Quality of life and recurrence concern in survivors of head and neck cancer

Objectives/Hypothesis: A cohort of 3-year survivors of head and neck cancer was evaluated for persistent quality of life (QOL) concerns and long-term treatment effects, Study Design: Mailed questionnaire. Methods: The questio nnaire with the University of Washington Quality of Life (UWQOL) scale, the Performance Status Scale for Head and Neck Cancer (PSS-HN), the Functional Assessment of Cancer Therapy (FACT) scale, and the Functional Assessment o f Cancer Therapy Head and Neck (FACT-ICN) scale and locally prepared questi ons was sent to 111 3-year disease-free survivors. Analysis was performed t o statistically evaluate the effect of stage, site, treatment type, surgery , and cancer concern on QOL, Current smoking information was gathered. Resu lts: Seventy-two survivors completed the questionnaire. Advanced stage was correlated with lower QOL scores in the domains of disfigurement, chewing a bility, speech, and eating in public, QOL scores did not vary by initial tu mor site. Patients treated with irradiation alone had statistically better QOL scores than those treated with combined surgery/radiation therapy in th e pain, disfigurement, chewing, and speech domains. Laryngectomy and compos ite resection survivors reported lower QOL scores than patients treated wit h irradiation alone. A low level of cancer concern persisted in about half of the long-term survivors. Cancer concern was associated with continued pa in, disfigurement, and limitations on eating in public, Three-quarters of t he tobacco users had quit by the time of the questionnaire. Nevertheless, t he patients were not thoroughly convinced that tobacco had caused their can cer. Conclusions: Long-term survivors of head and neck cancer experience QO L effects well after completion of treatment. Effects are most pronounced i n survivors who required combined surgery/radiation therapy. Continuing low levels of cancer concern persist in about half of the survivors. Many canc er survivors successfully quit smoking.