REHABILITATION OUTCOMES OF LONG-TERM SURVIVORS TREATED FOR HEAD AND NECK-CANCER

Background. Little is known about the rehabilitation outcomes of long- term survivors following treatment for head and neck cancer. There are , for example, no studies on physical and psychosocial rehabilitation outcomes of T1 glottic larynx carcinoma, despite the fact that these f orm the majority of head and neck cancer sites. Thus, this investigati on afforded a unique opportunity for examining similarities and differ ences among T1 glottic larynx patients, laryngectomy patients, and tho se who had surgery for cancer of the oral cavity and/or oropharynx alo ng a variety of physical and psychosocial dimensions. Methods. To desc ribe the impact of these three types of head and neck cancer and their treatment on the physical and psychosocial functioning of long-term s urvivors, a self-report questionnaire was completed by 110 patients tr eated between 2 and 6 years previously in a major cancer center. Resul ts. Data indicate that a higher percentage of patients treated with la ryngectomy or commando procedures still experience severe psychosocial distress between 2 and 6 years after their last treatment than do pat ients treated with radiotherapy for a T1 carcinoma of the glottic lary nx. Psychosocial and physical complaints are still reported by many la ryngectomy patients, apparently the result of problems in effective co mmunication with others. Many commando procedure patients experience p roblems with respect to food intake, and with disfigurement and its co nsequences. T1 larynx patients mainly experience a considerable number of physical complaints. The greater the time that had elapsed since t reatment, the fewer the psychosocial problems associated with head and neck tumors. Open discussion of the illness in the family, social sup port, acid perceptions of adequate information from the specialist are the most important predictors of positive rehabilitation outcomes. Co nclusions. This study indicates that T1 larynx patients report many ph ysical complaints even though several years had elapsed since treatmen t. Also, laryngectomy patients may need psychosocial guidance for a lo nger posttreatment period and that health care personnel must involve the partner as much as possible in all communications. Commando proced ure patients in particular feel hindered by their disfigurement and it s consequences. Future research with respect to validation of the spec ific head and neck modules is needed. (C) 1995 John Wiley & Sons, Inc.