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


METHODS
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.
Meyer
Tanya K
TK
Department of Otolaryngology & Communication Sciences, The Medical College of Wisconsin, Milwaukee, Wisconsin 53226-3522, USA.
Kuhn
Joan C
JC
Campbell
Bruce H
BH
Marbella
Anne M
AM
Myers
Katherine B
KB
Layde
Peter M
PM
D005260:Female; D006258:Head and Neck Neoplasms / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D013065:Speech Intelligibility; D017741:Survivors; D013997:Time Factors