Psychosocial considerations of the post-treatment of head and neck cancer patients.

The quality of life factor in the rehabilitation of head and neck cancer patients following surgery or other forms of treatment can be summarized as follows: 1. Because of serious functional disabilities, such as speech impairment and chewing-swallowing difficulties, along with facial disfigurement, these individuals suffer the most problems of any type of cancer patient. 2. Without skilled rehabilitation intervention, their emotional, social, economic, and physical well-being will be greatly impacted, perhaps for life. 3. With skilled intervention, building on patients' often amazing recuperative powers, successful rehabilitation to normal, or near-normal, levels comparative with their predisease condition may be achieved in a period between 6 months and a year. 4. Given continuing research and more generally available rehabilitation treatment, the prognosis is favorable. However, it would be less than honest to ignore one highly disquieting fact. Despite better treatment methods today, despite higher survival rates, we have not sufficiently changed our attitudes toward cancer rehabilitation. The same social stigma has stubbornly lingered, together with the fears of morbidity, uncertainty, and unpredictability. To help the patient recover old skills and pleasures, we must overcome these obstacles. To feel like a useful human being without any stigma attached, without undue fears and pressures but with a sense of being needed and wanted, that is what life is all about. All our rehabilitation efforts should be directed toward that goal, with the professional as well as the layman feeling optimism without feeling reservation and contagiously exuding it. To some extent, a real effort must be made to educate the professional as well as the layman to face the diagnosis of cancer without evasion and go forward from there. It is heartening that with support from both the government and private sectors there have been increasing numbers of major centers for rehabilitation established throughout the United States in recent years. The American Cancer Society, the National Cancer Institute, and the volunteers and philanthropists of America have been in the vanguard of this movement. With only some exceptions as noted above, the profession, including nurses as well as physicians, has responded to the call for more intensive rehabilitation efforts, as have social workers, family counselors, physical therapists, occupational therapists, speech pathologists, and other specialists. The challenge is enormous. Each patient has his or her own highly individual mind set and emotional characteristics and cultural, religious, economic, and class backgrounds, all of which will affect the response to the rehabilitation program.(ABSTRACT TRUNCATED AT 400 WORDS)