Fear of recurrence impacts health-related quality of life and continued tobacco use in head and neck cancer survivors.
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To examine the impact of fear of recurrence (FOR) on health-related quality of life (HRQOL) and tobacco use among head and neck cancer (HNC) survivors.A cross-sectional subset of patients (N = 138) from a large, prospective study of oncologic outcomes in HNC was assessed for FOR, in addition to the parent study's ongoing assessments of HRQOL and tobacco use. FOR was measured using the Fear of Cancer Recurrence Inventory and HNC-specific HRQOL was assessed with the Head and Neck Cancer Inventory (HNCI). Tobacco use was patient-reported as "Current," "Previous," or "Never."After controlling for relevant clinical and demographic variables, hierarchical regression analyses revealed that higher FOR significantly predicted lower HRQOL across all HNCI domains (eating (p < .05), aesthetics (p < .01), speech (p < .01), and social disruption (p = .001)) and increased tobacco use (p < .01). A total of 60.1% of the sample expressed clinically significant levels of FOR. These patients reported lower HRQOL (eating: p < .05, aesthetics: p < .05, social disruption: p < .05) and were more likely to be using tobacco compared with patients with subclinical FOR (26.6% and 4.9%, respectively; p < .01).Results suggest that FOR is prevalent among HNC survivors and is related to decreased HRQOL and increased tobacco use.Keywords:
Subclinical infection
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Abstract Purpose: The management of head and neck cancer (HNC) patients requires balancing disease control with structural, cosmetic, and functional deficits that can negatively impact quality of life (QoL). Therefore, understanding the physical, emotional and social aspects of QoL of patients throughout their HNC treatment process can help providers better treat this populations of patients in order to improve their QoL. Methods: This was a prospective cohort study of sixty-eight consecutive patients with HNC receiving curative intent RT at Princess Margaret Cancer Centre who had completed the self-administered UW-QoL v4 pre-RT, Mid-RT, 1-month and 6-months post-RT. Results: All scores on the questionnaire decreased mid-RT, with taste and saliva demonstrating the greatest decrease (p <. 05). All scores increased and therefore improved 1-month post-RT and further improved at 6-months post-RT (p <.05). Mean scores did not return to the mean pre-RT levels for the domains swallowing, taste, saliva, and for the physical function composite scores. Conclusions: HNC patients undergoing RT treatment need to be supported and monitored by health care providers for alterations in QoL during and post-RT, especially with respect to their taste and saliva.
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Head and neck cancer (HNC) treatment can cause oral morbidities, such as oral dryness and dysphagia, affecting the patient's quality of life (QOL). The relationship between oral functions and QOL in patients with early-stage HNC remains poorly studied. This study aimed to evaluate changes in the QOL of patients with early-stage HNC and identify factors that affect the QOL of these patients.In this prospective cohort study, 37 patients who underwent early-stage (Stage I/Stage II) HNC treatment were evaluated for their oral function, swallowing function, and the QOL score at baseline (BL) and 12 months after surgical treatment (12 M). The participants were divided into two groups: patients who returned to the BL QOL score at 12 M (RE; n = 26) and those who did not (NR; n = 11).In total, 29.7% (11/37) patients with early-stage HNC did not return to the BL QOL score at 12 M. There was no significant difference between the RE and NR groups regarding the oral and swallowing function. Moreover, oral and swallowing function of all patients returned to the BL at 12 M. The NR group showed lower QOL scores than the RE group in the global health status, and "sticky saliva" parameters in the questionnaires.Restoration of the oral function is insufficient to improve the QOL of patients with early-stage HNC. The treatment of these patients should instead consider several factors that affect their QOL.
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SUMMARY Thyroid function and lipid tests were measured in 29 premenopausal women with subclinical hypothyroidism. This group was compared with 41 euthyroid women matched for age and metabolic parameters. In basal condition there was no difference in thyroid hormone levels between the two groups except for TSH concentration ( P <0.01). Total cholesterol, triglycerides and apolipoprotein (apo A1, A2, B) of women with subclinical hypothyroidism were not different from controls. HDL cholesterol was significantly decreased in subclinical hypothyroidism compared to the controls ( P <0.01). With thyroxine therapy, normalization of serum TSH was associated with (1) no significant change in total cholesterol and triglycerides, (2) an increase of HDL cholesterol ( P <0.01) and apoprotein Al ( P <0.05) levels. Total cholesterol/HDL cholesterol ratio was increased in subclinical hypothyroidism ( P <0.01). During L‐thyroxine therapy this ratio returned to normal value. Decreased HDL cholesterol concentration might cause coronary heart disease reported in women with subclinical hypothyroidism.
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Head and neck cancer (HNC) is one of the fastest increasing cancer-types, where both disease and oncologic treatment have severe impact on health-related quality of life (HRQL). This study aimed to report HRQL prospectively up to 5-years following radiotherapy-treatment in HNC and to, if possible, identify trends in HRQL over time.This prospective study followed 211 patients receiving curatively intended radiotherapy pre-diagnosis, 3-, 6-, 12- and 60-months post-radiotherapy completion. HRQL was measured using EORTC QLQ-C30 and EORTC QLQ-HN35.A deterioration three months post-radiotherapy was reported in 14/15 domains of EORTC QLQ-C30. Eight out of 12 domains had recovered to baseline-values at 12 months post-radiotherapy and remained unchanged up to study endpoint. Corresponding figures for EORTC QLQ-HN35 were deteriorations in 15/16 domains at three months post-radiotherapy, with recovery of 5 domain at 12-months, whereas the other 11 domains remained significantly worse at 5-years post-RT compared to baseline.Following the deterioration in HRQL seen immediately following radiotherapy, the continued course of HRQL can be divided into three trends: short-term deterioration, long-term deterioration and long-term improvements. The combination of disease- and diagnosis-specific questionnaires is crucial when assessing HRQL in the HNC population.
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