First year after head and neck cancer: quality of life.
OBJECTIVE
Treatment regimens for head and neck cancer patients profoundly affect several quality-of-life domains. Rehabilitative needs have been identified through cross-sectional analyses; however, few studies have prospectively assessed quality of life, included assessment of psychosocial variables, and identified predictors of long-term follow-up.


METHODS
The present study addresses these limitations through a prospective assessment of 105 patients with a newly diagnosed first primary squamous cell carcinoma of the oral cavity, pharynx, or larynx. Participants were enrolled onto a larger randomized controlled trial comparing a provider-delivered smoking cessation intervention with a usual-care-advice control condition. Participants completed a battery of self-report measures after diagnosis and before treatment and additional quality-of-life instruments at 1 and 12 months after initial smoking cessation advice.


RESULTS
Participants displayed improvements at 12 months in functional status (P = .006) and in the areas of eating, diet, and speech; however, the latter three represent areas of continued dysfunction, and the changes were not statistically significant. Despite these improvements, patients reported a decline in certain quality-of-life domains, including marital (P = .002) and sexual functioning (P = .017), as well as an increase in alcohol use (P < .001). Predictors of quality of life at 12 months included treatment type, the Vigor subscale of the Profile of Mood States instrument, and quality-of-life scores obtained 1 month after initial smoking cessation advice.


CONCLUSIONS
Results reinforce the need for rehabilitation management through the integration of psychologic and behavioral interventions in medical follow-up.
Gritz
E R
ER
Department of Behavioral Science, University of Texas M.D. Anderson Cancer Center, Houston, TX 77030-4095, USA. egritz@notes.mdacc.tmc.edu
Carmack
C L
CL
de Moor
C
C
Coscarelli
A
A
Schacherer
C W
CW
Meyers
E G
EG
Abemayor
E
E
D000203:Activities of Daily Living; D000428:Alcohol Drinking; D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D004435:Eating; D005260:Female; D006258:Head and Neck Neoplasms / Q000523:psychology / Q000628:therapy*; D006801:Humans; D017567:Karnofsky Performance Status; D007822:Laryngeal Neoplasms / Q000523:psychology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000523:psychology / Q000628:therapy; D010610:Pharyngeal Neoplasms / Q000523:psychology / Q000628:therapy; D011446:Prospective Studies; D011788:Quality of Life; D012907:Smoking; D013060:Speech