Rehabilitation outcomes of long-term survivors treated for head and neck cancer
Article first published online: 18 JUL 2006
Copyright © 1995 Wiley Periodicals, Inc., A Wiley Company
Head & Neck
Volume 17, Issue 6, pages 503–515, November/December 1995
How to Cite
de Boer, M. F., Pruyn, J. F. A., van den Borne, B., Knegt, P. P., Ryckman, R. M. and Verwoerd, C. D. A. (1995), Rehabilitation outcomes of long-term survivors treated for head and neck cancer. Head Neck, 17: 503–515. doi: 10.1002/hed.2880170608
- Issue published online: 18 JUL 2006
- Article first published online: 18 JUL 2006
- Manuscript Accepted: 28 MAR 1995
- Netherlands Cancer Foundation
Background. Little is known about the rehabilitation outcomes of long-term survivors following treatment for head and neck cancer. There are, for example, no studies on physical and psychosocial rehabilitation outcomes of T1 glottic larynx carcinoma, despite the fact that these form the majority of head and neck cancer sites. Thus, this investigation afforded a unique opportunity for examining similarities and differences among T1 glottic larynx patients, laryngectomy patients, and those who had surgery for cancer of the oral cavity and/or oropharynx along a variety of physical and psychosocial dimensions.
Methods. To describe the impact of these three types of head and neck cancer and their treatment on the physical and psychosocial functioning of long-term survivors, a selfreport questionnaire was completed by 110 patients treated between 2 and 6 years previously in a major cancer center.
Results. Data indicate that a higher percentage of patients treated with laryngectomy or commando procedures still experience severe psychosocial distress between 2 and 6 years after their last treatment than do patients treated with radiotherapy for a T1 carcinoma of the glottic larynx. Psychosocial and physical complaints are still reported by many laryngectomy patients, apparently the result of problems in effective communication with others. Many commando procedure patients experience problems with respect to food intake, and with disfigurement and its consequences. T1 Iarynx patients mainly experience a considerable number of physical complaints. The greater the time that had elapsed since treatment, the fewer the psychosocial problems associated with head and neck tumors. Open discussion of the illness in the family, social support, and perceptions of adequate information from the specialist are the most important predictors of positive rehabilitation outcomes.
Conclusions. This study indicates that T1 Iarynx patients report many physical complaints even though several years had elapsed since treatment. Also, Iaryngectomy patients may need psychosocial guidance for a longer posttreatment period and that health care personnel must involve the partner as much as possible in all communications. Commando procedure patients in particular feel hindered by their disfigurement and its consequences. Future research with respect to validation of the specific head and neck modules is needed.