Eating problems haunt head/neck cancer survivors

Eating problems due to poor oropharyngeal functioning and persistent pain appear to be the most prevalent problems faced by long-term survivors of head and neck cancer, according to a new study in the Archives of Otolaryngology -- Head & Neck Surgery (January 16, 2012).

The study, conducted by Gerry Funk, MD, of the University of Iowa Hospitals and Clinics, included 337 patients diagnosed with head and neck cancer between January 1995 and December 2004 who enrolled in the Outcomes Assessment Project and survived at least five years.

Relatively few studies have evaluated long-term health-related quality of life outcomes five or more years from diagnosis in patients with head and neck cancer, Dr. Funk and his co-authors noted.

They found that more than 50% of the survivors in their study had problems eating, 28.5% reported depressive symptoms, and 17.3% reported substantial pain. However, the average general health of the long-term survivors was equivalent to age-matched norms from the general population. In addition, at long-term follow-up, 13.6% of the survivors continued to smoke and 38.9% used alcohol.

Multivariate analyses showed that pain and diet in the first year were the strongest independent predictors of five-year, health-related quality of life outcomes, the researchers reported.

"Early interventions addressing eating issues, swallowing problems, and pain management will be a crucial component in improving this patient population's long-term QOL [quality of life], especially in those who are functioning poorly one year after diagnosis," they wrote.

Their study, along with others, demonstrate that poor oral and oropharyngeal function was a persistent problem in long-term survivors that can be due to neuromuscular changes, anatomic deficits after surgery, pain, dental deficits, and other factors.

"In addition, poor swallowing function may exert more than a detrimental effect on HRQOL [health-related quality of life]," the study authors noted.

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