Mehanna and Morton studied long-term survivors of head and neck cancer. They found that these patients suffered deterioration in their quality of life over time. The authors are from University Hospitals Coventry and Warwickshire, Heart of England Foundation Trust in Birmingham and Auckland City Hospital in New Zealand.
Patient selection: survivor of head and neck cancer, 10 years or more after treatment
Of the original cohort 68% had died at the time of follow-up.
Factors contributing to a poor quality of life may include:
(1) sequelae of radical neck dissection
(2) complications of radiation therapy to the head and neck
(3) late sequelae of chemotherapy
(4) poor quality of life prior to treatment
Early stage disease treated with less aggressive methods may have fewer complications.
Specific problems for the patients may include:
(1) chronic cough
(2) difficulty speaking
(3) pain in the head, neck, shoulder and/or arm
(4) difficulty swallowing
Part of the long-term follow-up of patients with head and neck cancer should be regular assessment of psychosocial issues that may impact the patient's quality of life.
