Department of Social Anthropology, Basic Psychology and Public Health Faculty of Social Sciences, University Pablo de Olavide Ctra. de Utrera, 1, 41013 Seville, Spain
Med Oral Patol Oral Cir Bucal. 2023 Sep 1;28(5):e467-e473. doi: 10.4317/medoral.25878.
Cancer is the second cause of death all over the world and it causes considerable morbidity, disability, and treatment sequela, which often lead to post-treatment pain and disfigurement. This study aims to evaluate such physical sequelae, and their psychological, (cognitive and emotional), impact, in a cohort of patients treated for Head and Neck (HNC) cancer, in search for methods to help such patients deal effectively with the psychological effects of their cancer treatments adverse consequences.
The sample consists of 56 subjects, 47 men and 9 women, ranging from 47 years to 86 years of age, who were treated for head and neck cancers at Spanish Public General Hospital in the Otolaryngology Unit, Surgery Section. Two types of questionnaires were used in the study: the Questionnaire of Sequelae after Treatment of head and neck carcinoma and the State-Trait Anxiety Inventory (STAI-E and R).
With respect to anxiety, the study found high levels of state anxiety which was significantly associated with the degree of perception of social stigma but was not associated with the post-treatment sequelae themselves nor with the level of discomfort that such symptomatic sequelae produced. The presence of a post-surgical stoma with cannula, increased patient's stigma (both components: external rejection and self-rejection) and state anxiety ratings, while there was no difference in state anxiety between cannulated and non-cannulated patients. There are few differences between men and women in terms of the presence of anxiety and their responses are similar in terms of the after-effects of surgery.
Our study confirmed that current treatments for Head and Neck carcinoma generate adverse symptomatic sequela that impose significant psychological and physical burden for these patients. We will discuss the various pathways for preventive intervention that these findings open up.
癌症是全球第二大致死原因，它会导致相当大的发病率、残疾和治疗后遗症，这往往会导致治疗后的疼痛和毁容。本研究旨在评估头颈部（HNC）癌症患者治疗后的这些身体后遗症及其对心理、（认知和情感）的影响，寻找帮助这些患者有效应对癌症治疗不良后果的心理影响的方法。
该样本由 56 名患者组成，其中 47 名男性和 9 名女性，年龄从 47 岁到 86 岁，他们在西班牙公立综合医院耳鼻喉科外科接受了头颈部癌症治疗。研究中使用了两种问卷：头颈部癌治疗后后遗症问卷和状态-特质焦虑量表（STAI-E 和 R）。
在焦虑方面，研究发现状态焦虑水平较高，且与社会耻辱感的感知程度显著相关，但与治疗后的后遗症本身无关，也与这些症状后遗症引起的不适程度无关。手术后存在带插管的造口会增加患者的耻辱感（两个组成部分：外部排斥和自我排斥）和状态焦虑评分，而带插管和不带插管的患者在状态焦虑方面没有差异。在焦虑的存在方面，男性和女性之间几乎没有差异，他们对手术后遗症的反应也相似。
我们的研究证实，目前对头颈部癌的治疗会产生不良的症状后遗症，给这些患者带来重大的心理和身体负担。我们将讨论这些发现为预防性干预开辟的各种途径。
