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Semin Plast Surg 2023; 37(01): 046-052
DOI: 10.1055/s-0042-1759798
Review Article

Psychological Survivorship in Head and Neck Cancer

Ciaran Lane
1   Department of Otolaryngology – Head and Neck Surgery, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania
,
Ryan C. Higgins
1   Department of Otolaryngology – Head and Neck Surgery, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania
,
Neerav Goyal
1   Department of Otolaryngology – Head and Neck Surgery, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania
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Abstract

Survivorship for head and neck cancer patients presents unique challenges related to the anatomic location of their disease. After treatment, patients often have functional impairments requiring additional care and support. In addition, patients may have psychological challenges managing the effect of the disease and treatment. Routine screening is recommended for the identification of psychological conditions. This article reviews the latest research on key psychological conditions associated with head and neck cancer. It discusses risk factors for the development of each condition and provides recommendations for the management of patients who may present with psychological concerns.

Keywords

survivorship - psychology - anxiety - depression - suicide - body image disturbance


Publication History

Article published online:
19 December 2022

© 2022. Thieme. All rights reserved.

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  • References

  • 1 Hong WK, Weber RS. Head and Neck Cancer: Basic and Clinical Aspects. Springer; 2012
    PubMedGoogle Scholar
  • 2 Cohen EE, LaMonte SJ, Erb NL. et al. American Cancer Society Head and Neck Cancer Survivorship Care Guideline. CA Cancer J Clin 2016; 66 (03) 203-239
    CrossrefPubMedGoogle Scholar
  • 3 Pagedar NA, Kendell N, Christensen AJ, Thomsen TA, Gist M, Seaman AT. Head and neck cancer survivorship from the patient perspective. Head Neck 2020; 42 (09) 2431-2439
    CrossrefPubMedGoogle Scholar
  • 4 Goyal N, Day A, Epstein J. et al. Head and neck cancer survivorship consensus statement from the American Head and Neck Society. Laryngoscope Investig Otolaryngol 2021; 7 (01) 70-92
    CrossrefPubMedGoogle Scholar
  • 5 Beynon RA, Lang S, Schimansky S. et al. Tobacco smoking and alcohol drinking at diagnosis of head and neck cancer and all-cause mortality: results from head and neck 5000, a prospective observational cohort of people with head and neck cancer. Int J Cancer 2018; 143 (05) 1114-1127
    CrossrefPubMedGoogle Scholar
  • 6 Di Credico G, Polesel J, Dal Maso L. et al. Alcohol drinking and head and neck cancer risk: the joint effect of intensity and duration. Br J Cancer 2020; 123 (09) 1456-1463
    CrossrefPubMedGoogle Scholar
  • 7 McCarter K, Baker AL, Britton B. et al. Smoking, drinking, and depression: comorbidity in head and neck cancer patients undergoing radiotherapy. Cancer Med 2018; 7 (06) 2382-2390
    CrossrefPubMedGoogle Scholar
  • 8 Howren MB, Christensen AJ, Pagedar NA. Problem alcohol and tobacco use in head and neck cancer patients at diagnosis: associations with health-related quality of life. Support Care Cancer 2022; 30 (10) 8111-8118
    CrossrefPubMedGoogle Scholar
  • 9 Balachandra S, Eary RL, Lee R. et al. Substance use and mental health burden in head and neck and other cancer survivors: a National Health Interview Survey analysis. Cancer 2022; 128 (01) 112-121
    CrossrefPubMedGoogle Scholar
  • 10 Lee JH, Ba D, Liu G, Leslie D, Zacharia BE, Goyal N. Association of head and neck cancer with mental health disorders in a large insurance claims database. JAMA Otolaryngol Head Neck Surg 2019; 145 (04) 339-344
    CrossrefPubMedGoogle Scholar
  • 11 Selzer ML, Vinokur A, van Rooijen L. A self-administered short Michigan Alcoholism Screening Test (SMAST). J Stud Alcohol 1975; 36 (01) 117-126
    CrossrefPubMedGoogle Scholar
  • 12 Heatherton TF, Kozlowski LT, Frecker RC, Fagerström KO. The Fagerström test for nicotine dependence: a revision of the Fagerström Tolerance Questionnaire. Br J Addict 1991; 86 (09) 1119-1127
    CrossrefPubMedGoogle Scholar
  • 13 West R, Hajek P, Stead L, Stapleton J. Outcome criteria in smoking cessation trials: proposal for a common standard. Addiction 2005; 100 (03) 299-303
    CrossrefPubMedGoogle Scholar
  • 14 Hodgson R, Alwyn T, John B, Thom B, Smith A. The FAST alcohol screening test. Alcohol Alcohol 2002; 37 (01) 61-66
    CrossrefPubMedGoogle Scholar
  • 15 Schofield A. The CAGE questionnaire and psychological health. Br J Addict 1988; 83 (07) 761-764
    CrossrefPubMedGoogle Scholar
  • 16 McCarter K, Martínez Ú, Britton B. et al. Smoking cessation care among patients with head and neck cancer: a systematic review. BMJ Open 2016; 6 (09) e012296
    CrossrefPubMedGoogle Scholar
  • 17 Tang MW, Oakley R, Dale C, Purushotham A, Møller H, Gallagher JE. A surgeon led smoking cessation intervention in a head and neck cancer centre. BMC Health Serv Res 2014; 14 (01) 636
    CrossrefPubMedGoogle Scholar
  • 18 Kim J, Hua G, Zhang H. et al. Rate of second primary head and neck cancer with cannabis use. Cureus 2020; 12 (11) e11483
    PubMedGoogle Scholar
  • 19 Berthiller J, Lee YCA, Boffetta P. et al. Marijuana smoking and the risk of head and neck cancer: pooled analysis in the INHANCE consortium. Cancer Epidemiol Biomarkers Prev 2009; 18 (05) 1544-1551
    CrossrefPubMedGoogle Scholar
  • 20 Williams AM, Gilbert M, Siddiqui F. Cannabis use in patients with head and neck cancer and radiotherapy outcomes. Int J Radiat Oncol Biol Phys 2022; 112 (05) e60-e61
    CrossrefPubMedGoogle Scholar
  • 21 Mücke M, Weier M, Carter C. et al. Systematic review and meta-analysis of cannabinoids in palliative medicine. J Cachexia Sarcopenia Muscle 2018; 9 (02) 220-234
    CrossrefPubMedGoogle Scholar
  • 22 Zayed S, Lin C, Boldt RG. et al. Risk of chronic opioid use after radiation for head and neck cancer: a systematic review and meta-analysis. Adv Radiat Oncol 2020; 6 (02) 100583
    CrossrefPubMedGoogle Scholar
  • 23 Hinther A, Rasool A, Nakoneshny SC. et al. Chronic opioid use following surgery for head and neck cancer patients undergoing free flap reconstruction. J Otolaryngol Head Neck Surg 2021; 50 (01) 28
    CrossrefPubMedGoogle Scholar
  • 24 Butler SF, Fernandez K, Benoit C, Budman SH, Jamison RN. Validation of the revised Screener and Opioid Assessment for Patients with Pain (SOAPP-R). J Pain 2008; 9 (04) 360-372
    CrossrefPubMedGoogle Scholar
  • 25 Webster LR, Webster RM. Predicting aberrant behaviors in opioid-treated patients: preliminary validation of the Opioid Risk Tool. Pain Med 2005; 6 (06) 432-442
    CrossrefPubMedGoogle Scholar
  • 26 Butler SF, Budman SH, Fernandez KC. et al. Development and validation of the Current Opioid Misuse Measure. Pain 2007; 130 (1-2): 144-156
    CrossrefPubMedGoogle Scholar
  • 27 Ducharme J, Moore S. Opioid use disorder assessment tools and drug screening. Mo Med 2019; 116 (04) 318-324
    PubMedGoogle Scholar
  • 28 Carmichael AN, Morgan L, del Fabbro E. Identifying and assessing the risk of opioid abuse in patients with cancer: an integrative review. Subst Abuse Rehabil 2016; 7: 71-79
    PubMedGoogle Scholar
  • 29 Arneson DL, Coss DC, Rovick LP, Guthrie PF. An interprofessional pain diary in transitional care: a feasibility project. J Dr Nurs Pract 2020; 13 (03) 195-201
    PubMedGoogle Scholar
  • 30 Chou R, Gordon DB, de Leon-Casasola OA. et al. Management of postoperative pain: a clinical practice guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' Committee on Regional Anesthesia, Executive Committee, and Administrative Council. J Pain 2016; 17 (02) 131-157
    CrossrefPubMedGoogle Scholar
  • 31 Go BC, Go CC, Chorath K, Moreira A, Rajasekaran K. Multimodal analgesia in head and neck free flap reconstruction: a systematic review. Otolaryngol Head Neck Surg 2022; 166 (05) 820-831
    CrossrefPubMedGoogle Scholar
  • 32 Hinther A, Nakoneshny SC, Chandarana SP. et al. Efficacy of multimodal analgesia for postoperative pain management in head and neck cancer patients. Cancers (Basel) 2021; 13 (06) 1266
    CrossrefPubMedGoogle Scholar
  • 33 Goldberg SF, Pozek JJ, Schwenk ES, Baratta JL, Beausang DH, Wong AK. Practical management of a regional anesthesia-driven acute pain service. Adv Anesth 2017; 35 (01) 191-211
    CrossrefPubMedGoogle Scholar
  • 34 Schwenk ES, Mariano ER. Designing the ideal perioperative pain management plan starts with multimodal analgesia. Korean J Anesthesiol 2018; 71 (05) 345-352
    CrossrefPubMedGoogle Scholar
  • 35 Hammermüller C, Hinz A, Dietz A. et al. Depression, anxiety, fatigue, and quality of life in a large sample of patients suffering from head and neck cancer in comparison with the general population. BMC Cancer 2021; 21 (01) 94
    CrossrefPubMedGoogle Scholar
  • 36 Götze H, Friedrich M, Taubenheim S, Dietz A, Lordick F, Mehnert A. Depression and anxiety in long-term survivors 5 and 10 years after cancer diagnosis. Support Care Cancer 2020; 28 (01) 211-220
    CrossrefPubMedGoogle Scholar
  • 37 Wu YS, Lin PY, Chien CY. et al. Anxiety and depression in patients with head and neck cancer: 6-month follow-up study. Neuropsychiatr Dis Treat 2016; 12: 1029-1036
    PubMedGoogle Scholar
  • 38 Chen AM, Daly ME, Vazquez E. et al. Depression among long-term survivors of head and neck cancer treated with radiation therapy. JAMA Otolaryngol Head Neck Surg 2013; 139 (09) 885-889
    CrossrefPubMedGoogle Scholar
  • 39 Lenze NR, Bensen JT, Yarbrough WG, Shuman AG. Characteristics and outcomes associated with anxiety and depression in a head and neck cancer survivorship cohort. Am J Otolaryngol 2022; 43 (03) 103442
    CrossrefPubMedGoogle Scholar
  • 40 Shunmugasundaram C, Rutherford C, Butow PN, Sundaresan P, Dhillon HM. What are the optimal measures to identify anxiety and depression in people diagnosed with head and neck cancer (HNC): a systematic review. J Patient Rep Outcomes 2020; 4 (01) 26
    CrossrefPubMedGoogle Scholar
  • 41 William WK. Zung self-rating depression scale. In: Michalos AC. ed. Encyclopedia of Quality of Life and Well-Being Research. Dordrecht: Springer; 2014: 7317
    Google Scholar
  • 42 Zung WWK. A rating instrument for anxiety disorders. Psychosomatics 1971; 12 (06) 371-379
    CrossrefPubMedGoogle Scholar
  • 43 Kroenke K, Spitzer RL, Williams JBW. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001; 16 (09) 606-613
    CrossrefPubMedGoogle Scholar
  • 44 National Comprehensive Cancer Network. NCCN Guidelines Version 1.2022 Distress Management. Guidelines. Published online 2022. Accessed August 17, 2022 at: https://www.nccn.org/docs/default-source/patient-resources/nccn_distress_thermometer.pdf?sfvrsn=ef1df1a2_4
    PubMedGoogle Scholar
  • 45 Kroenke K, Theobald D, Wu J. et al. Effect of telecare management on pain and depression in patients with cancer: a randomized trial. JAMA 2010; 304 (02) 163-171
    CrossrefPubMedGoogle Scholar
  • 46 Jabbour J, Milross C, Sundaresan P. et al. Education and support needs in patients with head and neck cancer: a multi-institutional survey. Cancer 2017; 123 (11) 1949-1957
    CrossrefPubMedGoogle Scholar
  • 47 Ringash J, Bernstein LJ, Devins G. et al. Head and neck cancer survivorship: learning the needs, meeting the needs. Semin Radiat Oncol 2018; 28 (01) 64-74
    CrossrefPubMedGoogle Scholar
  • 48 Richardson AE, Broadbent E, Morton RP. A systematic review of psychological interventions for patients with head and neck cancer. Support Care Cancer 2019; 27 (06) 2007-2021
    CrossrefPubMedGoogle Scholar
  • 49 Lydiatt WM, Bessette D, Schmid KK, Sayles H, Burke WJ. Prevention of depression with escitalopram in patients undergoing treatment for head and neck cancer: randomized, double-blind, placebo-controlled clinical trial. JAMA Otolaryngol Head Neck Surg 2013; 139 (07) 678-686
    PubMedGoogle Scholar
  • 50 Barsevick AM, Sweeney C, Haney E, Chung E. A systematic qualitative analysis of psychoeducational interventions for depression in patients with cancer. Oncol Nurs Forum 2002; 29 (01) 73-84 , quiz 85–87
    CrossrefPubMedGoogle Scholar
  • 51 Ostuzzi G, Matcham F, Dauchy S, Barbui C, Hotopf M. Antidepressants for the treatment of depression in people with cancer. Cochrane Database Syst Rev 2018; 4 (04) CD011006
    PubMedGoogle Scholar
  • 52 Massa ST, Hong SA, Osazuwa-Peters N. Lethal suicidal acts among head and neck cancer survivors: the tip of a distress iceberg. JAMA Otolaryngol Head Neck Surg 2021; 147 (11) 989-990
    CrossrefPubMedGoogle Scholar
  • 53 Kendal WS. Suicide and cancer: a gender-comparative study. Ann Oncol 2007; 18 (02) 381-387
    CrossrefPubMedGoogle Scholar
  • 54 Henry M, Rosberger Z, Bertrand L. et al. Prevalence and risk factors of suicidal ideation among patients with head and neck cancer: longitudinal study. Otolaryngol Head Neck Surg 2018; 159 (05) 843-852
    CrossrefPubMedGoogle Scholar
  • 55 Misono S, Weiss NS, Fann JR, Redman M, Yueh B. Incidence of suicide in persons with cancer. J Clin Oncol 2008; 26 (29) 4731-4738
    CrossrefPubMedGoogle Scholar
  • 56 Chang DC, Chen AWG, Lo YS, Chuang YC, Chen MK. Factors associated with suicidal ideation risk in head and neck cancer: a longitudinal study. Laryngoscope 2019; 129 (11) 2491-2495
    CrossrefPubMedGoogle Scholar
  • 57 Rhoten BA, Murphy B, Ridner SH. Body image in patients with head and neck cancer: a review of the literature. Oral Oncol 2013; 49 (08) 753-760
    CrossrefPubMedGoogle Scholar
  • 58 Ellis MA, Sterba KR, Day TA. et al. Body image disturbance in surgically treated head and neck cancer patients: a patient-centered approach. Otolaryngol Head Neck Surg 2019; 161 (02) 278-287
    CrossrefPubMedGoogle Scholar
  • 59 Fingeret MC, Yuan Y, Urbauer D, Weston J, Nipomnick S, Weber R. The nature and extent of body image concerns among surgically treated patients with head and neck cancer. Psychooncology 2012; 21 (08) 836-844
    CrossrefPubMedGoogle Scholar
  • 60 Ellis MA, Sterba KR, Brennan EA. et al. A systematic review of patient-reported outcome measures assessing body image disturbance in patients with head and neck cancer. Otolaryngol Head Neck Surg 2019; 160 (06) 941-954
    Google Scholar
  • 61 Beal BT, White EK, Behera AK. et al. Patients' body image improves after Mohs micrographic surgery for nonmelanoma head and neck skin cancer. Dermatol Surg 2018; 44 (11) 1380-1388
    CrossrefPubMedGoogle Scholar
  • 62 Clarke SA, Newell R, Thompson A, Harcourt D, Lindenmeyer A. Appearance concerns and psychosocial adjustment following head and neck cancer: a cross-sectional study and nine-month follow-up. Psychol Health Med 2014; 19 (05) 505-518
    CrossrefPubMedGoogle Scholar
  • 63 Macias D, Hand BN, Maurer S. et al. Factors associated with risk of body image-related distress in patients with head and neck cancer. JAMA Otolaryngol Head Neck Surg 2021; 147 (12) 1019-1026
    CrossrefPubMedGoogle Scholar
  • 64 Chen SC, Yu PJ, Hong MY. et al. Communication dysfunction, body image, and symptom severity in postoperative head and neck cancer patients: factors associated with the amount of speaking after treatment. Support Care Cancer 2015; 23 (08) 2375-2382
    CrossrefPubMedGoogle Scholar
  • 65 Fingeret MC, Vidrine DJ, Reece GP, Gillenwater AM, Gritz ER. Multidimensional analysis of body image concerns among newly diagnosed patients with oral cavity cancer. Head Neck 2010; 32 (03) 301-309
    CrossrefPubMedGoogle Scholar
  • 66 Henry M, Albert JG, Frenkiel S. et al. Body image concerns in patients with head and neck cancer: a longitudinal study. Front Psychol 2022; 13: 816587
    CrossrefPubMedGoogle Scholar
  • 67 Dropkin MJ. Body image and quality of life after head and neck cancer surgery. Cancer Pract 1999; 7 (06) 309-313
    CrossrefPubMedGoogle Scholar
  • 68 Hopwood P, Fletcher I, Lee A, Al Ghazal S. A body image scale for use with cancer patients. Eur J Cancer 2001; 37 (02) 189-197
    CrossrefPubMedGoogle Scholar
  • 69 Graboyes EM, Maurer S, Park Y. et al. Evaluation of a novel telemedicine-based intervention to manage body image disturbance in head and neck cancer survivors. Psychooncology 2020; 29 (12) 1988-1994
    CrossrefPubMedGoogle Scholar
  • 70 Melissant HC, Jansen F, Eerenstein SEJ. et al. A structured expressive writing activity targeting body image-related distress among head and neck cancer survivors: who do we reach and what are the effects?. Support Care Cancer 2021; 29 (10) 5763-5776
    CrossrefPubMedGoogle Scholar
  • 71 Benyo S, Phan C, Goyal N. Health and well-being needs among head and neck cancer caregivers - a systematic review. Ann Otol Rhinol Laryngol 2022; (e-pub ahead of print) DOI: 10.1177/00034894221088180.
    CrossrefPubMedGoogle Scholar
  • 72 Robinson BC. Validation of a caregiver strain index. J Gerontol 1983; 38 (03) 344-348
    CrossrefPubMedGoogle Scholar
  • 73 Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav 1983; 24 (04) 385-396
    CrossrefPubMedGoogle Scholar
  • 74 Richardson A, Plant H, Moore S, Medina J, Cornwall A, Ream E. Developing supportive care for family members of people with lung cancer: a feasibility study. Support Care Cancer 2007; 15 (11) 1259-1269
    CrossrefPubMedGoogle Scholar
  • 75 Sterba KR, Armeson K, Zapka J. et al. Evaluation of a survivorship needs assessment planning tool for head and neck cancer survivor-caregiver dyads. J Cancer Surviv 2019; 13 (01) 117-129
    CrossrefPubMedGoogle Scholar
  • 76 Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption–II. Addiction 1993; 88 (06) 791-804
    CrossrefPubMedGoogle Scholar
  • 77 Spitzer RL, Kroenke K, Williams JBW, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med 2006; 166 (10) 1092-1097
    CrossrefPubMedGoogle Scholar
  • 78 Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988; 56 (06) 893-897
    CrossrefPubMedGoogle Scholar
  • 79 Parkerson Jr GR, Broadhead WE, Tse CK. The Duke Health Profile. A 17-item measure of health and dysfunction. Med Care 1990; 28 (11) 1056-1072
    PubMedGoogle Scholar
  • 80 Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961; 4: 561-571
    CrossrefPubMedGoogle Scholar
  • 81 Beck AT, Steer RA, Ranieri WF. Scale for Suicide Ideation: psychometric properties of a self-report version. J Clin Psychol 1988; 44 (04) 499-505
    CrossrefPubMedGoogle Scholar
  • 82 Alphs L, Fu DJ, Williamson D. et al. Suicide Ideation and Behavior Assessment Tool (SIBAT): evaluation of intra- and inter-rater reliability, validity, and mapping to Columbia Classification Algorithm of Suicide Assessment. Psychiatry Res 2020; 294: 113495
    CrossrefPubMedGoogle Scholar
  • 83 Klassen A, Newton J, Goodacre T. The Derriford appearance scale (DAS-59). Br J Plast Surg 2001; 54 (07) 647-648
    CrossrefPubMedGoogle Scholar
  • 84 Bruchon-Schweitzer M. Dimensionality of the body-image: the body-image questionnaire. Percept Mot Skills 1987; 65 (03) 887-892
    CrossrefPubMedGoogle Scholar
  • 85 Dewey ME, Newton T, Brodie D, Kiemle G. Development and preliminary validation of the body satisfaction scale (BSS). Psychol Health 1990; 4 (03) 213-220
    CrossrefPubMedGoogle Scholar