Speech Intelligibility and Quality of Life in Head and Neck Cancer Survivors

Authors

  • Tanya K. Meyer MD,

    1. Department of Otolaryngology & Communication Sciences, The Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A.
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  • Joan C. Kuhn MS, CCC-SLP,

    1. Department of Otolaryngology & Communication Sciences, The Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A.
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  • Bruce H. Campbell MD,

    Corresponding author
    1. Department of Otolaryngology & Communication Sciences, The Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A.
    2. MCW Cancer Center, The Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A.
    • Bruce H. Campbell, MD, FACS, Medical College of Wisconsin, Department of Otolaryngology and Communication Sciences, 9200 W. Wisconsin Avenue, Milwaukee WI 53226–3522, U.S.A.
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  • Anne M. Marbella MS,

    1. Department of Family & Community, The Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A.
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  • Katherine B. Myers RN, BSN,

    1. Department of Otolaryngology & Communication Sciences, The Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A.
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  • Peter M. Layde MD, MSc

    1. Department of Family & Community, The Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A.
    2. MCW Cancer Center, The Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A.
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  • Supported by a grant from the National Cancer Institute (R01 CA78940) (b.h.c.).

Abstract

Objective: Poor speech intelligibility adversely affects quality of life self-assessment in long term survivors of head and neck cancer treatment.

Study Design: Observational case series including both objective clinical speech testing and subjective quality of life questionnaire administration.

Methods: Five-year head and neck cancer survivors were recruited to study the association between speech intelligibility and quality of life. Survivors were analyzed as an entire group, and also subdivided into laryngectomees and non-laryngectomees. Objective testing included sentence and word intelligibility. Subjective testing included quality of life questionnaires (UWQOL, FACT, FACT-head and neck, and PSS-HN) and a locally prepared “cancer concern” question. Associations were sought between intelligibility, quality of life and demographics.

Results: Sixty-two survivors underwent testing. Lower sentence intelligibility and word intelligibility scores were associated with diminished self-perceived UWQOL Speech (P = .0001 and P = .0001, respectively) and PSS-HN Understandability of Speech (P = .009 and P = .005). Decreased word intelligibility was additionally associated with decreased UWQOL Chewing (P = .003), UWQOL Swallowing (P = .02), UWQOL Recreation (P = .05), PSS-HN Willingness to Eat in Public (P = .03), and PSS-HN Normalcy of Diet (P = .0001). The associations continued even after patients who had undergone laryngectomy were excluded.

Conclusions: Long-term survivors of head and neck cancer continue to have both objective and subjective deficits in speech parameters five years after treatment. Objective deficits are associated with subjective concerns about speech, eating, and recreation. Understanding how communication deficits affect quality of life in long-term head and neck cancer survivors may allow more effective therapies to modulate these concerns in the recovery period.

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