Assessing Long-Term Quality-of-Life Concerns Through Survivorship Clinics in Head and Neck Cancer Patients

Tuesday, October 1, 2024

10:24 AM – 10:30 AM EDT

Location: MBCC, 208

Disclosure(s):

Andrew Yousef, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Ariadne A. Nichol, BA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Kristen Linnemeyer-Risser, MA, CCC-SLP, BCS-S:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: There is an absence of long-term data (over 3 years) to understand quality-of-life metrics for post-treatment head and neck cancer (HNC) patients. This study aimed to characterize the concerns of HNC patients attending our unique survivorship clinic and discern changes in quality of life during long-term follow up.

Methods: A retrospective review was conducted in patients with a history of HNC seen in our survivorship clinic between January 2020 and December 2023. Patients were given the University of Washington Quality of Life (UW-QOL) Questionnaire, which evaluated patients on multiple domains with lower scores indicating higher symptom burden. Ordered logistic regression was used and corrected for a history of radiation and tumor subsite.

Results: 253 patients were seen for 385 encounters. Patients were split into 4 groups: pre-treatment (n=132), 0-12 months post-treatment (n=93), 1-3 years post-treatment (n=74), and >3 years post-treatment (n=67). The average length of follow up after treatment was 3.2 years (range: 0 - 20.1 years). Anxiety and pain scores were lowest pre-treatment and improved in long-term survivors (>1 year post-treatment) (anxiety: p< 0.001; pain: p=0.004). Saliva and taste scores were significantly higher pre-treatment before hitting their nadir immediately after treatment. These scores improved, but never returned to pre-treatment scores (saliva: p=0.006; taste: p= 0.007).
Pre-treatment patients reported their top three concerns were pain (40.9%), anxiety (35.6%) and swallowing (31.1%). In patients >3 years post-treatment, their top concerns were pain (26.9%), swallowing (23.9%), and activity (20.9%). Post-treatment patients had fewer anxiety concerns (16.7% v 34.8%; p=0.03), appearance concerns (11.5% v 19.7%; p=0.01), and pain concerns (28.2 v 40.9%; p=0.01) compared to the pre-treatment group.

Conclusions: Understanding the evolving concerns of HNC patients is imperative for enhancing care. Even after 3 years post-treatment, patients continued to express high rates of concern regarding pain and swallowing, emphasizing the pivotal role of survivorship clinics in cancer care.

Presenting Author(s)

Andrew Yousef, MD

Resident Physician
University of California - San Diego
San Diego, CA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

AN

Ariadne A. Nichol, BA

Medical Student
University of California, San Diego
La Jolla, CA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Bao K. Luu, Other

Medical Student
UC San Diego School of Medicine
San Diego, CA, United States

Disclosure information not submitted.
CM

Carie Montesa, MSN, RN, AGACNP-BC, NCTTP

University of California, San Diego, United States

Disclosure information not submitted.
CR

Celia Ramsey, MS

University of California, San Diego, United States

Disclosure information not submitted.
LB

Liza Blumenfeld, CCC-SLP, BCS-S

University of California, San Diego, United States

Disclosure information not submitted.
KL

Kristen Linnemeyer-Risser, MA, CCC-SLP, BCS-S

University of California, San Diego, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

Theresa W. Guo, MD

Assistant Professor
Department of Otolaryngology-Head and Neck Surgery, University of California San Diego Health
La Jolla, CA, United States

Disclosure information not submitted.