Quality of Life Assessment of Head and Neck Cancer Patients from a Patient Perspective

Abstract

Background and Purpose: Head and Neck Cancer (HNC) is a major cause of morbidity and mortality for the concerned patients. HNCs alone account for 30-40% of all cancers prevalent in India. Moreover there are approximately 800,000 new cases of HNC diagnosed each year. There is a dire need for clinicians to select the optimal therapeutic regimen among available alternatives targeting HNCs. A particular cause of concern is the vast side-effects profile of HNC treatment, be it chemotherapy or radiotherapy. There are many cases where patients seem to suffer more from the treatment side-effects instead of their cancer. As a result, it would be necessary to take into consideration patients‟ mental and physical status during their treatment as a means of consolation and optimisation. The aim of this study is to determine, among patients receiving Head and Neck cancer therapy, the impact on quality of life from a patient perspective, first-hand. Methods: A single-centric, retrospective study was carried out to examine HNC patients that were candidates for curative treatments. The study was done from January 2014 to April 2014 at the HCG Cancer Centre, Ahmedabad. Both genders of all ages were included in the study. The HCG Cancer Centre database was used to identify HNC patients and the centre‟s ethics committee approved the protocol for the current study. Head and Neck Cancer patients were diagnosed based on radio-imaging techniques and biopsy. The patients‟ treatments, which are usually chemotherapy, radiotherapy or a combination of both, were decided by the physicians at their own discretion. The data for patients‟ operative history, co-morbidities and risk factors was obtained from the Medical Records Department (MRD) of HCG. The University of Washington Quality of Life (QOL) Questionnaire was used in the study. The patients‟ average functionality scores, average quality of life scores, and the mean scores of their QOL compared to a month before diagnosis were determined from the UWQOL questionnaire. Results: From the data of forty-seven patients that were found to be eligible for the study, most of the patients were male (91%), and were in the age group of 51-60 years. A majority of the patients had cancer of the Buccal Mucosa, followed by those with cancer of the tongue. 53% of the patients were post-operative with ten patients having Diabetes Mellitus and ten having Hypertension. Fourteen patients had a habit of tobacco consumption and 5 were smokers. A noteworthy correlation was observed as eight patients who had cancer of the Buccal Mucosa had a habit of tobacco/gutka consumption. The non-operative patients had less functionality scores as well as QOL scores compared to the post-operative ones. The Quality of Life of smokers compared to a month before they had cancer is of particular concern. Conclusion: Most of the patients had their average Quality of Life Scores below the median range. It was observed that chewing, swallowing and pain were the functionality parameters that are of significant concern for such patients. Whether routine use of QOL measures in the clinical setting is beneficial to patients or not has yet to be determined. Moreover, studies with bigger and diverse patient populations are necessary to establish accurate results for optimisation of therapy.