Abstract
Patients with head and neck cancers (HNC) face multiple psychosocial and physical challenges that require multidisciplinary attention and care throughout their disease process. The psychoemotional symptoms may be triggered by cosmetic disfigurement and/or functional deficits related to the cancer itself or cancer-directed treatments. These physical and emotional symptoms can be demoralizing and require acute and long-term professional assistance throughout a patient’s lifespan. HNC remains one of the most challenging cancers to treat due to disfigurement, emotional suffering, social isolation, and loss of self-esteem. The emotional and physical symptoms a supportive care team can address are discussed in this chapter.
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Abbreviations
- HNC:
-
Head and Neck Cancer
- NCCN:
-
National Comprehensive Cancer Network
- MDD:
-
Major Depressive Disorder
- EOL:
-
End of Life
- ENT:
-
Ear, Nose, Throat
- 5-HT3 receptor:
-
5-hydroxytryptamine receptor antagonists
- QOL:
-
Quality of Life
- CNS:
-
Central Nervous System
References
America CTCo. Palliative care for head and neck cancer. http://www.cancercenter.com/community/newsletter/article/palliative-care-for-head-and-neck-cancer/. Accessed Sept 25, 2017
Lin YL, Lin IC, Liou JC (2011) Symptom patterns of patients with head and neck cancer in a palliative care unit. J Palliat Med. 14(5):556–559
Ethunandan M, Rennie A, Hoffman G, Morey PJ, Brennan PA (2005) Quality of dying in head and neck cancer patients: a retrospective analysis of potential indicators of care. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 100(2):147–152
Devins GM (2015) Head and Neck Cancer. In: Holland JC, Breitbart WS, Jacobsen PB, Loscalzo MJ, McCorkle R, Butow PN (eds) Psycho-Oncology (3rd edn). Oxford University Press, Oxford, 92–97
Neilson K, Pollard A, Boonzaier A et al (2013) A longitudinal study of distress (depression and anxiety) up to 18 months after radiotherapy for head and neck cancer. Psycho-oncology 22(8):1843–1848
Holland JC, Andersen B, Breitbart WS et al (2010) Distress management. J Natl Compr Cancer Netw 8(4):448–485
Loscalzo M, Clark K, Dillehunt J, Rinehart R, Strowbridge R, Smith D (2010) SupportScreen: a model for improving patient outcomes. J Natl Compr Cancer Netw 8(4):496–504
Clark K, Bergerot CD, Philip EJ, Buga S, Obenchain R, Loscalzo MJ (2016) Biopsychosocial problem-related distress in cancer: examining the role of sex and age. Psycho-oncology, n/a-n/a
Merriam-Webster.com. Body Image. https://www.merriam-webster.com/medical/body%20image. Accessed 13 Sept 2016
Rhoten BA, Murphy B, Ridner SH (2013) Body image in patients with head and neck cancer: a review of the literature. Oral Oncol 49(8):753–760
Gamba A, Romano M, Grosso IM et al (1992) Psychosocial adjustment of patients surgically treated for head and neck cancer. Head Neck 14(3):218–223
Newell R (2000) Psychological difficulties amongst plastic surgery ex-patients following surgery to the face: a survey. Br J Plast Surg 53(5):386–392
Rumsey N, Clarke A, White P, Wyn-Williams M, Garlick W (2004) Altered body image: appearance-related concerns of people with visible disfigurement. J Adv Nurs 48(5):443–453
Low C, Fullarton M, Parkinson E et al (2009) Issues of intimacy and sexual dysfunction following major head and neck cancer treatment. Oral Oncol 45(10):898–903
Fingeret MC, Vidrine DJ, Reece GP, Gillenwater AM, Gritz ER (2010) Multidimensional analysis of body image concerns among newly diagnosed patients with oral cavity cancer. Head Neck 32(3):301–309
Fingeret MC, Yuan Y, Urbauer D, Weston J, Nipomnick S, Weber R (2012) The nature and extent of body image concerns among surgically treated patients with head and neck cancer. Psycho-oncology 21(8):836–844
Fingeret MC, Teo I, Goettsch K (2015) Body image: a critical psychosocial issue for patients with head and neck cancer. Current Oncol Rep 17(1):422
Rhoten BA, Deng J, Dietrich MS, Murphy B, Ridner SH (2014) Body image and depressive symptoms in patients with head and neck cancer: an important relationship. Support Care Cancer: official journal of the Multinational Association of Supportive Care in Cancer 22(11):3053–3060
Katz MR, Irish JC, Devins GM, Rodin GM, Gullane PJ (2000) Reliability and validity of an observer-rated disfigurement scale for head and neck cancer patients. Head Neck 22(2):132–141
Wu YS, Lin PY, Chien CY et al (2016) Anxiety and depression in patients with head and neck cancer: 6-month follow-up study. Neuropsychiatr Dis Treat 12:1029–1036
Singer S, Krauss O, Keszte J et al (2012) Predictors of emotional distress in patients with head and neck cancer. Head Neck 34(2):180–187
Smith JD, Shuman AG, Riba MB (2017) Psychosocial issues in patients with head and neck cancer: an updated review with a focus on clinical interventions. Current Psychiatry Rep 19(9):56
Jabbour J, Milross C, Sundaresan P et al (2017) Education and support needs in patients with head and neck cancer: a multi-institutional survey. Cancer 123(11):1949–1957
Chen AM, Daly ME, Vazquez E et al (2013) Depression among long-term survivors of head and neck cancer treated with radiation therapy. JAMA Otolaryngol Head Neck Surg 139(9):885–889
Misono S, Weiss NS, Fann JR, Redman M, Yueh B (2008) Incidence of suicide in persons with cancer. J Clinic Oncol: official journal of the American Society of Clinical Oncology 26(29):4731–4738
Kam D, Salib A, Gorgy G et al (2015) Incidence of Suicide in Patients With Head and Neck Cancer. JAMA Otolaryngol Head Neck Surg 141(12):1075–1081
Pattison N, Brown MR, Gubbay A et al (2016) Towards a pain free hospital: an in-depth qualitative analysis of the pain experiences of head and neck cancer patients undergoing radiotherapy. Br J Pain 10(1):29–37
van den Beuken-van Everdingen MH, de Rijke JM, Kessels AG, Schouten HC, van Kleef M, Patijn J (2007) Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Ann Oncol: official journal of the European Society for Medical Oncology 18(9):1437–1449
Whale Z, Lyne PA, Papanikolaou P (2001) Pain experience following radical treatment for head and neck cancer. Eur J Oncol Nurs: the official journal of European Oncology Nursing Society 5(2):112–120
Feingold D, Goor-Aryeh I, Bril S, Delayahu Y, Lev-Ran S (2017) Problematic use of prescription opioids and medicinal cannabis among patients suffering from chronic pain. Pain medicine (Malden, Mass) 18(2):294–306
Scharpf J, Karnell LH, Christensen AJ, Funk GF (2009) The role of pain in head and neck cancer recurrence and survivorship. Arch Otolaryngol Head Neck Surg 135(8):789–794
Allal AS, Nicoucar K, Mach N, Dulguerov P (2003) Quality of life in patients with oropharynx carcinomas: assessment after accelerated radiotherapy with or without chemotherapy versus radical surgery and postoperative radiotherapy. Head Neck 25(10):833–839; discussion 839–840
Bianchini C, Malago M, Crema L et al (2016) Post-operative pain management in head and neck cancer patients: predictive factors and efficacy of therapy. Acta otorhinolaryngologica Italica: organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale 36(2):91–96
Lu W, Rosenthal DS (2013) Acupuncture for cancer pain and related symptoms. Curr Pain Headache Rep 17(3):321
Sohl SJ, Stossel L, Schnur JB, Tatrow K, Gherman A, Montgomery GH (2010) Intentions to use hypnosis to control the side effects of cancer and its treatment. Am J Clinic Hypn 53(2):93–100
Ing JW (2017) Head and neck cancer pain. Otolaryngol Clin North Am 50(4):793–806
McMenamin EM, Grant M (2015) Pain prevention using head and neck cancer as a model. J Adv Pract Oncol 6(1):44–49
Clarkson JE, Worthington HV, Eden OB (2007) Interventions for treating oral mucositis for patients with cancer receiving treatment. Cochrane Database Syst Rev (2):Cd001973
Miller RC, Le-Rademacher J, Sio TTW et al, A Phase III, Randomized double-blind study of doxepin rinse versus magic mouthwash versus placebo in the treatment of acute oral mucositis pain in patients receiving head and neck radiotherapy with or without chemotherapy (Alliance A221304). Int J Radiat Oncol Biol Phys 96(5):938
Bur AM, Brant JA, Mulvey CL et al (2016) Association of clinical risk factors and postoperative complications with unplanned hospital readmission after head and neck cancer surgery. JAMA Otolaryngol Head Neck Surg 142(12):1184–1190
Cohen EEW, LaMonte SJ, Erb NL et al (2016) American Cancer Society head and neck cancer survivorship care guideline. CA Cancer J Clin 66(3):203–239
Quill TE (1998) Principle of double effect and end-of-life pain management: additional myths and a limited role. J Palliat Med. 1(4):333–336
Khelemsky Y, Goldberg AT, Hurd YL et al (2017) Perioperative patient beliefs regarding potential effectiveness of marijuana (cannabinoids) for treatment of pain: a prospective population survey. Reg Anesth Pain Med 42(5):652–659
Piper BJ, DeKeuster RM, Beals ML et al (2017) Substitution of medical cannabis for pharmaceutical agents for pain, anxiety, and sleep. J Psychopharmacol (Oxford, England) 31(5):569–575
Cote M, Trudel M, Wang C, Fortin A (2016) Improving quality of life with nabilone during radiotherapy treatments for head and neck cancers: a randomized double-blind placebo-controlled trial. Ann Otol Rhinol Laryngol 125(4):317–324
Fallon MT, Albert Lux E, McQuade R et al (2017) Sativex oromucosal spray as adjunctive therapy in advanced cancer patients with chronic pain unalleviated by optimized opioid therapy: two double-blind, randomized, placebo-controlled phase 3 studies. Br J Pain 11(3):119–133
Crowell TL (2016) Understanding Patients’ Process to Use Medical Marijuana: A Southern New Jersey Community Engagement Project. Journal of patient experience. 3(3):81–87
Chwistek M (2017) Recent advances in understanding and managing cancer pain. F1000Research 6:945
Maher DP, Cohen SP (2017) Medical marijuana research for chronic pain. Lancet Psychiatry 4(7):513–515
Maida V, Daeninck PJ (2016) A user’s guide to cannabinoid therapies in oncology. Current Oncol (Toronto, Ont) 23(6):398–406
Kroenke K, Cheville A (2017) Management of chronic pain in the aftermath of the opioid backlash. JAMA 317(23):2365–2366
Elliott DA, Nabavizadeh N, Romer JL, Chen Y, Holland JM (2016) Medical marijuana use in head and neck squamous cell carcinoma patients treated with radiotherapy. Support Care Cancer: official journal of the Multinational Association of Supportive Care in Cancer 24(8):3517–3524
Zheng WK, Inokuchi A, Yamamoto T, Komiyama S (2002) Taste dysfunction in irradiated patients with head and neck cancer. Fukuoka igaku zasshi = Hukuoka acta medica 93(4):64–76
Ripamonti C, Zecca E, Brunelli C et al (1998) A randomized, controlled clinical trial to evaluate the effects of zinc sulfate on cancer patients with taste alterations caused by head and neck irradiation. Cancer 82(10):1938–1945
Caudell JJ, Schaner PE, Meredith RF et al (2009) Factors associated with long-term dysphagia after definitive radiotherapy for locally advanced head-and-neck cancer. Int J Radiat Oncol Biol Phys 73(2):410–415
Berger AM, Mooney K, Alvarez-Perez A et al (2015) Cancer-related fatigue, version 2.2015. J Natl Compr Cancer Netw JNCCN 13(8):1012–1039
Morrow GR (2007) Cancer-related fatigue: causes, consequences, and management. Oncologist 12(Suppl 1):1–3
Vandaveer J. Fatigue. HospiScript Services; 2015
Mucke M, Cuhls H, Peuckmann-Post V, Minton O, Stone P, Radbruch L (2015) Pharmacological treatments for fatigue associated with palliative care. Cochrane Database Syst Rev (5):Cd006788
Bower JE, Bak K, Berger A et al (2014) Screening, assessment, and management of fatigue in adult survivors of cancer: an American Society of Clinical Oncology clinical practice guideline adaptation. J Clinic Oncol: official journal of the American Society of Clinical Oncology 32(17):1840–1850
Spathis A, Fife K, Blackhall F et al (2014) Modafinil for the treatment of fatigue in lung cancer: results of a placebo-controlled, double-blind, randomized trial. J Clinic Oncol: official journal of the American Society of Clinical Oncology 32(18):1882–1888
Grauer PA. Dyspnea. HospiScript Services; 2015
Personal habits and indoor combustions. Volume 100 E. A review of human carcinogens. IARC monographs on the evaluation of carcinogenic risks to humans 2012;100(Pt E):1–538
Chaturvedi AK, Engels EA, Pfeiffer RM et al (2011) Human papillomavirus and rising oropharyngeal cancer incidence in the United States. J Clinic Oncol: official journal of the American Society of Clinical Oncology 29(32):4294–4301
Blot WJ, McLaughlin JK, Winn DM et al (1988) Smoking and drinking in relation to oral and pharyngeal cancer. Can Res 48(11):3282–3287
Ostroff JS, Jacobsen PB, Moadel AB et al (1995) Prevalence and predictors of continued tobacco use after treatment of patients with head and neck cancer. Cancer 75(2):569–576
Gritz ER, Nisenbaum R, Elashoff RE, Holmes EC (1991) Smoking behavior following diagnosis in patients with stage I non-small cell lung cancer. Cancer Causes Control: CCC 2(2):105–112
Dresler CM, Bailey M, Roper CR, Patterson GA, Cooper JD (1996) Smoking cessation and lung cancer resection. Chest 110(5):1199–1202
Davison AG, Duffy M (1982) Smoking habits of long-term survivors of surgery for lung cancer. Thorax 37(5):331–333
Walker MS, Larsen RJ, Zona DM, Govindan R, Fisher EB (2004) Smoking urges and relapse among lung cancer patients: findings from a preliminary retrospective study. Prev Med 39(3):449–457
Parsons A, Daley A, Begh R, Aveyard P (2010) Influence of smoking cessation after diagnosis of early stage lung cancer on prognosis: systematic review of observational studies with meta-analysis. BMJ 340:b5569
Kawahara M, Ushijima S, Kamimori T et al (1998) Second primary tumours in more than 2-year disease-free survivors of small-cell lung cancer in Japan: the role of smoking cessation. Br J Cancer 78(3):409–412
Do KA, Johnson MM, Doherty DA et al (2003) Second primary tumors in patients with upper aerodigestive tract cancers: joint effects of smoking and alcohol (United States). Cancer Causes Control CCC 14(2):131–138
Browman GP, Wong G, Hodson I et al (1993) Influence of cigarette smoking on the efficacy of radiation therapy in head and neck cancer. N Engl J Med 328(3):159–163
Zhang J, Kamdar O, Le W, Rosen GD, Upadhyay D (2009) Nicotine induces resistance to chemotherapy by modulating mitochondrial signaling in lung cancer. Am J Respir Cell Mol Biol 40(2):135–146
Zevallos JP, Mallen MJ, Lam CY et al (2009) Complications of radiotherapy in laryngopharyngeal cancer: effects of a prospective smoking cessation program. Cancer 115(19):4636–4644
Arcavi L, Benowitz NL (2004) Cigarette smoking and infection. Arch Intern Med 164(20):2206–2216
Moller AM, Pedersen T, Villebro N, Schnaberich A, Haas M, Tonnesen R (2003) A study of the impact of long-term tobacco smoking on postoperative intensive care admission. Anaesthesia 58(1):55–59
Smith JB, Fenske NA (1996) Cutaneous manifestations and consequences of smoking. J Am Acad Dermatol 34(5 Pt 1):717–732; quiz 733–714
Berg CJ, Thomas AN, Mertens AC et al (2013) Correlates of continued smoking versus cessation among survivors of smoking-related cancers. Psycho-oncology 22(4):799–806
Freedman ND, Schatzkin A, Leitzmann MF, Hollenbeck AR, Abnet CC (2007) Alcohol and head and neck cancer risk in a prospective study. Br J Cancer 96(9):1469–1474
Alcohol consumption and ethyl carbamate. IARC monographs on the evaluation of carcinogenic risks to humans. 2010;96:3-1383
Tilley C, Lipson J, Ramos M (2016) Palliative wound care for malignant fungating wounds: holistic considerations at end-of-life. Nurs Clinic N Am 51(3):513–531
Serious Illness Care Resources (2017) https://www.ariadnelabs.org/areas-of-work/serious-illness-care/resources/#Downloads&Tools. Accessed 25 Sept 2017
VitalTalk [computer program] (2017)
Connor SR (2013) The family, larger systems and the dying process. In: Meagher DK, Balk DE (eds) Handbook of thanatology: the essential body of knowledge for the study of death, dying, and bereavement. Taylor & Francis, pp 33–49
Houvras Y, Nagarkatti S, Wirth LJ (2011) Multidisciplinary management of thyroid cancer. In: Haddad R (ed) Multidisciplinary management of head and neck cancer. Demos Medical Publishing L.L.C., New York, pp 161–177
Freeman B (2015) Compassionate person-centered care of the dying: an evidence based palliative care guide for nurses. Springer Publishing Company, LLC, New York
Connor SR, Pyenson B, Fitch K, Spence C, Iwasaki K (2007) Comparing hospice and nonhospice patient survival among patients who die within a three-year window. J Pain Symptom Manag 33(3):238–246
Kelley AS, Meier DE (2010) Palliative care—a shifting paradigm. N Engl J Med 363(8):781–782
Berry LL, Connor SR, Stuart B (2017) Practical ideas for improving the quality of hospice care. J Palliat Med 20(5):449–452
Price KA, Moore EJ, Moynihan T, Price DL (2009) Symptoms and terminal course of patients who died of head and neck cancer. J Palliat Med 12(2):117–118
Freeman B (2015) Sedation for refractory symptoms. In: Ferrell B, Coyle N, Paice J (eds) HPNA palliative nursing manual: care of the imminently dying. Oxford University Press, New York
Garcia-Egido AA, Payares-Herrera MC (2011) Managing hemorrhages in patients with head and neck carcinomas: a descriptive study of six years of admissions to an internal medicine/palliative care unit. J Palliat Med 14(2):124–125
Balfe M, O’Brien KM, Timmons A et al (2016) Informal caregiving in head and neck cancer: caregiving activities and psychological well-being. Eur J Cancer Care
Maltoni M, Pittureri C, Scarpi E et al (2009) Palliative sedation therapy does not hasten death: results from a prospective multicenter study. Ann Oncol 20(7):1163–1169
Bobb B (2016) A review of palliative sedation. Nurs Clinic N Am 51(3):449–457
Brajtman S, Wright D, Hogan DB et al (2011) Developing guidelines on the assessment and treatment of delirium in older adults at the end of life. Can Geriatr J CGJ 14(2):40–50
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A special thank you to Karen Clark, MS of City of Hope for helping to analyze the data and assisting with content edits.
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Buga, S., Banerjee, C., Salman, J., Cangin, M., Zachariah, F., Freeman, B. (2018). Supportive Care for the Head and Neck Cancer Patient. In: Maghami, E., Ho, A. (eds) Multidisciplinary Care of the Head and Neck Cancer Patient. Cancer Treatment and Research, vol 174. Springer, Cham. https://doi.org/10.1007/978-3-319-65421-8_15
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