of America
| | - Katherine R Sterba
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States of America
| | - Masanari G Kato
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, United States of America; Stony Brook University School of Medicine, Stony Brook, New York, United States of America
| | - Kent E Armeson
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States of America
| | - Terry A Day
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, United States of America
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Zhang MJ, Mu JW, Qu XS, Feng C, Zhao W. Effect of neuromuscular electrical stimulation for fatigue management in patients with advanced laryngeal cancer receiving chemoradiotherapy. Medicine (Baltimore) 2018; 97:e11370. [PMID: 29995774 PMCID: PMC6076145 DOI: 10.1097/md.0000000000011370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This study retrospectively investigated the effect of neuromuscular electrical stimulation (NMES) for fatigue management in patients with advanced laryngeal cancer (ALC) receiving chemoradiotherapy.A total of 60 eligible patients with ALC receiving chemoradiotherapy were included. These patients were assigned equally to a treatment group and a control group. Patients in the treatment group received NMES therapy and were treated for a total of 8 weeks, while the patients in the control group did not receive NMES therapy. The primary outcome was fatigue, measured by the multidimensional fatigue inventory (MFI). The secondary outcomes included anxiety and depression, measured by the Hospital Anxiety and Depression Scale (HADS), and sleep quality, measured by the Pittsburgh Sleep Quality Index (PSQI). All outcomes were evaluated before and after 8-week NMES treatmentAfter 8-week NMES treatment, the patients in the treatment group did not exert better effect than patients in the control group in fatigue relief, measured by the MFI score, anxiety and depression decrease, assessed by HADS, and sleep quality improvement, evaluated by PSQI.The results of this study demonstrate that NMES may not benefit for fatigue relief in patients with ALC receiving chemoradiotherapy. Future studies should still focus on this topic and warrant these results.
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Affiliation(s)
- Mei-jia Zhang
- Department of Otolaryngology, First Affiliated Hospital of Jiamusi University
| | - Ji-wei Mu
- Department of Otolaryngology, First Affiliated Hospital of Jiamusi University
| | - Xiu-sheng Qu
- Department of Radiotherapy, Second Affiliated Hospital of Jiamusi University, Jiamusi
| | - Chong Feng
- Department of Ultrasound, Hongqi Affiliated Hospital of Mudanjiang Medical University
| | - Wei Zhao
- Department of Anatomy, Mudanjiang Medical University, Mudanjiang, China
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12
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Waalboer-Spuij R, Hollestein LM, Timman R, van de Poll-Franse LV, Nijsten TE. Development and Validation of the Basal and Squamous Cell Carcinoma Quality of Life (BaSQoL) Questionnaire. Acta Derm Venereol 2018; 98:234-239. [PMID: 28952653 DOI: 10.2340/00015555-2806] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Health-related quality of life (HRQoL) is important in the management of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Disease-specific questionnaires exist, but with important shortcomings. The aim of this study was to develop and validate a questionnaire suitable for use in all patients with BCC and those with SCC. In a 4-phase trajectory, a preliminary questionnaire was created and population-based testing (1,173 patients) carried out. The questionnaire was reduced using exploratory factor analysis and item response theory. Individual item performance was assessed using classical test theory. A total of 721 patients completed the questionnaire. The number of items was reduced to 16, covering 5 scales. Confirmatory factor analysis showed a good fit. Cronbach�s ?s (range 0.67�0.82) were reasonable to high with good internal consistency. In conclusion, the Basal and Squamous Cell Carcinoma Quality of Life questionnaire has good face, content and construct validity. It is useful in the wide range of BCC and SCC patients and captures HRQoL impact over different time-frames.
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Affiliation(s)
- Rick Waalboer-Spuij
- Department of Dermatology, Erasmus MC University Medical Centre, Postbus 2040, NL-3000 CA Rotterdam, The Netherlands.
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Solomon I, Voiculescu VM, Caruntu C, Lupu M, Popa A, Ilie MA, Albulescu R, Caruntu A, Tanase C, Constantin C, Neagu M, Boda D. Neuroendocrine Factors and Head and Neck Squamous Cell Carcinoma: An Affair to Remember. Dis Markers 2018; 2018:9787831. [PMID: 29854027 PMCID: PMC5966665 DOI: 10.1155/2018/9787831] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 03/21/2018] [Accepted: 04/15/2018] [Indexed: 02/07/2023]
Abstract
Head and neck squamous cell carcinoma (HNSCC) is one of the most aggressive malignancies. Therefore, the major goal of cancer treatment is inhibition of tumor cell growth and of metastasis development. In order to choose the best management option for HNSCC patients, we need to identify reliable prognostic factors and to develop new molecular techniques in order to obtain a better understanding of therapy resistance. By acting as neurohormones, neurotransmitters, or neuromodulators, the neuroendocrine factors are able to signal the maintenance of physiological homeostasis or progression to malignant disease. Certain neuropeptides possess strong antitumor properties acting as tumor suppressors and immunomodulators, providing additional benefits for future potential therapeutic strategies. In light of the current understanding, cancer starts as a localized disease that can be effectively treated if discovered on proper time. Unfortunately, more than often cancer cells migrate to the surrounding tissues generating distant metastases, thus making the prognosis and survival in this stage much worse. As cellular migration is mandatory for tumor invasion and metastasis development, searching for alternate controllers of these processes, such as the neuroendocrine factors, it is an active tremendous task.
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Affiliation(s)
- Iulia Solomon
- 1Department of Dermatology and Allergology, Elias Emergency University Hospital, Bucharest, Romania
| | - Vlad Mihai Voiculescu
- 1Department of Dermatology and Allergology, Elias Emergency University Hospital, Bucharest, Romania
- 2Department of Dermatology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Constantin Caruntu
- 3Department of Physiology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- 4Department of Dermatology, “Prof. N. C. Paulescu” National Institute of Diabetes, Nutrition and Metabolic Diseases, Bucharest, Romania
| | - Mihai Lupu
- 5Department of Dermatology, MEDAS Titan Medical Center, Bucharest, Romania
| | - Alexandra Popa
- 1Department of Dermatology and Allergology, Elias Emergency University Hospital, Bucharest, Romania
| | - Mihaela Adriana Ilie
- 6Dermatology Research Laboratory, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- 7Department of Biochemistry, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Radu Albulescu
- 8Chemical and Pharmaceutical National Institute, Bucharest, Romania
| | - Ana Caruntu
- 9Department of Oral and Maxillofacial Surgery, Carol Davila Central Military Emergency Hospital, Bucharest, Romania
- 10Faculty of Medicine, Titu Maiorescu University, Bucharest, Romania
| | - Cristiana Tanase
- 10Faculty of Medicine, Titu Maiorescu University, Bucharest, Romania
- 11Victor Babes National Institute of Pathology, Bucharest, Romania
| | - Carolina Constantin
- 11Victor Babes National Institute of Pathology, Bucharest, Romania
- 12Colentina Clinical Hospital, Bucharest, Romania
| | - Monica Neagu
- 11Victor Babes National Institute of Pathology, Bucharest, Romania
- 12Colentina Clinical Hospital, Bucharest, Romania
- 13Faculty of Biology, University of Bucharest, Bucharest, Romania
| | - Daniel Boda
- 6Dermatology Research Laboratory, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
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Rigoni L, Bruhn RF, De Cicco R, Kanda JL, Matos LL. Quality of life impairment in patients with head and neck cancer and their caregivers: a comparative study. Braz J Otorhinolaryngol 2016; 82:680-686. [PMID: 27133907 PMCID: PMC9444724 DOI: 10.1016/j.bjorl.2015.12.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 12/08/2015] [Indexed: 11/29/2022] Open
Abstract
Introduction Head and neck cancer represents 3% of all the types of malignant neoplasms and squamous cell carcinoma (SCC) is responsible for 90% of these cases. There have been some studies evaluating the quality of life of these patients, but little is known about the physical and emotional effects on their caregivers. Objective To evaluate the quality of life of patients with head and neck cancer and their caregivers by applying validated questionnaires. Methods Thirty patients with advanced tumors (SCC stage III or IV) and their 30 caregivers were included. Specific questionnaires (Coop/Wonca, EORTC QLQ–C30, EORTC H&N35, Coop/Wonca, and Caregiver Strain Index – CSI) were applied during routine medical consultations. Results Of the 30 patients, 28 were males and 25 had stage IV tumors, with mean age of 56.6 years. 36.7% had the primary tumor in the oropharynx and 70% reported pain. The functional cognitive, physical, and emotional scales were the most affected. Pain, fatigue, and sleep disorders were the most prevalent symptoms. Of the 30 caregivers, 23 were females and 70% were the primary caregivers. 36.7% of the caregivers had high levels of stress, mainly related to the feeling of incapacity. The comparison between patients and caregivers demonstrated that the two groups had similar quality of life impairment: physical fitness (p = 0.487), mental health (p = 0.615), daily activities (p = 0.793), social activities (p = 0.301), changes in health (p = 0.649), and overall health (p = 0.168). Conclusion Quality of life impairment is similar between patients and their caregivers. This result demonstrates that not only the patients show quality of life impairment, but their caregivers also have it and at similar proportions.
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Affiliation(s)
- Laís Rigoni
- Faculdade de Medicina do ABC, Santo André, SP, Brazil.
| | - Raphaella Falco Bruhn
- Faculdade de Medicina do ABC, Disciplina de Cirurgia de Cabeça e Pescoço, Santo André, SP, Brazil
| | - Rafael De Cicco
- Faculdade de Medicina do ABC, Disciplina de Cirurgia de Cabeça e Pescoço, Santo André, SP, Brazil
| | - Jossi Ledo Kanda
- Faculdade de Medicina do ABC, Disciplina de Cirurgia de Cabeça e Pescoço, Santo André, SP, Brazil
| | - Leandro Luongo Matos
- Faculdade de Medicina do ABC, Disciplina de Saúde Coletiva (Curso de Bioestatística), Santo André, SP, Brazil
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Chao YT, Wang LW, Chu PY, Yang MH, Hsu YB, Lee TL, Wang YF, Tai SK. Minimal benefit of tonsillectomy in T1-T2 tonsillar squamous cell carcinoma treated with chemoradiotherapy. J Chin Med Assoc 2016; 79:570-6. [PMID: 27449724 DOI: 10.1016/j.jcma.2016.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 04/01/2016] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Chemoradiotherapy (CRT) has become the mainstay of treatment for tonsillar squamous cell carcinoma (SCC). Pre-CRT tonsillectomy is frequently performed, mostly for small primary tumors (T1-T2). However, the benefits of pre-CRT tonsillectomy remain unclear. METHODS A retrospective review was performed in 66 patients with T1-T2 tonsillar SCCs treated by CRT from 1997 to 2009. The efficacy of pre-CRT tonsillectomy was analyzed with regard to oncological and functional outcomes. RESULTS Thirty patients (45.5%) received tonsillectomy (pre-CRT tonsillectomy group), and 36 patients (54.5%) did not (CRT group). Except for a trend toward more T1 cases (33.3% vs. 13.9%, p = 0.061) and significantly less chemotherapy use (60% vs. 86.1%, p = 0.016) in the pre-CRT tonsillectomy group, there were no differences between the two groups in terms of age, gender, N classification (nodal status), overall stage, radiation dose, duration, or technique. In the pre-CRT tonsillectomy group, eight cases (26.7%) achieved an adequate operative margin judged by the surgeon, and only one (12.5%) had a negative pathological margin. In long-term follow-up, there were no statistically significant differences between the two groups regarding local (93.3% vs. 91.7%, p = 0.82) or regional control (93.3% vs. 94.4%, p = 0.84). The pre-CRT tonsillectomy group did not have a better 5-year disease-specific survival rate (83.3% vs. 94.4%, p = 0.177) or 5-year overall survival rate (70% vs. 94.4%, p = 0.017). There were no differences in complications or functional results (feeding tube and tracheostomy dependence), and quality of life demonstrated no significant difference. CONCLUSION Pre-CRT tonsillectomy contributes little to oncological and functional outcomes in patients with T1-T2 tonsillar SCC.
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Affiliation(s)
- Yun-Ting Chao
- Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ling-Wei Wang
- Cancer Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Pen-Yuan Chu
- Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Otolaryngology, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Muh-Hwa Yang
- Infection and Immunity Research Center, National Yang-Ming University, Taipei, Taiwan, ROC; Immunology Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC; Division of Medical Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Yen-Bin Hsu
- Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Otolaryngology, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Tsung-Lun Lee
- Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Otolaryngology, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Yi-Fen Wang
- Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Otolaryngology, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Shyh-Kuan Tai
- Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Otolaryngology, National Yang-Ming University, Taipei, Taiwan, ROC; Infection and Immunity Research Center, National Yang-Ming University, Taipei, Taiwan, ROC; Immunology Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
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16
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Abstract
A retrospective study of 13 patients assessed the use of a full thickness skin graft for nail unit reconstruction after total nail unit removal for nail bed malignancies. No failures of the graft were observed and no patient had recurrence of the malignant tumour at 4 year follow-up. Full thickness skin grafting is a simple procedure which provides a good cosmetic outcome and does not produce significant donor site morbidity.
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Affiliation(s)
- A Lazar
- Institut de la Main, 6 square Jouvenet, and Hôpital Saint Antoine, 184 Rue du Faubourg Saint Antoine, Paris, France
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17
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Lee EH, Klassen AF, Lawson JL, Scott AM, Pusic AL. Patient experiences and outcomes following facial skin cancer surgery: A qualitative study. Australas J Dermatol 2016; 57:e100-4. [PMID: 25833383 PMCID: PMC5461874 DOI: 10.1111/ajd.12323] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 02/05/2015] [Indexed: 11/29/2022]
Abstract
Early melanoma and non-melanoma skin cancer of the facial area are primarily treated with surgery. Little is known about the outcomes of treatment for facial skin cancer patients. The objective of the study was to identify concerns about aesthetics, procedures and health from the patients' perspective after facial skin surgery. Semi-structured in-depth interviews were conducted with 15 participants. Line-by-line coding was used to establish categories and develop themes. We identified five major themes on the impact of skin cancer surgery: appearance-related concerns; psychological (e.g., fear of new cancers or recurrence); social (e.g. impact on social activities and interaction); physical (e.g. pain and swelling) concerns and satisfaction with the experience of care (e.g., satisfaction with surgeon). The priority of participants was the removal of the facial skin cancer, as this reduced their overall worry. The aesthetic outcome was secondary but important, as it had important implications on the participants' social and psychological functioning. The participants' experience with the care provided by the surgeon and staff also contributed to their satisfaction with their treatment. This conceptual framework provides the basis for the development of a new patient-reported outcome instrument.
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Affiliation(s)
- Erica H. Lee
- Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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18
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Rettig EM, D'Souza G, Thompson CB, Koch W, Eisele D, Fakhry C. Health-related quality of life before and after head and neck squamous cell carcinoma: Analysis of the Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey linkage. Cancer 2016; 122:1861-70. [PMID: 27182694 PMCID: PMC4950667 DOI: 10.1002/cncr.30005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 01/31/2016] [Accepted: 03/04/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND Understanding health-related quality of life (HRQOL) is crucial to providing high-quality survivorship care for patients with head and neck squamous cell carcinoma (HNSCC). Trends in and prognostic significance of HRQOL before and after HNSCC have not been well described. METHODS HRQOL for older individuals with HNSCC was examined using the linked Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey database. Surveys assessing HRQOL from 5 years prediagnosis to 10 years postdiagnosis were included. HRQOL over time was modeled using multilevel linear regression with restricted cubic splines and was reported as either total HRQOL or change in HRQOL (denoted Δ). The association of prediagnosis HRQOL with survival was examined. RESULTS In total, 1653 individuals were included; of these, 61% completed 1 survey, and 39% completed multiple surveys. Overall HRQOL decreased progressively until 13 months postdiagnosis, then recovered toward baseline between 2 and 5 years. However, after stratification by survival group, the postdiagnosis recovery was not observed. Individuals with shorter survival had lower HRQOL prediagnosis (<2-year survivors, 87.3; > 5-year survivors, 96.4; P = .004) with a steeper decline in HRQOL during diagnosis and treatment (<2-year survivors: Δ, -16.6; 95% confidence interval [CI], -23.8, -9.4; > 5-year survivors: Δ, -0.9; 95% CI, -1.8, 0.08). Radiotherapy and advanced stage were associated with greater declines in HRQOL during diagnosis and treatment (P < .001). Higher prediagnosis HRQOL was independently associated with improved overall survival (adjusted hazard ratio for 10-point increase, 0.91; 95% CI, 0.85-0.97). CONCLUSIONS HRQOL declines before and after HNSCC, whereas any observed posttreatment recovery is likely an artifact of shorter survival among individuals with the lowest HRQOL. The prognostic implication of prediagnosis HRQOL may inform patient counseling. Cancer 2016;122:1861-70. © 2016 American Cancer Society.
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Affiliation(s)
- Eleni M Rettig
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine
| | - Gypsyamber D'Souza
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health
| | - Carol B Thompson
- Biostatistics Center, Johns Hopkins Bloomberg School of Public Health
| | - Wayne Koch
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine
| | - David Eisele
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine
| | - Carole Fakhry
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health
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19
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Chiou CR, Kaufman D. Lucky: Reflecting on Relationships in Family Medicine. Am Fam Physician 2016; 93:911. [PMID: 27281833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Kelly C, Paleri V, Downs C, Shah R. Deterioration in quality of life and depressive symptoms during radiation therapy for head and neck cancer. Otolaryngol Head Neck Surg 2016; 136:108-11. [PMID: 17210344 DOI: 10.1016/j.otohns.2006.06.1278] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2006] [Accepted: 06/29/2006] [Indexed: 11/25/2022]
Abstract
OBJECTIVE: The aim of this study was to assess the quality of life and psychologic profile during radiation therapy for head and neck cancer. STUDY DESIGN AND SETTING: The University of Washington QoL instrument and the Hospital Anxiety and Depression Scale were administered to 202 patients at two or three time points during radiation therapy. RESULTS: A total of 118 (54.6%) patients completed the questionnaires at the beginning and at the end of the study. A mid-treatment dataset was also available for 67 (31.0%) patients. There was a statistically significant deterioration in composite QoL scores ( P < 0.000) and a statistically significant increase in depression ( P < 0.000). There was no difference in anxiety levels ( P = 0.276). CONCLUSION: Patients undergoing radiation are increasingly depressed as treatment progresses, with worsening QoL during the treatment. SIGNIFICANCE: This study underlines the need for good psychologic support during radiation therapy in head and neck cancer. © 2007 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.
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Affiliation(s)
- Charles Kelly
- Northern Centre for Cancer Treatment, Newcastle upon Tyne, UK
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21
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Robinson JK, Friedewald J, Gordon EJ. Perceptions of Risk of Developing Skin Cancer for Diverse Audiences: Enhancing Relevance of Sun Protection to Reduce the Risk. J Cancer Educ 2016; 31:153-157. [PMID: 26209181 PMCID: PMC4881419 DOI: 10.1007/s13187-015-0885-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Sixty-five percent of kidney transplant recipients (KTRs) develop squamous cell carcinoma (SCC). Perceptions of risk of developing skin cancer, amelioration of this risk with sun protection, and having choices among sun protection strategies may enhance sun protection use by KTRS, who are at greater risk than the general population. Thirty KTRs stratified among non-Hispanic Whites, non-Hispanic Blacks, and Hispanic/Latinos evaluated three versions of the interactive, web-based, electronic sun protection program and suggested refinements. The sequence of content presentation prepared the participant to accept the credibility, accuracy, and relevance of the message. Beginning with informing participants that using sun protection reduces the chance of developing skin cancer made the information credible to KTRs. Showing skin cancer on all skin types and patient testimonials enhanced participants' awareness of their susceptibility to develop skin cancer and primed patients to receive their personal risk of developing skin cancer. Coupling presentation of knowledge about the benefits of sun protection in reducing the risk of developing skin cancer with the personal risk of getting the disease was essential to KTRs believing that they could influence their health outcome.
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Affiliation(s)
- June K Robinson
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 St. Clair Street, Suite 1260, Chicago, IL, 60611, USA.
| | - John Friedewald
- Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Elisa J Gordon
- Center for Healthcare Studies and Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Nueangkhota P, Liang YJ, Zheng GS, Su YX, Yang WF, Liao GQ. Reconstruction of Tongue Defects With the Contralateral Nasolabial Island Flap. J Oral Maxillofac Surg 2015; 74:851-9. [PMID: 26549474 DOI: 10.1016/j.joms.2015.10.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 10/08/2015] [Accepted: 10/08/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE Reconstruction of tongue defects after cancer resection is challenging for reconstructive surgeons. Conventional local flaps are usually compromised in patients with suspected ipsilateral neck metastasis. To extend the application of the nasolabial flap, especially in circumstances in which a free flap is unavailable, the contralateral nasolabial island flap was used, with favorable outcomes. PATIENTS AND METHODS Seven patients presenting with tongue carcinoma underwent surgical resection and neck dissection. Tongue defects were simultaneously reconstructed using a contralateral nasolabial island flap. Clinical outcomes, including locoregional recurrence and distant metastasis, were recorded. Subjective functional outcomes were investigated using the University of Washington Quality of Life Questionnaire. RESULTS All flaps survived without partial or complete necrosis. All patients survived without locoregional recurrence or distant metastasis during follow-up (6 months to 2 years). Functional outcomes were satisfactory, especially swallowing and speech functions. Donor-site morbidity was minimal and the scars were inconspicuously hidden in the nasolabial fold. CONCLUSIONS The contralateral nasolabial island flap is technically feasible and can be an excellent option for tongue reconstruction without compromising oncologic safety.
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Affiliation(s)
- Pajjai Nueangkhota
- Resident, Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Yu-jie Liang
- Lecturer, Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Guang-sen Zheng
- Lecturer, Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Yu-xiong Su
- Associate Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Wei-fa Yang
- Resident, Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Gui-qing Liao
- Professor and Chief, Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China.
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Aro K, Bäck L, Loimu V, Saarilahti K, Rogers S, Sintonen H, Roine R, Mäkitie A. Trends in the 15D health-related quality of life over the first year following diagnosis of head and neck cancer. Eur Arch Otorhinolaryngol 2015. [PMID: 26216625 DOI: 10.1007/s00405-015-3732-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Management of head and neck cancer influences both physical and mental wellbeing. Measuring the health-related quality of life (HRQoL) is important, as various treatment modalities are associated with significant morbidity and mortality. In this prospective cohort study, we tested the feasibility of the generic 15D HRQoL instrument in 214 head and neck cancer patients managed with surgery, definitive (chemo)radiotherapy, or with combined modality treatment. HRQoL was assessed at baseline and three times after treatment onset during 1 year, and compared with that of general population standardized for age and sex. At baseline, the patients' mean 15D score was significantly worse compared with general population. Overall HRQoL was at lowest at 3 months after treatment onset, it gradually improved towards 12 months but never reached baseline levels. The dimensions "vitality", "distress", "depression" and "sexual activity" showed marked deterioration at 3 months after the treatment onset, but improved gradually during 12 months. The 15D instrument seems useful for evaluation of HRQoL of head and neck cancer patients. Dimensions reflecting mental wellbeing improved gradually after 3 months, but they seldom reached baseline levels. The support for patients at the time of diagnosis, during treatment, and recovery is emphasized.
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Affiliation(s)
- K Aro
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital (HUH), P.O. Box 220, 00029, Helsinki, Finland
| | - L Bäck
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital (HUH), P.O. Box 220, 00029, Helsinki, Finland
| | - V Loimu
- Department of Oncology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - K Saarilahti
- Department of Oncology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - S Rogers
- Evidence-Based Practice Research Centre, Faculty of Health and Social Care, Edge Hill University, Liverpool, UK
| | - H Sintonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - R Roine
- Department of Health and Social Management, Research Centre for Comparative Effectiveness and Patient Safety, University of Eastern Finland, Kuopio, Finland
- Group Administration, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Antti Mäkitie
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital (HUH), P.O. Box 220, 00029, Helsinki, Finland.
- Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institute and Karolinska Hospital, Stockholm, Sweden.
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Xie K, Wen H, Wen B, Li Q, Zhou C, Qi X, He R. [Clinical application of perforator flap in extended radical vulvectomy of vulvar carcinoma]. Zhonghua Fu Chan Ke Za Zhi 2014; 49:834-837. [PMID: 25603908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To evaluate the clinical application of perforator flap in extended radical vulvectomy of vulvar carcinoma. METHODS Retrospectively, twelve cases of vulva carcinoma were treated by radical extensive excision, and the defects were repaired with perforator flap. RESULTS All the flaps were survived and healed with first intention except one infection. The wound infection patient was treated with change of the dressing and antibiotics. The reconstructed vulvae were plump and elastic. It appeared like the normal vulvae and there was no contraction of the vagina. CONCLUSIONS Vulvar reconstruction with the perforator flap after the radical vulvectomy could make the patients recover easily, which produces almost normal appearance and function of the vulvae, reduces the time of wound healing, the patient could get the next therapy more quickly and the quality of life improving. It has wide clinical application value.
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Affiliation(s)
- Kun Xie
- Department of Plastic Surgery, Peking University First Hospital, Beijing 100034, China
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de Almeida FCS, Moreira MS, Araujo ME, da Silva DP, Cazal C. The symbolic value of prostheses in maxillofacial rehabilitation. Oral Oncol 2014; 50:e69-70. [PMID: 25282253 DOI: 10.1016/j.oraloncology.2014.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 09/02/2014] [Indexed: 11/17/2022]
Affiliation(s)
| | - Maria Stella Moreira
- School of Dentistry, Universidade de São Paulo, Av. Prof. Lineu Prestes, 2227, São Paulo SP 05508000, Brazil.
| | - Maria Ercilia Araujo
- School of Dentistry, Universidade de São Paulo, Av. Prof. Lineu Prestes, 2227, São Paulo SP 05508000, Brazil.
| | - Dorival Pedroso da Silva
- School of Dentistry, Universidade de São Paulo, Av. Prof. Lineu Prestes, 2227, São Paulo SP 05508000, Brazil.
| | - Claudia Cazal
- School of Medicine, Universidade Federal de Pernambuco, Av. Prof. Moraes Rego, 1235, Cidade Universitária, Recife, PE 50670-901, Brazil.
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Kucuk H, Kurnaz SC, Kutlar G. Treatment expectations and quality of life outcomes of patients with laryngeal cancer based on different treatment methods. Eur Arch Otorhinolaryngol 2014; 272:1245-50. [PMID: 24789062 DOI: 10.1007/s00405-014-3066-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Accepted: 04/15/2014] [Indexed: 11/29/2022]
Abstract
The treatment expectations of patients with laryngeal carcinoma and their quality of life after treatment were evaluated. We enrolled patients who were receiving treatment for epidermoid carcinoma of the larynx between January 2011 and January 2012. Their expectations from the treatment were evaluated using the visual analog scale (VAS) prior to and at the end of the treatment. Quality of life was assessed using the EORTC QLQ C 30 and EORTC H&N 35 questionnaires 3 months after completion of the treatment. In addition, the Beck Depression Inventory was used for mood assessment of the patients after treatment. As per the VAS scores pre-treatment, no differences were found between treatment expectations of early and advanced-stage tumors groups in pre-treatment expectations, but post-treatment evaluation statistically found difference between two groups in terms of average VAS score. Emotional, cognitive, and social functions of the EORTC QLQ C 30 questionnaire were the most affected items in the advanced-stage tumor group. Sense and speech problems in the symptom scales of the EORTC H&N 35 questionnaire were found to be significantly higher in patients with advanced-stage tumors than in those with early stage tumors. The present study is the first to assess the treatment expectations of patients with laryngeal carcinoma by using the VAS. Although the treatment expectations of the patients with early and advanced-stage tumors did not differ according to VAS scores in pre-treatment evaluation, early stage groups had better score than advanced-stage group. VAS was an easy and a simple applicable method for evaluating treatment expectations.
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Affiliation(s)
- Harun Kucuk
- Department of Otolaryngology Head and Neck Surgery, Batman Regional State Hospital, Batman, Turkey,
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Affiliation(s)
- Shofiq Islam
- Department of Maxillofacial Surgery, Leicester Royal Infirmary, Leicester, UK.
| | - Jonathan P Hayter
- Department of Maxillofacial Surgery, Leicester Royal Infirmary, Leicester, UK
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Aarstad HJ, Osthus AA, Olofsson J, Aarstad AKH. Level of distress predicts subsequent survival in successfully treated head and neck cancer patients: a prospective cohort study. Acta Otolaryngol 2014; 134:211-9. [PMID: 24256042 DOI: 10.3109/00016489.2013.841989] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION Our findings indicate a unique survival prediction from general health questionnaire (GHQ) sum scores in successfully treated head and neck squamous cell carcinoma (HNSCC) patients and also to some extent with inclusion of health-related quality of life (HRQoL) scores. OBJECTIVE To examine the survival prediction from the level of distress, measured by GHQ scores obtained from at inclusion successfully treated HNSCC patients. METHODS Structured interviews were conducted for 135 successfully treated cognitive functioning HNSCC patients 67 ± 31 (mean ± SD) months after diagnosis following a regular follow-up visit. GHQ scores, alcohol consumption history, smoking status, present comorbidities, level of neuroticism, choice of psychological coping with the cancer disease, and HRQoL scores (EORTC QLQ-C30 and -H&N35) were determined. The TNM stage, treatment provided and tumour site were obtained from the hospital records. Forty-three deaths were noted during a minimum 8.5 years of observation. RESULTS The GHQ sum scores predicted survival in univariate (p < 0.05) and multivariate analyses with the above-mentioned covariates included (p < 0.01). Using clinically relevant cut-off levels, GHQ scores predicted survival in both univariate (hazard ratio (HR) 1.9; p = 0.05) and multivariate Cox regression analyses (HR 3.8; p = 0.001). We also demonstrated survival prediction from GHQ scores when adjusted by HRQoL scores.
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Affiliation(s)
- Hans Jørgen Aarstad
- Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen
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Kurkjian N, Kurkjian C, Pant S, Tucker P. Psycho-oncology: a brief history and case study. J Okla State Med Assoc 2013; 106:471-474. [PMID: 24620412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Ms. W. is a 55-year-old retired Caucasian woman who was diagnosed with esophageal cancer in October 2011. She underwent neoadjuvant chemotherapy with subsequent esophagectomy. She sought psychiatric help after receiving her cancer diagnosis. The field of psycho-oncology was developed to assist cancer patients and caregivers through their "cancer journey" from the time of diagnosis, throughout treatment and beyond. Criteria-defined psychiatric disorder, with adjustment disorder being the most common, is reported in approximately 33% to 50% of cancer patients. These realities have given psychiatry a role in the multi-disciplinary care approach in major cancer centers around the country. In this article, we describe the challenges faced by Ms. W. during her cancer diagnosis and provide a review of the literature in the emerging field of psycho-oncology and its role in the multidisciplinary care of cancer patients.
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Baxi SS, Shuman AG, Corner GW, Shuk E, Sherman EJ, Elkin EB, Hay JL, Pfister DG. Sharing a diagnosis of HPV-related head and neck cancer: the emotions, the confusion, and what patients want to know. Head Neck 2013; 35:1534-41. [PMID: 23169350 PMCID: PMC3689851 DOI: 10.1002/hed.23182] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2012] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Oropharyngeal cancers are increasingly associated with human papillomavirus (HPV). Little is known about the experience of patients receiving this diagnosis. METHODS Semistructured interviews were conducted with ten survivors of HPV-related oropharyngeal cancer. The interviews were transcribed, and recurring themes were identified. RESULTS Physicians were a trusted source of information regarding HPV. Framing the diagnosis in terms of prognosis resonated with patients. The uncertainty about transmission, latency, and communicability colored the dialogue about HPV. Despite some understanding of prevalence and transmission, patients worried about their partner's risk. Patients sought information about HPV on the Internet, but it was not easily navigable. Emotional reactions to the diagnosis remained mostly cancer-centric rather than HPV-centric. A patient-education handout was developed in response to patient questions. CONCLUSIONS Additional educational resources explaining the facts about HPV in HNSCC in a consistent way including content of highest priority to patients may improve understanding of HPV.
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Affiliation(s)
- Shrujal S. Baxi
- Head and Neck Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10065
| | - Andrew G. Shuman
- Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065
- Department of Public Health, Weil Medical College of Cornell University, New York, NY 10021
| | - Geoffrey W. Corner
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY 10065
| | - Elyse Shuk
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY 10065
| | - Eric J. Sherman
- Head and Neck Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10065
- Department of Medicine, Weil Medical College of Cornell University, New York, NY 10021
| | - Elena B. Elkin
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY 10065
- Department of Public Health, Weil Medical College of Cornell University, New York, NY 10021
| | - Jennifer L. Hay
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY 10065
- Department of Psychiatry, Weil Medical College of Cornell University, New York, NY 10021
| | - David G. Pfister
- Head and Neck Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10065
- Department of Medicine, Weil Medical College of Cornell University, New York, NY 10021
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Alami AY, El Sabbagh RF, Hamdan A. Knowledge of oral cancer among recently graduated medical and dental professionals in Amman, Jordan. J Dent Educ 2013; 77:1356-1364. [PMID: 24098040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Oral cancer is a devastating disease, and despite advances in treatment, the survival rate remains low. Early diagnosis can improve survival and outcomes. Delayed referrals are often due to the inadequate knowledge of general health professionals. The aim of this study was to assess the knowledge of oral cancer among recently graduated dental and medical professionals interested in working in a cancer center in Amman, Jordan. The study was conducted using a questionnaire to assess the knowledge of risk factors and the ability to correctly identify the oral lesions most commonly associated with oral cancer. A total of 112 individuals completed the questionnaire. The results revealed an inadequate level of knowledge of oral cancer among the study population, with significant differences between the dental and medical professionals. This study suggests there is a need for improvement of the undergraduate curriculum in oral cancer in both medical and dental schools in Jordan and for the provision of postgraduate and continuing education on this topic.
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Affiliation(s)
- Arwa Yousef Alami
- King Hussein Cancer Center, P.O. Box 142801, Queen Rania Alabdullah Street, Amman 11814, Jordan;
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Themstrup L, Jemec GE, Lock-Andersen J. Patients highly value routine follow-up of skin cancer and cutaneous melanoma. Dan Med J 2013; 60:A4713. [PMID: 24083527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
INTRODUCTION Skin cancer follow-up is a substantial burden to outpatient clinics. Few studies have investigated patients' views on skin cancer follow-up and cutaneous melanoma. The objective was to investigate patients' perceived benefits and the impact of follow-up. MATERIAL AND METHODS This study included an open sample of patients attending routine follow-up at the outpatient Departments of Plastic Surgery and Dermatology, Roskilde Hospital. A total of 218 follow-up patients diagnosed with cutaneous malignant melanoma (MM), non-melanoma skin cancer (NMSC) or actinic keratosis (AK) completed a structured interview. RESULTS A total of 97% patients found follow-up useful. Continuity and consistency were important. One third of patients felt some degree of pre follow-up anxiety. The number of anxious MM patients was significantly greater than that of NMSC patients. No significant difference was found between the number of anxious MM and AK patients. Female gender, cohabitation and age younger than 50 years were associated with increased levels of anxiety. No relation was found between the number of anxious patients or the level of anxiety and the duration of the follow-up period. CONCLUSION The majority of patients who attended found that the follow-up had been useful. Certain demographic characteristics were associated with higher levels of anxiety and may be addressed by supportive efforts targeting these groups.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Anxiety/epidemiology
- Attitude to Health
- Carcinoma, Basal Cell/prevention & control
- Carcinoma, Basal Cell/psychology
- Carcinoma, Basal Cell/therapy
- Carcinoma, Squamous Cell/prevention & control
- Carcinoma, Squamous Cell/psychology
- Carcinoma, Squamous Cell/therapy
- Continuity of Patient Care/standards
- Female
- Health Care Surveys
- Humans
- Keratosis, Actinic/prevention & control
- Keratosis, Actinic/psychology
- Keratosis, Actinic/therapy
- Male
- Melanoma/prevention & control
- Melanoma/psychology
- Melanoma/therapy
- Middle Aged
- Neoplasm Recurrence, Local/prevention & control
- Patient Satisfaction
- Prognosis
- Secondary Prevention/statistics & numerical data
- Skin Neoplasms/prevention & control
- Skin Neoplasms/psychology
- Skin Neoplasms/therapy
- Young Adult
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Affiliation(s)
- Lotte Themstrup
- Dermatologisk Afdeling, Roskilde Hospital, 4000 Roskilde, Denmark.
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Javed S, Javed SA, Mays RM, Tyring SK. Clinical characteristics and awareness of skin cancer in Hispanic patients. Dermatol Online J 2013; 19:19623. [PMID: 24050296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 09/13/2013] [Indexed: 06/02/2023] Open
Abstract
Skin cancer in darker skin is associated with considerable morbidity and mortality. We sought to assess the clinical characteristics of cutaneous malignancy amongst Hispanic skin cancer patients and compare them to age-matched non-Hispanic Caucasians. In this retrospective study, 150 Hispanic skin cancer patients were identified from electronic medical records and age-matched to 150 non-Hispanic Caucasian controls with skin cancer. The incidence of actinic keratoses (AKs) in Hispanic skin cancer patients (34.0%) was statistically lower than age-matched non-Hispanic Caucasian skin cancer controls (61.3%, P <0.001; odds ratio, 3.08; 95% confidence interval, 1.92 - 4.93). Moreover, non-Hispanic Caucasian SCC (squamous cell cancer) controls were much more likely to report AKs (36.1%, P = 0.003) than Hispanic SCC patients (25.0%, P = 0.19). This study illustrates a lower incidence of AKs in Hispanic skin cancer patients as compared to their age-matched non-Hispanic Caucasians. The Hispanic skin malignancies present at a more advanced state and there is usually a lack of awareness in such cases. Therefore, patient knowledge and education is crucial for early detection and prevention of skin cancer in the Hispanic population.
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Affiliation(s)
- Saba Javed
- University of Texas Medical School at Houston
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Flaitz CM, Carlin N. Living in limbo: Ethics and experience in a conversation about persistent oral lesions. Tex Dent J 2013; 130:692-701. [PMID: 24236390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This case report presents a conversation that the authors had with a patient who is suffering from oral lichen planus and oral cancer. The reason that the authors approached the patient for an interview was to find out why he decided to enroll in an experimental study related to his oral cancer. The patient reported that it was "the waiting" that led him to enroll in this study--that is, the pressure of waiting for oral cancer to reemerge was simply unbearable, and enrolling in this experimental study enabled him to take a more proactive approach to his illness. The authors view this "waiting" as a "limbo experience" and reflect on the implications of this limbo experience for dental ethics and research ethics.
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Affiliation(s)
- Catherine M Flaitz
- Department of Diagnostic and Biomedical Sciences, The University of Texas School of Dentistry at Houston, Texas, USA
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Mortensen GL, Jakobsen JK. Patient perspectives on quality of life after penile cancer. Dan Med J 2013; 60:A4655. [PMID: 23809966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
INTRODUCTION Penile cancer (PC) is a rare, but ominous disease. In 50-60% of squamous cell carcinomas of the penis, human papilloma virus infection, particularly with types 16 and 18, is part of the pathogenesis. Depending on cancer invasiveness, PC is treated with local resection of the glans and partial or total penectomy. This quality of life (QoL) study aimed at obtaining in-depth knowledge about patients' experiences with PC. MATERIAL AND METHODS A literature study was carried out to identify relevant topics for a semi-structured interview. Qualitative interviews with four former PC patients were transcribed verbatim and analysed using a medical anthropological approach. The analysis focused on the ways patients frame their disease experiences and relate the physical, sexual and emotional disease impact. RESULTS Varying degrees of amputation affected the participants' sexual capabilities. Still, three participants (aged 66-72 years) said that their partner relationships were not negatively affected by the disease. In contrast, the impact on sexual function and self-esteem had been devastating to the fourth participant (aged 44 years) who was single and worried about the disease impeding his chance of finding love in life. For all participants, having had a potentially fatal disease put the physical disease impact into perspective. CONCLUSION PC may greatly impact the psycho-sexual QoL of PC patients, particularly at a younger age and depending on their partnership status. Disease impact appears to be related to age, overall life situation and the cancer experience. FUNDING The study was funded by an unrestricted research grant from Sanofi Pasteur MSD. TRIAL REGISTRATION not relevant.
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Kuo YY, Chu PY, Chang SY, Wang YF, Tsai TL, Yang MH, Wang LW, Tai SK. Treatment selection for tonsillar squamous cell carcinoma. J Chin Med Assoc 2013; 76:211-7. [PMID: 23557888 DOI: 10.1016/j.jcma.2012.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2012] [Accepted: 04/30/2012] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND The optimal treatment for tonsillar squamous cell carcinoma (SCC) remains controversial. The purpose of this study was to evaluate long-term treatment outcomes of patients with tonsillar SCC, in order to aid in appropriate treatment selection. METHODS We conducted a retrospective chart review of 105 patients with curatively treated tonsillar SCC between January 1996 and December 2005. Forty-three patients (41.0%) underwent primary surgery with or without adjuvant therapy (primary surgery group), and 62 patients (59.0%) were treated with radiotherapy/chemoradiotherapy (RT/CRT, organ preservation group). Twenty patients (19%) received tumor tonsillectomy before definitive RT/CRT and were grouped into the organ preservation group. RESULTS No significant differences were observed between the primary surgery and organ preservation groups in terms of local control (p = 0.212), regional control (p = 0.684), distant metastasis (p = 0.627), 5-year disease-specific survival (DSS, p = 0.774), and overall survival rates (OS, p = 0.667). The rates of major complication (p = 0.216), long-term dependency on feeding tubes (p = 0.876), and tracheostomy (p = 0.401) were also similar. Advanced T classification (T3-4) was the only factor associated with significantly worse DSS (p = 0.007) and OS (p = 0.012). However, there was also no difference in final treatment outcomes in T3-4 patients regardless of whether they were treated with primary surgery or RT/CRT. In the organ preservation group, tumor tonsillectomy before RT/CRT did not improve local control (p = 0.520) or other treatment outcomes, including 5-year DSS (p = 0.707) and OS (p = 0.745). CONCLUSION Both primary surgery and RT/CRT organ preservation are effective treatments for tonsillar SCC. Single modality treatment, either surgery or RT/CRT, can typically be provided for stage I-II diseases. Although RT/CRT organ preservation is used more frequently for stage III-IV tonsillar SCC in recent years, primary surgery combined with adjuvant therapy still achieves equivalent outcomes. Multidisciplinary pretreatment counseling and the facilities and personnel available are therefore important for decision-making. In addition, if RT/CRT organ preservation is selected as the primary treatment, tumor tonsillectomy is not indicated.
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Affiliation(s)
- Yao-Yuan Kuo
- Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
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Duffy SA, Teknos T, Taylor JMG, Fowler KE, Islam M, Wolf GT, McLean S, Ghanem TA, Terrell JE. Health behaviors predict higher interleukin-6 levels among patients newly diagnosed with head and neck squamous cell carcinoma. Cancer Epidemiol Biomarkers Prev 2013; 22:374-81. [PMID: 23300019 PMCID: PMC3596441 DOI: 10.1158/1055-9965.epi-12-0987] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Health behaviors have been shown to be associated with recurrence risk and survival rates in patients with cancer and are also associated with interleukin-6 (IL-6) levels, but few epidemiologic studies have investigated the relationship of health behaviors and IL-6 among cancer populations. The purpose of the study is to look at the relationship between five health behaviors, viz.: smoking, alcohol problems, body mass index (BMI; a marker of nutritional status), physical activity, and sleep and pretreatment IL-6 levels in persons with head and neck cancer. METHODS Patients (N = 409) were recruited in otolaryngology clinic waiting rooms and invited to complete written surveys. A medical record audit was also conducted. Descriptive statistics and multivariate analyses were conducted to determine which health behaviors were associated with higher IL-6 levels controlling for demographic and clinical variables among patients with newly diagnosed head and neck cancer. RESULTS While smoking, alcohol problems, BMI, physical activity, and sleep were associated with IL-6 levels in bivariate analysis, only smoking (current and former) and decreased sleep were independent predictors of higher IL-6 levels in multivariate regression analysis. Covariates associated with higher IL-6 levels were age and higher tumor stage, whereas comorbidities were marginally significant. CONCLUSION Health behaviors, particularly smoking and sleep disturbances, are associated with higher IL-6 levels among patients with head and neck cancer. IMPACT Treating health behavior problems, especially smoking and sleep disturbances, may be beneficial to decreasing IL-6 levels, which could have a beneficial effect on overall cancer treatment outcomes.
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Affiliation(s)
- Sonia A Duffy
- Corresponding Author: Sonia A. Duffy, University of Michigan, School of Nursing, 400 North Ingalls Building, Room 3178, Ann Arbor, MI 48109-5482, USA.
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Fierz J, Bürgin W, Mericske-Stern R. Patients with oral tumors. Part 2: Quality of life after treatment with resection prostheses. Resection prosthetics: evaluation of quality of life. Schweiz Monatsschr Zahnmed 2013; 123:180-191. [PMID: 23526454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Accepted: 08/23/2012] [Indexed: 06/02/2023]
Abstract
In the present study, the oral health-related quality of life of 18 patients (13 men and 5 women) was evaluated using validated questionnaires as proposed by the European Organization of Research and Treatment of Cancer (EORTC). The patients belonged to a cohort of 48 patients, whose prosthetic treatment was performed during the years 2004-2007. In the course of tumor resection, 12 patients underwent graft surgery and 14 patients radiotherapy. One patient required a nasal epithesis since resection of the nose became necessary. Five patients underwent a full block resection of the mandible, and tumor resection in 3 patients resulted in a large oronasal communication. Prosthetic rehabilitation was performed in all patients, and the follow-up period with regular care covered a minimum of 3 years. Eleven patients received dental implants for better support and retention of the prostheses. In spite of compromised oral conditions, functional restrictions, and some difficulties with the prostheses, the answers to the questionnaire were quite positive. The majority judged their general health as good or even excellent. The subjective perception of the patients may contradict the objective view by the dentist. In fact, the individual patient's history and experience provide a better understanding of the impact of oral tumors on daily life. The overall assessment identified 4 items that were perceived as major problems by all patients: swallowing solid food, dry mouth, limited mouth opening, and appearance. Prosthetic rehabilitation has only a limited influence on such problems.
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Affiliation(s)
- Janine Fierz
- Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Dey SK, Jha S, Ghosh I, Bhattacharya SK, Das A, Gangopadhyay S. Knowledge, attitude and practice of smoking in subjects of lung cancer. J Indian Med Assoc 2012; 110:880-884. [PMID: 23936950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Lung cancer is the most common cancer in the world since 1988, both in terms of incidence and mortality among both men and women. Approximately half of the cases of lung cancer now occur in developing countries compared to 1980. Tobacco smoking is by far the predominant risk factor for lung cancer. A knowledge, attitude and practice of smoking among 132 cases of lung cancer in this study was undertaken. Amongst 113 ever smokers, out of 132 cases, 91.18% of males and 36.36% of female subjects continued smoking despite knowing the harmful effects of tobacco, displayed over the cigarette or bidi packets. In these group squamous cell carcinoma was the most common type followed by adenocarcinoma. Among the never smokers adenocarcinoma was the commonest type, females accounting for 75% of the cases, though a good number was observed among male ever smokers, signifying the changing histological types of lung cancer today.
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Affiliation(s)
- Subir Kumar Dey
- Department of Chest Medicine, Calcutta National Medical College, Kolkata
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Lee EH, Klassen AF, Nehal KS, Cano SJ, Waters J, Pusic AL. A systematic review of patient-reported outcome instruments of nonmelanoma skin cancer in the dermatologic population. J Am Acad Dermatol 2012; 69:e59-67. [PMID: 23102770 DOI: 10.1016/j.jaad.2012.09.017] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Revised: 08/22/2012] [Accepted: 09/04/2012] [Indexed: 11/18/2022]
Abstract
BACKGROUND Treatment of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) has traditionally focused on minimizing recurrence and complication rates. However, the assessment of patient satisfaction and quality of life (QOL) is also important. These outcomes are best assessed by patient-reported outcome (PRO) instruments. OBJECTIVES We sought to conduct a systematic review of published PRO instruments purporting to measure aspects associated with QOL and/or patient satisfaction in the dermatologic BCC/SCC population and evaluate their development, content, and psychometric properties. METHODS PubMed, Embase, Cochrane via Wiley, PsycINFO, CINAHL, and HaPI from inception to April 2011 were searched. Articles that discussed the instrument development and validation process were included. RESULTS A total of 2212 articles were identified. Twenty met our inclusion criteria resulting in 6 PRO instruments: 3 general dermatology (Skindex, Dermatology Life Quality Index, dermatology quality of life scales), 1 general plastic surgery (Patient Outcomes of Surgery-Head/Neck), and 2 skin cancer-specific (Skin Cancer Index, disease-specific questionnaire). The 6 instruments all underwent some degree of formal development and validation, however, only the Skin Cancer Index was developed and validated in the BCC/SCC population. LIMITATIONS The review may not have included all relevant PRO instruments. CONCLUSIONS The Skin Cancer Index demonstrates the most evidence of its usefulness in patients with BCC/SCC. The Skindex-16, Dermatology QOL Scales, and Dermatology Life Quality Index target different aspects of QOL and should be used depending on the specific question being investigated. The Patient Outcomes of Surgery-Head/Neck may be beneficial to assess perceptions in appearance before and after surgical intervention.
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Affiliation(s)
- Erica H Lee
- Memorial Sloan-Kettering Cancer Center, New York, New York 10022, USA.
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Boyapati RP, Shah KC, Flood V, Stassen LFA. Quality of life outcome measures using UW-QOL questionnaire v4 in early oral cancer/squamous cell cancer resections of the tongue and floor of mouth with reconstruction solely using local methods. Br J Oral Maxillofac Surg 2012; 51:502-7. [PMID: 23068128 DOI: 10.1016/j.bjoms.2012.09.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Accepted: 09/18/2012] [Indexed: 11/15/2022]
Abstract
Cancer treatment either by surgery alone or in a combination of surgery, radiotherapy±chemotherapy has significant consequences on the physical, mental, emotional and psychosocial wellbeing of the patient. Measurement of quality of life (QOL) is necessary to understand the patient's perception of their own treatment, as clinicians' views can be biased. Reconstruction of a cancerous defect with a free vascular flap is ideal in large, often composite defects, provided it is appropriate to the advanced stage and prognosis of the disease, medical condition of the patient, availability of surgical and financial resources and allows the prosthetic rehabilitation of the anatomic area. Using University of Washington Quality of life 4 questionnaire (UW-QOL4), we assessed the QOL of 38 patients, who underwent local surgical reconstructions after resection of T1/T2 tongue/floor of mouth squamous cell carcinoma defects. Objective assessment of speech and swallow function was also carried out using therapy outcome measure (TOM) scores by the speech and language therapy team (SALT) aiming to see the differences in the scores obtained in patients who underwent post-operative radiotherapy. Our study, conducted 6months after completion of all oncologic treatment for the primary disease, showed satisfactory levels of quality of life parameters with good function showing that local reconstructive methods are successful and may have benefits in the management of early oral cancers involving the tongue and floor of mouth. They are beneficial by providing a good quality in terms of function, by reducing the operating time, the surgical morbidity, simplifying post-operative care and thereby becoming an efficient, effective and a cost effective method.
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Affiliation(s)
- Raghuram P Boyapati
- National Maxillofacial unit, St James's Hospital, James's Street, Dublin, Ireland.
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Vargo JA, Heron DE, Ferris RL, Rwigema JCM, Wegner RE, Kalash R, Ohr J, Kubicek GJ, Burton S. Prospective evaluation of patient-reported quality-of-life outcomes following SBRT ± cetuximab for locally-recurrent, previously-irradiated head and neck cancer. Radiother Oncol 2012; 104:91-5. [PMID: 22677037 DOI: 10.1016/j.radonc.2012.04.020] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2011] [Revised: 03/15/2012] [Accepted: 04/30/2012] [Indexed: 11/16/2022]
Abstract
PURPOSE Stereotactic body radiotherapy (SBRT) has emerged as a promising salvage strategy for unresectable, previously-irradiated recurrent squamous cell carcinomas of the head and neck (rSCCHN). Here-in, we report the first prospective evaluation of patient-reported quality-of-life (PR-QoL) following re-irradiation with SBRT±cetuximab for rSCCHN. MATERIALS AND METHODS From November 2004 to May 2011, 150 patients with unresectable, rSCCHN in a previously-irradiated field receiving >40 Gy were treated with SBRT to 40-50 Gy in 5 fractions ± concurrent cetuximab. PR-QoL was prospectively acquired using the University of Washington Quality-of-Life Revised (UW-QoL-R). RESULTS Overall PR-QoL, health-related PR-QoL, and select domains commonly affected by re-irradiation progressively increase following an initial 1-month decline with statistically significant improvements noted in swallowing (p=0.025), speech (p=0.017), saliva (p=0.041), activity (p=0.032) and recreation (p=0.039). CONCLUSIONS Especially for patients surviving >1-year, improved tumor control associated with SBRT re-irradiation may ameliorate decreased PR-QoL resulting from rSCCHN. These improvements in PR-QoL transcend all measured domains in a validated PR-QoL assessment tool independent of age, use of cetuximab, tumor volume, and interval since prior irradiation.
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Affiliation(s)
- John A Vargo
- University of Pittsburgh Cancer Institute, Pittsburgh, PA 15232, USA
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Dhabhar FS, Saul AN, Holmes TH, Daugherty C, Neri E, Tillie JM, Kusewitt D, Oberyszyn TM. High-anxious individuals show increased chronic stress burden, decreased protective immunity, and increased cancer progression in a mouse model of squamous cell carcinoma. PLoS One 2012; 7:e33069. [PMID: 22558071 PMCID: PMC3338811 DOI: 10.1371/journal.pone.0033069] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Accepted: 02/03/2012] [Indexed: 12/30/2022] Open
Abstract
In spite of widespread anecdotal and scientific evidence much remains to be understood about the long-suspected connection between psychological factors and susceptibility to cancer. The skin is the most common site of cancer, accounting for nearly half of all cancers in the US, with approximately 2-3 million cases of non-melanoma cancers occurring each year worldwide. We hypothesized that a high-anxious, stress-prone behavioral phenotype would result in a higher chronic stress burden, lower protective-immunity, and increased progression of the immuno-responsive skin cancer, squamous cell carcinoma. SKH1 mice were phenotyped as high- or low-anxious at baseline, and subsequently exposed to ultraviolet-B light (1 minimal erythemal dose (MED), 3 times/week, 10-weeks). The significant strengths of this cancer model are that it uses a normal, immunocompetent, outbred strain, without surgery/injection of exogenous tumor cells/cell lines, and produces lesions that resemble human tumors. Tumors were counted weekly (primary outcome), and tissues collected during early and late phases of tumor development. Chemokine/cytokine gene-expression was quantified by PCR, tumor-infiltrating helper (Th), cytolytic (CTL), and regulatory (Treg) T cells by immunohistochemistry, lymph node T and B cells by flow cytometry, adrenal and plasma corticosterone and tissue vascular-endothelial-growth-factor (VEGF) by ELISA. High-anxious mice showed a higher tumor burden during all phases of tumor development. They also showed: higher corticosterone levels (indicating greater chronic stress burden), increased CCL22 expression and Treg infiltration (increased tumor-recruited immuno-suppression), lower CTACK/CCL27, IL-12, and IFN-γ gene-expression and lower numbers of tumor infiltrating Th and CTLs (suppressed protective immunity), and higher VEGF concentrations (increased tumor angiogenesis/invasion/metastasis). These results suggest that the deleterious effects of high trait anxiety could be: exacerbated by life-stressors, accentuated by the stress of cancer diagnosis/treatment, and mediate increased tumor progression and/or metastasis. Therefore, it may be beneficial to investigate the use of chemotherapy-compatible anxiolytic treatments immediately following cancer diagnosis, and during cancer treatment/survivorship.
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Affiliation(s)
- Firdaus S Dhabhar
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, California, United States of America.
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Gudmundsson Astrup J, Yadete D. [Neglected non-melanoma skin cancer]. Ugeskr Laeger 2012; 174:876-877. [PMID: 22456177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
In Denmark the incidence of non-melanoma skin cancer (NMSC) has increased over the past 30 years, and it is presumed that the incidence of neglected NMSC will increase. Neglected NMSC is frequently seen in patients with psychosocial disabilities. If treatment is delayed consequences regarding treatment options and prognosis can be severe. We describe two cases of patients with psychosocial disabilities and neglected NMSC. In conclusion physicians, who treat patients with psychosocial disabilities and NMSCs, should be aware of the risk of neglect and ensure that treatment is complied.
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Affiliation(s)
- Jakob Gudmundsson Astrup
- Klinik for Plastikkirurgi, Brystkirurgi og Brandsårsbehandling, HovedOrtoCentret, Rigshospitalet, København Ø, Denmark.
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Kanatas A, Ghazali N, Lowe D, Rogers SN. The identification of mood and anxiety concerns using the patients concerns inventory following head and neck cancer. Int J Oral Maxillofac Surg 2012; 41:429-36. [PMID: 22264641 DOI: 10.1016/j.ijom.2011.12.021] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2011] [Revised: 11/30/2011] [Accepted: 12/07/2011] [Indexed: 12/16/2022]
Abstract
The aim of this study was to investigate the concurrent use of the Patient Concerns Inventory (PCI) and the University of Washington Quality of life instruments (UW-QOL), as a means of identifying mood and anxiety concerns in patients following head and neck cancer treatment. From August 2007 to July 2009, 204 patients (454 clinic appointments) attending one consultant's oncology review clinic completed the UW-QOLv4 and PCI prior to their consultation. Before entering consultations, 17% (79/454) of patients reported problems with mood and 20% (89/454) reported problems with anxiety on the UW-QOL. Regarding the items raised by patients using the PCI prior to consultation, 'mood' was raised in 10% (46/454), 'anxiety' in 13% (58/454) and 'depression' in 10% (44/454) of cases. In 32% (145/454) of consultations, 44% (89/204) patients had reported significant anxiety or mood problems on the UW-QOL, or highlighted issues of anxiety, mood and/or depression on the PCI for discussion. Patients completing the PCI were more often referred to the clinical psychologist and to the emotional support worker. The results showed that the combination of the UW-QOL questionnaire and the PCI provide a practical means of screening for psychological distress in clinics.
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Affiliation(s)
- A Kanatas
- Oral and Maxillofacial Surgery, Leeds Teaching Hospitals and St James Institute of Oncology, Leeds, UK
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Wygant C, Hui D, Bruera E. Childhood sexual abuse in advanced cancer patients in the palliative care setting. J Pain Symptom Manage 2011; 42:290-5. [PMID: 21444190 DOI: 10.1016/j.jpainsymman.2010.11.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Revised: 10/28/2010] [Accepted: 11/06/2010] [Indexed: 11/25/2022]
Abstract
Childhood sexual abuse (CSA) is a common, distressing, yet rarely discussed topic in palliative care. The long-term effects of CSA can have a significant impact on patients' quality of life, particularly at the end of life. In this article, we aim to initiate a discussion regarding the need to address CSA in the palliative care setting, using the example of an advanced cancer patient and her caregiver sister who revealed their common past. Specifically, we will be discussing 1) the comorbidities, psychological distress, and family distress associated with CSA, 2) its impact on health care delivery, 3) an approach to initiating conversations regarding CSA, and 4) various management strategies. Successful management of CSA necessitates an interprofessional team approach and may help to improve the quality of life of patients and their families.
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Affiliation(s)
- Carmella Wygant
- Department of Social Work, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, 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] [What about the content of this article? (0)] [Affiliation(s)] [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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Flaitz CM, Carlin N. Living in limbo: ethics and experience in a conversation about persistent oral lesions. Tex Dent J 2011; 128:427-437. [PMID: 21834365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This case report presents a conversation that the authors had with a patient who is suffering from oral lichen planus and oral cancer. The reason that the authors approached the patient for an interview was to find out why he decided to enroll in an experimental study related to his oral cancer. The patient reported that it was "the waiting" that led him to enroll in this study--that is, the pressure of waiting for oral cancer to re-emerge was simply unbearable, and enrolling in this experimental study enabled him to take a more proactive approach to his illness. The authors view this "waiting" as a "limbo experience" and reflect on the implications of this limbo experience for dental ethics and research ethics.
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MESH Headings
- Attitude to Health
- Bioethical Issues
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/psychology
- Cell Transformation, Neoplastic/pathology
- Choice Behavior
- Dentist-Patient Relations/ethics
- Disease Progression
- Ethics, Dental
- Humans
- Leukoplakia, Oral/pathology
- Lichen Planus, Oral/pathology
- Lichen Planus, Oral/psychology
- Male
- Middle Aged
- Neoplasm Recurrence, Local/pathology
- Neoplasm Recurrence, Local/psychology
- Patient Education as Topic
- Personal Autonomy
- Precancerous Conditions/pathology
- Precancerous Conditions/psychology
- Quality of Life
- Randomized Controlled Trials as Topic
- Stress, Psychological/psychology
- Tongue Neoplasms/pathology
- Tongue Neoplasms/psychology
- Truth Disclosure/ethics
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Affiliation(s)
- Catherine M Flaitz
- Department of Diagnostic Sciences, The University of Texas Dental Branch at Houston, 6516 M.D. Anderson Blvd., Room 3.094H, Houston, TX 77030-3402, USA.
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de Jong M, de Cubber J, de Roeck F, Lethaus B, Buurman D, Kessler P. [The art of facial prosthetics]. Ned Tijdschr Geneeskd 2011; 155:A3967. [PMID: 22200146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Anaplastology is the discipline devoted to the construction of epithesis. An epithesis is a prosthesis that replaces soft tissue. This offers a solution for patients with a facial defect. CASE DESCRIPTION A 78-year-old woman, who had undergone ablative surgical treatment for a squamous cell carcinoma of the left ear, was left with a large defect in the mastoid region. This defect had a severe impact on her psychosocial functioning. For this patient an episthesis was constructed to replace the left ear. After this, her psychosocial problems were greatly improved. CONCLUSION A nearly-realistic episthesis can reduce the negative psychosocial effects of facial mutilation. The construction requires multidisciplinary treatment. In order to achieve the optimal result, an anaplastologist must have well developed artistic capacities. Feeling for detail, form and colour are essential. Modern 3D technology contributes to a more precise, quicker and cosmetically high-quality result.
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Affiliation(s)
- Maarten de Jong
- Academisch ziekenhuis Maastricht, afd. Mondziekten, Kaak- en Aangezichtschirurgie, Maastricht, the Netherlands.
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