The role of psychological characteristics and quality of life in patients with head and neck tumors during treatment and rehabilitation

Cover Page

Cite item

Full Text

Abstract

Introduction. Betterment of techniques and methods of treatment of oncological diseases promotes improved patient rehabilitation. Improvement of biopsychosocial status of these patients significantly depends on determination of rehabilitation potential. Due to increased survival of oncological patients, problems associated with the quality of life have become more urgent.

Aim. To determine the possibility of using a non-specific questionnaire Short Form-36 (SF-36) for evaluation of quality-of-life characteristics and rehabilitation potential of patients with malignant head and neck neoplasms during different schemes of radical radiation therapy.

Materials and methods. The study included 68 patients with malignant head and neck neoplasms who underwent chemo / radiotherapy with accompanying symptomatic treatment and nutritional support between 2019 and 2021 (treatment group). In 32 (47.08 %) patients, the tumor was located in the larynx, in 8 (11.76 %) in the pharynx, in 6 (8.82 %) in the parotid gland, in 13 (19.11 %) in the oral cavity, in 9 (13.23 %) in the paranasal sinuses and nasopharynx. A course of radical photon therapy as monotherapy was administered to 59 (86.76 %) patients, a course of chemoradiation treatment to 9 (13.24 %) patients. Control group consisted of healthy people (n = 679) who at the time of questioning did not have a diagnosis of malignant neoplasms. Mean age of the participants was 64 years. Quality of life characteristics associated with rehabilitation potential were determined using a non-specific questionnaire for quality of life evaluation SF-36.

Results. In patients of the treatment group, significant decrease in such quality-of-life characteristics as bodily pain and role-physical functioning was observed. In general, quality of life characteristics in this group were lower than in the control group. It was shown that patients with head and neck malignant neoplasms are prone to limiting social contacts which can be caused by their physical and emotional condition, and have significant pain syndrome. Role functioning is based on the effect of physical condition on daily role performance (work, daily chores) (р = 0.001). On the other hand, every characteristic reflecting various aspects of quality of life of patients with malignant head and neck tumors such as pain intensity, role-physical functioning can be corrected using symptomatic rehabilitation medicine and psychological support.

Conclusion. Data obtained using the SF-36 questionnaire can form a basis for early patient rehabilitation during in-hospital treatment. Th use of various quality of life questionnaires in oncological patients positively affects treatment outcomes. The identified deviations of quality-of-life characteristics from normal values in patients with malignant head and neck neoplasms can be considered psychotherapeutic targets for psychologists, treatment physicians, rehabilitation specialists forming an interdisciplinary team. Collection of information about the patient prior to outpatient appointment promotes improved communication between the patient and the doctor, increases awareness about patient needs after treatment in medical specialists, increases quality of medical care and implementation of personalized medicine principles.

About the authors

A. I. Kuznetsova

South Ural State Medical University, Ministry of Health of Russia; National Research Tomsk State University; Clinical Hospital “Russian Railways-Medicine” of the city of Chelyabinsk

Author for correspondence.
Email: kafonco74@mail.ru
ORCID iD: 0000-0002-2496-8273
Russian Federation, 64 Vorovskiy St., Chelyabinsk 454141 ; 36 Lenin Prospekt, Tomsk 634050; 23 Dovator St., Chelyabinsk 454091

A. V. Vazhenin

South Ural State Medical University, Ministry of Health of Russia

Email: kafonco74@mail.ru
ORCID iD: 0000-0002-7912-9039
Russian Federation, 64 Vorovskiy St., Chelyabinsk 454141

I. V. Ponomareva

National Research Tomsk State University; South Ural State University

Email: kafonco74@mail.ru
ORCID iD: 0000-0001-8600-3533
Russian Federation, 36 Lenin Prospekt, Tomsk 634050; 76 Lenina Prospekt, Chelyabinsk 454001

D. A. Tsiring

National Research Tomsk State University

Email: kafonco74@mail.ru
ORCID iD: 0000-0001-7065-0234
Russian Federation, 36 Lenin Prospekt, Tomsk 634050

E. S. Menshikova

Clinical Hospital “Russian Railways-Medicine” of the city of Chelyabinsk

Email: kafonco74@mail.ru
Russian Federation, 23 Dovator St., Chelyabinsk 454091

References

  1. Crowder S.L. Quality of life, coping strategies, and supportive care needs in head and neck cancer survivors: a qualitative study. Support Care Cancer 2021;29(8):4349–56. doi: 10.1007/s00520-020-05981-1
  2. Rogers S.N. The development of a Patients Concerns Inventory (PCI) to help reveal patients concerns in the head and neck clinic. Oral Oncol 2009;45(7):555–61. doi: 10.1016/j.oraloncology.2008.09.004
  3. Ghazali N. Treatment referral before and after the introduction of the Liverpool Patients Concerns Inventory (PCI) into routine head and neck oncology outpatient clinics. Support Care Cancer 2011;19(11):1879–86. doi: 10.1007/s00520-011-1222-9
  4. Flexen J., Ghazali N. Identifying appearance-related concerns in routine follow-up clinics following treatment for oral and oropharyngeal cancer. Br J Oral Maxillofac Surg 2012;50(4):314–20. doi: 10.1016/j.bjoms.2011.05.005
  5. Vazhenin A.V., Tsiring D.A. Psychological factors of women with breast cancer seeking specialized medical care. Voprosy onkologii = Issues of Oncology 2023;69(1):102–7. (In Russ.).
  6. Ghazali N., Kanatas A. Use of the Patient Concerns Inventory to identify speech and swallowing concerns following treatment for oral and oropharyngeal cancer. J Laryngol Otol 2012;126(8):800–8. doi: 10.1017/S0022215112001107
  7. Kanatas A., Ghazali N. The identification of mood and anxiety concerns using the patients concerns inventory following head and neck cancer. Int J Oral Maxillofac Surg 2012;41(4):429–36. doi: 10.1016/j.ijom.2011.12.021
  8. Rogers S.N., Cleator A.J. Identifying pain-related concerns in routine follow-up clinics following oral and oropharyngeal cancer. World J Clin Oncol 2012;3(8):116–25. doi: 10.5306/wjco.v3.i8.116
  9. Ghazali N., Cadwallader E. Fear of recurrence among head and neck cancer survivors: longitudinal trends. Psychooncology 2013;22(4):807–13. doi: 10.1002/pon.3069
  10. Ghazali N., Kanatas A. The Patient Concerns Inventory: a tool to uncover unmet needs in a cancer outpatient clinic. Bull Royal College Surg Engl 2013;95(3):1–6. doi: 10.1308/147363513X13500508919899
  11. Ghazali N., Roe B., Lowe D., Rogers S.N. Uncovering patients’ concerns in routine head and neck oncology follow up clinics: an exploratory study. Br J Oral Maxillofac Surg 2013;51(4):294–300. doi: 10.1016/j.bjoms.2012.08.002
  12. Kanatas A., Ghazali N., Lowe D. et al. Issues patients would like to discuss at their review consultation: variation by early and late stage oral, oropharyngeal and laryngeal subsites. Eur Arch Otorhinolaryngol 2013;270(3):1067–74. doi: 10.1007/s00405-012-2092-6
  13. Hatta J.M., Doss J.G., Rogers S.N. The feasibility of using Patients Concerns Inventory (PCI) in managing Malaysian oral cancer patients. Int J Oral Maxillofac Surg 2014;43(2):147–55. doi: 10.1016/j.ijom.2013.08.006
  14. Ghazali N., Roe B., Lowe D., Rogers S.N. Patients concerns inventory highlights perceived needs and concerns in head and neck cancer survivors and its impact on health-related quality of life. Br J Oral Maxillofac Surg 2015;53(4):371–9. doi: 10.1016/j.bjoms.2015.01.022
  15. Rogers S.N., Hazeldine P. How often do head and neck cancer patients raise concerns related to intimacy and sexuality in routine follow-up clinics? Eur Arch Otorhinolaryngol 2015;272(1):207–17. doi: 10.1007/s00405-014-2971-0
  16. Rogers S.N., Lowe D., Kanatas A. Suitability of the Patient Concerns Inventory as a holistic screening tool in routine head and neck cancer follow-up clinics. Br J Oral Maxillofac Surg 2016;54(4):415–21. doi: 10.1016/j.bjoms.2016.01.018
  17. Allen S., Lowe D., Harris R.V. et al. Is social inequality related to different patient concerns in routine oral cancer follow-up clinics? Eur Arch Otorhinolaryngol 2017;274(1):451–9. doi: 10.1007/s00405-016-4208-x.2016Jul22
  18. Breeze J., Morrison A., Dawson D. et al. Health-related quality of life after treatment for neoplasia of the major salivary glands: a pilot study. Br J Oral Maxillofac Surg 2016;54(7):806–11. doi: 10.1016/j.bjoms.2016.05.018
  19. Aguilar M.L., Sandow P., Werning J.W. et al. The head and neck cancer Patient Concern Inventory: patient concerns’ prevalence, dental concerns’ impact, and relationships of concerns with quality of life measures. J Prosthodont 2017;26(3):186–95. doi: 10.1111/jopr.12496
  20. Rogers S.N., Pearson T., Lowe D. How easy and confident do patients feel about using an iPad to complete the Patient Concerns Inventory without assistance in a busy head and neck oncology outpatient review clinic. Oral Cancer 2017;1:1–5. doi: 10.1007/s41548-017-0001-9
  21. Ghazali N., Roe B., Lowe D. et al. Using the patients concerns inventory for distress screening in post-treatment head and neck cancer survivors. J Craniomaxillofac Surg 2017;45(10):1743–8. doi: 10.1016/j.jcms.2017.07.009
  22. Miller N., Rogers S.N. A review of question prompt lists used in the oncology setting with comparison to the patient concerns inventory. Eur J Cancer Care (Engl) 2018;27(1). doi: 10.1111/ecc.12489
  23. Ozakinci G., Swash B., Humphris G. et al. Fear of cancer recurrence in oral and oropharyngeal cancer patients: an investigation of the clinical encounter. Eur J Cancer Care (Engl) 2018;27(1). doi: 10.1111/ecc.12785
  24. Rogers S.N., Ahiaku S., Lowe D. Is routine holistic assessment with a prompt list feasible during consultations after treatment for oral cancer? Br J Oral Maxillofac Surg 2018;56(1):24–8. doi: 10.1016/j.bjoms.2017.09.013
  25. Kanatas A., Rogers S.N. The role of the Head and Neck cancer-specific Patient Concerns Inventory (PCI-HN) in telephone consultations during the COVID-19 pandemic. Br J Oral Maxillofac Surg 2020;58(5):497–9. doi: 10.1016/j.bjoms.2020.04.010
  26. Ponomareva I.V., Pakhomova Ya.N. Psychological characteristics of patients with malignant neoplasms of the most common localizations. Palliativnaya meditsina i reabilitatsiya = Palliative Medicine and Rehabilitation 2023;2:41–7. (In Russ.).
  27. Aminnudin A.N., Doss J.G., Ismail S.M. et al. Can post-treatment oral cancer patients’ concerns reflect their cancer characteristics, HRQoL, psychological distress level and satisfaction with consultation? Ecancermedicalscience 2020;14:1118. doi: 10.3332/ecancer.2020.1118
  28. Broderick D. Mr., Lowe D., Kanatas A., Rogers S.N. How much of a problem is too much saliva for patients following head and neck cancer. Br J Oral Maxillofac Surg 2020;58(9):e51–6. doi: 10.1016/j.bjoms.2020.05.033
  29. Elaldi R., Roussel L.M., Gal J. et al. Correlations between long-term quality of life and patient needs and concerns following head and neck cancer treatment and the impact of psychological distress. A multicentric cross-sectional study. Eur Arch Otorhinolaryngol 2021;278(7):2437–45. doi: 10.1007/s00405-020-06326-8
  30. Rogers S.N., Monssen C., Humphris G.M. et al. Which head and neck cancer patients are most at risk of high levels of fear of cancer recurrence. Front Psychol 2021;12:671366. doi: 10.3389/fpsyg.2021.671366
  31. Twigg J., Kanatas A., Humphris G.M. et al. Risk stratification for poor health-related quality of life following head and neck cancer through the aid of a one-page item prompt list. Int J Oral Maxillofac Surg 2021;51(8):1000–6. doi: 10.1016/j.ijom.2021.08.028
  32. Ezeofor V., Spencer L.H., Rogers S.N. et al. An economic evaluation supported by qualitative data about the Patient Concerns Inventory (PCI) versus standard treatment pathway in the management of patients with head and neck cancer. Pharmacoecon Open 2022;6(3):389–403. doi: 10.1007/s41669-021-00320-4
  33. Mortensen A., Wessel I., Rogers S.N. et al. Needs assessment in patients surgically treated for head and neck cancer – a randomized controlled trial. Support Care Cancer 2022;30(5):4201–18. doi: 10.1007/s00520-021-06759-9
  34. Lukina E.Yu., Vazhenin A.V., Kuznetsova A.I. Evaluation of the effectiveness of combined photon-neutron therapy depending on the depth of the primary lesion in patients with malignant neoplasms of the head and neck. Opukholi golovy i shei = Head and Neck Tumors 2011;3:11–6. (In Russ.).
  35. Rogers L.Q., Courneya K.S., Robbins K.T. et al. Physical activity and quality of life in head and neck cancer survivors. Support Care Cancer 2006;14(10):1012–9. doi: 10.1007/s00520-006-0044-7
  36. Lee Y.H., Lai G.M., Lee D.C. et al. Promoting physical and psychological rehabilitation activities and evaluating potential links among cancer-related fatigue, fear of recurrence, quality of life, and physiological indicators in cancer survivors. Integr Cancer Ther 2018;17(4):1183–94. doi: 10.1177/1534735418805149

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2026 Kuznetsova A.I., Vazhenin A.V., Ponomareva I.V., Tsiring D.A., Menshikova E.S.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77-36990 от  21.07.2009.