title: Body image in patients with head and neck cancer: a review of the literature.
abstract: OBJECTIVE
  Patients with head and neck cancer have a high potential for body image disturbance due to highly visible disfigurement resulting from both the primary cancer and its treatment. The purpose of this review is to examine the conceptual framework for understanding body image in patients treated for head and neck cancer, present the current state of the science, discuss measurement issues, and identify areas for future investigation. A novel hypothetical model based on ongoing work is proposed, and it asserts that head and neck cancer therapy results in two main tumor/treatment related physical effects: (1) disfigurement and (2) dysfunction. In this model, personal, social and environmental factors moderate the effect of dysfunction and disfigurement on body image.
  
  
  RESULTS
  A search of the empirical literature revealed a paucity of data on body image in head and neck cancers including a lack of longitudinal data as well as a lack of data on the relationship between body image disturbance and other psychosocial variables such as depression, anxiety, and social isolation over the course of treatment and throughout recovery. Additionally, the need for measurement tools specifically developed for the assessment of body image in head and neck cancer patients was identified.
  
  
  CONCLUSIONS
  Prospective longitudinal studies that define the trajectory of body image issues and the mediating and moderating factors associated with body image will allow researchers to design targeted interventions to limit body image disturbance and thereby improve quality of life in patients with head and neck cancer.
authors.affiliation: Vanderbilt University School of Nursing, Nashville, TN 37240, USA. bethany.andrewsrhoten@vanderbilt.edu
authors.forename: Bethany Andrews
authors.initials: BA
authors.lastname: Rhoten
authors.forename: Barbara
authors.initials: B
authors.lastname: Murphy
authors.forename: Sheila H
authors.initials: SH
authors.lastname: Ridner
mesh_terms: D001828:Body Image; D006258:Head and Neck Neoplasms / Q000523:psychology*; D006801:Humans
keywords: Body image; Depression; Head and neck neoplasms; Physical activity; Psychology; Social isolation