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Qualitative Classification of Late Systemic Symptoms in Head and Neck Cancer Survivors.

作者信息

Schoenberg Poppy, Wulff-Burchfield Elizabeth, Schlundt David, Bonnet Kemberlee, Dietrich Mary, Murphy Barbara

机构信息

Osher Center for Integrative Health, Vanderbilt University Medical Center, Nashville, TN 37203, USA.

Department of Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA.

出版信息

Cancers (Basel). 2024 May 31;16(11):2106. doi: 10.3390/cancers16112106.


DOI:10.3390/cancers16112106
PMID:38893225
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11172150/
Abstract

Improved rates of cancer control have increased the head and neck cancer survivor population. Cancer survivorship clinics are not widely available in the USA, and longitudinal supportive care for patients undergoing multimodal therapy has not advanced at a pace commensurate with improvements in cancer control. Consequently, a large head and neck cancer survivor population whose quality of life may be chronically and/or permanently diminished presently exists. This lack of awareness perpetuates under-recognition and under-investigation, leaving survivors' (mostly detrimental) experiences largely uncharted. We conducted a qualitative exploration of survivors' experiences, aiming to unpack the profound impact of late systemic symptoms on daily life, encompassing work, relationships, and self-identity in the head and neck cancer survivor community. The study included 15 remitted head and neck survivors, ≥12 months from their final treatment, who participated in semi-structured interviews conducted by a medical oncologist. Data analysis comprised qualitative thematic analysis, specifically inductive hierarchical linear modeling, enriched by a deductive approach of anecdotal clinical reporting. Results highlighted that 43.36% of all quotation material discussed in the interviews pertained to chronic emotion disturbance with significant implications for other domains of life. A central symptom cluster comprised impairments in mood/emotions, daily activity, and significant fatigue. Dysfunction in sleep, other medical conditions, and cognitive deficits comprised a secondary cluster. Physical dysfunctionality, encompassing pain, appetite, and eating, and alterations in experienced body temperature, constituted a tertiary cluster, and perhaps were surprisingly the least discussed symptom burden among head and neck cancer survivors. Symptoms causing heightened long-term survivor burden may be considered epiphenomenal to central physical dysfunctionality, albeit being presently the least represented in cancer survivor care programs. Moving forward, the development of targeted and multi-dimensional treatment programs that encompass physical, psychosocial, and spiritual domains are needed to increase clinical specificity and effective holistic long-term solutions that will foster a more compassionate and informed future of care for the cancer survivorship community.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/384f/11172150/2cf3dcc8be9c/cancers-16-02106-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/384f/11172150/2cf3dcc8be9c/cancers-16-02106-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/384f/11172150/2cf3dcc8be9c/cancers-16-02106-g001.jpg

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[1]
Qualitative Classification of Late Systemic Symptoms in Head and Neck Cancer Survivors.

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[2]
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[3]
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[5]
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[6]
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本文引用的文献

[1]
Cancer statistics, 2024.

CA Cancer J Clin. 2024

[2]
The potential of a multimodal digital care program in addressing healthcare inequities in musculoskeletal pain management.

NPJ Digit Med. 2023-10-10

[3]
Increased microglia activation in late non-central nervous system cancer survivors links to chronic systemic symptomatology.

Hum Brain Mapp. 2023-12-1

[4]
Digital health and telehealth in cancer care: a scoping review of reviews.

Lancet Digit Health. 2023-5

[5]
Serious Long-Term Effects of Head and Neck Cancer from the Survivors' Point of View.

Healthcare (Basel). 2023-3-21

[6]
Use of Telehealth Among Cancer Survivors: A Scoping Review.

Telemed J E Health. 2023-7

[7]
Remote Symptom Monitoring of Patients With Cancer Undergoing Radiation Therapy.

Cureus. 2022-9-29

[8]
Virtual Reality Rehabilitation Systems for Cancer Survivors: A Narrative Review of the Literature.

Cancers (Basel). 2022-6-28

[9]
Status of Treatment and Prophylaxis for Radiation-Induced Oral Mucositis in Patients With Head and Neck Cancer.

Front Oncol. 2021-3-18

[10]
A systematic review of interventions to mitigate radiotherapy-induced oral mucositis in head and neck cancer patients.

Support Care Cancer. 2021-4

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