title: Symptom patterns of patients with head and neck cancer in a palliative care unit.
abstract: BACKGROUND
  Patients with end-stage head and neck cancer suffer from many physical and psychological symptoms, however, there have been relatively few studies looking at end-of-life symptoms in the head and neck cancer population. The objective of this study was to describe the symptom patterns of patients with terminal head and neck cancer in the palliative care unit.
  
  
  METHODS
  A retrospective chart review of 94 patients with terminal head and neck cancer admitted to a palliative care unit between May 2006 and December 2008 was performed. Demographic data, performance status, primary tumor site, time from diagnosis to first hospice admission, survival time after admission, medication for pain control, and main symptoms at the time of admission were examined.
  
  
  RESULTS
  The mean time from diagnosis to first hospice admission was 33.1 ± 51.6 months. The mean survival time in the hospice was 21.9 ± 18.9 days. In this study, the most common symptom experienced was weight loss, followed by pain, cough, dysphagia, feeding difficulties, and communication difficulties. A statistically significant association of communication difficulties was found with presence or absence of a tracheostomy (p < 0.001). Change of morphine dosage after hospice care is related to the site location of head and neck cancer. Levels of education seem to be related to the increasing use of morphine (p = 0.025). Change of morphine dosage was statistically correlated with survival time after hospice admission (p < 0.001)
  
  
  CONCLUSIONS
  Numerous symptoms at the end of life highlight the complexity of head and neck cancer patients that may necessitate early hospice referral for symptom control.
authors.affiliation: Family Medicine Department, Changhua Christian Hospital, Taiwan, Republic of China.
authors.forename: Ying-Li
authors.initials: YL
authors.lastname: Lin
authors.forename: I-Ching
authors.initials: IC
authors.lastname: Lin
authors.forename: Jenn-Chang
authors.initials: JC
authors.lastname: Liou
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006258:Head and Neck Neoplasms / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D010166:Palliative Care; D010361:Patients; D012189:Retrospective Studies; D019452:Terminally Ill