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Current Oncology
Special Issues
Psychosocial Effects of Head and Neck Cancer
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Psychosocial Effects of Head and Neck Cancer

A special issue of Current Oncology (ISSN 1718-7729). This special issue belongs to the section "Psychosocial Oncology".

Deadline for manuscript submissions: closed (31 March 2022) | Viewed by 41039

Special Issue Editor

Dr. Melissa Henry

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Guest Editor
1. Department of Oncology, Faculty of Medicine, McGill University, Montreal, QC H3A 0G4, Canada
2. Lady-Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC H3T 1E2, Canada
Interests: oncology; cancer; quality of life; advanced cancer; head and neck cancer; sociobehavioural determinants of health; prevention
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Head and neck cancers include cancers of the upper aerodigestive tract (oral cavity, nasopharynx, oropharynx, hypopharynx, and larynx), the paranasal sinuses, and the salivary glands. They are typically diagnosed in advanced stage, in men, and are treated using a combination of modalities including surgery, radiotherapy, chemotherapy, and/or immunotherapy. Disease-and treatment-related burden often involves disfigurement and dysfunction in visible areas involving survival, identity, and the social domain (e.g., eating, speech). As such, head and neck cancers are known to be associated with significant distress, which is enhanced by historical and contextual vulnerability. This Special Issue of Current Oncology is design to showcase research on the psychological and social aspects of head and neck cancer. We invite researchers to address either one of the following topics or a related topic: sociocultural aspects of cancer, cancer disparities, alcohol and tobacco use, stigma, fear of recurrence, issues around caregiving, anxiety and depressive disorders, body image, suicidality, impact of HPV, total pain, palliative care, pre- and re-habilitation, communication, health care professionals, impact of COVID-19, and psychosocial interventions. We will be looking forward to your contribution to this Special Issue, which will raise the profile of a cancer which is often overlooked and contribute to addressing its associated psychosocial consequences for better quality of life and wellbeing. 

Dr. Melissa Henry
Guest Editor

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Current Oncology is an international peer-reviewed open access monthly journal published by MDPI.

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Keywords

  • head and neck cancers
  • sociocultural aspects of cancer
  • cancer disparities
  • alcohol and tobacco use
  • stigma
  • caregiving
  • anxiety and depressive disorders
  • palliative care
  • pre- and re-habilitation
  • impact of COVID-19
  • psychosocial interventions

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Published Papers (11 papers)

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Editorial

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3 pages, 191 KiB  
Editorial
Psychosocial Oncology: Optimizing Outcomes through Interdisciplinary Care in Head and Neck Oncology
by Melissa Henry
Curr. Oncol. 2023, 30(7), 6859-6861; https://doi.org/10.3390/curroncol30070501 - 19 Jul 2023
Viewed by 1800
Abstract
Head and neck squamous cell carcinomas arise from the mucosal epithelium of the oral cavity (lips, buccal mucosa, anterior tongue, hard palate, floor of mouth, and retromolar trigone), nasopharynx, oropharynx (tonsils, base of tongue, soft palate, uvula, and posterior pharyngeal wall), hypopharynx, and [...] Read more.
Head and neck squamous cell carcinomas arise from the mucosal epithelium of the oral cavity (lips, buccal mucosa, anterior tongue, hard palate, floor of mouth, and retromolar trigone), nasopharynx, oropharynx (tonsils, base of tongue, soft palate, uvula, and posterior pharyngeal wall), hypopharynx, and larynx [...] Full article
(This article belongs to the Special Issue Psychosocial Effects of Head and Neck Cancer)

Research

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13 pages, 779 KiB  
Article
Validation of the Canadian Version of the Shame and Stigma Scale for Head and Neck Cancer Patients
by Irene Bobevski, David W. Kissane, Justin Desroches, Avina De Simone and Melissa Henry
Curr. Oncol. 2023, 30(8), 7553-7565; https://doi.org/10.3390/curroncol30080548 - 11 Aug 2023
Cited by 1 | Viewed by 1583
Abstract
Cancers of the head and neck and their treatment can cause disfigurement and loss of functioning, with a profound negative impact on the person’s self-image and psychosocial wellbeing. This can lead to experiences of shame and stigma, which are important targets for psychosocial [...] Read more.
Cancers of the head and neck and their treatment can cause disfigurement and loss of functioning, with a profound negative impact on the person’s self-image and psychosocial wellbeing. This can lead to experiences of shame and stigma, which are important targets for psychosocial interventions. Accurate measurement and identification of these problems enables clinicians to offer appropriate interventions and monitor patients’ progress. This study aimed to validate the Canadian version of the Shame and Stigma Scale (SSS) among French- and English-speaking head and neck cancer patients. Data from 254 patients from two major Canadian hospitals were analysed. The existing four-factor structure of the SSS was supported, with the following subscales: Shame with Appearance, Sense of Stigma, Regret, and Social/Speech Concerns. The Canadian SSS showed adequate convergent and divergent validity and test–retest reliability. Rasch analysis suggested scale improvement by removing two misfitting items and two items with differential functioning between French- and English-speaking patients. The final 16-item scale version was an adequate fit with the Rasch model. The SSS provides more accurate measures for people with high levels of shame and stigma, and thus has utility in identifying patients with more severe symptoms who may be in need of psychosocial interventions. Full article
(This article belongs to the Special Issue Psychosocial Effects of Head and Neck Cancer)
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17 pages, 1272 KiB  
Article
Biopsychosocial Markers of Body Image Concerns in Patients with Head and Neck Cancer: A Prospective Longitudinal Study
by Justine G. Albert, Christopher Lo, Zeev Rosberger, Saul Frenkiel, Michael Hier, Anthony Zeitouni, Karen Kost, Alex Mlynarek, Martin Black, Christina MacDonald, Keith Richardson, Marco Mascarella, Gregoire B. Morand, Gabrielle Chartier, Nader Sadeghi, Khalil Sultanem, George Shenouda, Fabio L. Cury and Melissa Henry
Curr. Oncol. 2022, 29(7), 4438-4454; https://doi.org/10.3390/curroncol29070353 - 22 Jun 2022
Cited by 10 | Viewed by 3559
Abstract
(1) Background: Patients and survivors of head and neck cancer (HNC) are at a high risk of developing body image concerns. Despite the prevalence of body image concerns in patients with HNC, there is a lack of longitudinal research exploring the wide array [...] Read more.
(1) Background: Patients and survivors of head and neck cancer (HNC) are at a high risk of developing body image concerns. Despite the prevalence of body image concerns in patients with HNC, there is a lack of longitudinal research exploring the wide array of its associated determinants. The current longitudinal study examined the determinants and longitudinal course of body image dissatisfaction in patients with HNC. (2) Methods: Patients participated in Structured Clinical Interviews and self-administered questionnaires at four time-points: (T1) upon cancer diagnosis, (T2) at 3 months post-diagnosis, (T3) at 6 months post-diagnosis, and (T4) at 12 months post-diagnosis. They also underwent a disfigurement rating on an objective scale. (3) Results: Two hundred and twenty-four patients participated in our study. Fourteen percent to twenty-eight percent of patients reported at least moderate body image concerns across time points, with the lowest rates at baseline and the highest at 3 months (T1). It was found that patients more predisposed to developing higher levels of body image concerns presented physical markers (i.e., advanced cancer stage, lower physical functioning, higher disfigurement), psychosocial markers (i.e., higher depression, higher anxiety, and higher levels of coping with denial), and health disparities (i.e., younger age, female sex, French language, and marital status, with divorced and widowers most affected). (4) Conclusions: The findings of this study highlight the multifaceted nature of body image concerns in patients with HNC and its biopsychosocial determinants. Clinicians should pay specific attention to these biopsychosocial markers in their clinics to predict high levels of body image concerns and tailor communication/refer for support accordingly. Full article
(This article belongs to the Special Issue Psychosocial Effects of Head and Neck Cancer)
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14 pages, 944 KiB  
Article
Screening for Distress and Health Outcomes in Head and Neck Cancer
by Bryan Gascon, Aliza A. Panjwani, Olivia Mazzurco and Madeline Li
Curr. Oncol. 2022, 29(6), 3793-3806; https://doi.org/10.3390/curroncol29060304 - 24 May 2022
Cited by 10 | Viewed by 3173
Abstract
Head and neck cancers (HNC) have higher rates of emotional distress than other cancer types and the general population. This paper compares the prevalence of emotional distress in HNC across various distress screening measures and examines whether significant distress or distress screening are [...] Read more.
Head and neck cancers (HNC) have higher rates of emotional distress than other cancer types and the general population. This paper compares the prevalence of emotional distress in HNC across various distress screening measures and examines whether significant distress or distress screening are associated with cancer-related survival. A retrospective observational cohort design was employed, with data collected from the Distress Assessment and Response Tool (DART) and linkages to administrative databases from 2010 to 2016. Descriptive and prevalence data were reported using multiple concurrently administered distress tools, including the Patient Health Questionaire-9 (PHQ-9), Generalized Anxiety Disorders-7 (GAD-7), Edmonton Symptom Assessment Scale-revised (ESAS-r), and MD Anderson Symptom Index-Head and Neck module (MDASI-HN). Across measures, 7.8 to 28.1% of the sample reported clinically significant emotional distress, with PHQ-9 and GAD-7 identifying lowest prevalence of moderate/severe distress, and the ultrashort distress screens within ESAS-r and MDASI-HN performing equivalently. Cox hazards models were used in univariate and multivariate survival analyses. ESAS depression (≥4), but not anxiety, was associated with increased risk of cancer-related mortality and patient completion of DART was associated with greater cancer-related survival. The findings underscore the importance of implementing routine distress screening for HNC populations and the utility of ultra-brief screening measures. Full article
(This article belongs to the Special Issue Psychosocial Effects of Head and Neck Cancer)
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23 pages, 348 KiB  
Article
Framing Concerns about Body Image during Pre- and Post-Surgical Consultations for Head and Neck Cancer: A Qualitative Study of Patient–Physician Interactions
by Maria Cherba, Boris H. J. M. Brummans, Michael P. Hier, Lauriane Giguère, Gabrielle Chartier, Hannah Jacobs, Véronique-Isabelle Forest, Alex Mlynarek, Khalil Sultanem and Melissa Henry
Curr. Oncol. 2022, 29(5), 3341-3363; https://doi.org/10.3390/curroncol29050272 - 5 May 2022
Cited by 2 | Viewed by 2749
Abstract
Patients with head and neck cancer report high unmet psychosocial needs as they undergo lifesaving treatments that can significantly alter their appearance and cause functional impairments. This qualitative analysis of recordings of 88 pre- and post-surgical consultations involving 20 patients respond to the [...] Read more.
Patients with head and neck cancer report high unmet psychosocial needs as they undergo lifesaving treatments that can significantly alter their appearance and cause functional impairments. This qualitative analysis of recordings of 88 pre- and post-surgical consultations involving 20 patients respond to the need for empirical studies of patient–provider conversations about body image concerns. It indicates that the emphasis on concerns about survival, cure, and physical recovery during clinical consultations may leave concerns about the impacts of surgery on appearance and function unexplored and even silenced. The interviews with patients and medical team members that complement the analysis of the recordings suggest that an emphasis on survival, cure, and physical recovery can respond to the need for reassurance in the context of serious illness. However, it can also be problematic as it contributes to the silencing of patients’ concerns and to a potential lack of preparedness for the consequences of surgery. The results of this study can contribute to raising surgeons’ awareness of the interactional dynamics during clinical consultations. Moreover, the results highlight the unique role that surgeons can play in validating patients’ psychosocial concerns to support patients’ rehabilitation in both physical and psychosocial domains. Full article
(This article belongs to the Special Issue Psychosocial Effects of Head and Neck Cancer)
15 pages, 444 KiB  
Article
Psychological Problems among Head and Neck Cancer Patients in Relation to Utilization of Healthcare and Informal Care and Costs in the First Two Years after Diagnosis
by Florie E. van Beek, Femke Jansen, Rob J. Baatenburg de Jong, Johannes A. Langendijk, C. René Leemans, Johannes H. Smit, Robert P. Takes, Chris H. J. Terhaard, José A. E. Custers, Judith B. Prins, Birgit I. Lissenberg-Witte and Irma M. Verdonck-de Leeuw
Curr. Oncol. 2022, 29(5), 3200-3214; https://doi.org/10.3390/curroncol29050260 - 30 Apr 2022
Cited by 6 | Viewed by 2506
Abstract
Background: To investigate associations between psychological problems and the use of healthcare and informal care and total costs among head and neck cancer (HNC) patients. Method: Data were used of the NETherlands QUality of Life and Biomedical Cohort study. Anxiety and depression disorder [...] Read more.
Background: To investigate associations between psychological problems and the use of healthcare and informal care and total costs among head and neck cancer (HNC) patients. Method: Data were used of the NETherlands QUality of Life and Biomedical Cohort study. Anxiety and depression disorder (diagnostic interview), distress, symptoms of anxiety and depression (HADS), and fear of cancer recurrence (FCR) and cancer worry scale (CWS) were measured at baseline and at 12-month follow-up. Care use and costs (questionnaire) were measured at baseline, 3-, 6-, 12-, and 24-month follow-up. Associations between psychological problems and care use/costs were investigated using logistic and multiple regression analyses. Results: Data of 558 patients were used. Distress, symptoms of anxiety or depression, FCR, and/or anxiety disorder at baseline were significantly associated with higher use of primary care, supportive care, and/or informal care (odds ratios (ORs) between 1.55 and 4.76). Symptoms of anxiety, FCR, and/or depression disorder at 12-month follow-up were significantly associated with use of primary care, supportive care, and/or informal care (ORs between 1.74 and 6.42). Distress, symptoms of anxiety, and FCR at baseline were associated with higher total costs. Discussion: HNC patients with psychological problems make more use of healthcare and informal care and have higher costs. This is not the result of worse clinical outcomes. Full article
(This article belongs to the Special Issue Psychosocial Effects of Head and Neck Cancer)
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Review

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13 pages, 470 KiB  
Review
HPV Vaccination: An Underused Strategy for the Prevention of Cancer
by Gilla K. Shapiro
Curr. Oncol. 2022, 29(5), 3780-3792; https://doi.org/10.3390/curroncol29050303 - 23 May 2022
Cited by 42 | Viewed by 10510
Abstract
Human papillomavirus (HPV) vaccination prevents cervical, head and neck, and anogenital cancers. However, global HPV vaccine coverage falls short of global targets and has seen unexpected and dramatic declines in some countries. This paper synthesizes the impact of HPV on the global burden [...] Read more.
Human papillomavirus (HPV) vaccination prevents cervical, head and neck, and anogenital cancers. However, global HPV vaccine coverage falls short of global targets and has seen unexpected and dramatic declines in some countries. This paper synthesizes the impact of HPV on the global burden of cancer and the potential benefit of HPV vaccination. Approximately 5% of the world’s cancers are specifically attributed to HPV. While the greatest global burden of HPV is cervical cancers in low- and middle-income countries, HPV-associated head and neck cancers are increasing in high-income countries and have surpassed cervical cancer as the primary HPV-associated cancer in some countries. Therefore, it is also critical to improve gender-neutral HPV vaccination. Understanding the modifiable drivers of vaccine acceptance and uptake is important for increasing HPV vaccination. The Behavioural and Social Drivers of Vaccination framework is broadly applied to identify key factors associated with HPV vaccination including domains concerning practical issues, motivation, social processes, and thinking and feeling. Among the behavioural strategies available to reduce the incidence and mortality of cancer, increasing HPV vaccination stands out as having unrealized potential to prevent disease, financial cost, and psychological distress. An understanding of the shifting burden of HPV and the factors associated with vaccination can be leveraged to regularly measure these factors, develop interventions to promote vaccine uptake, and improve global HPV vaccine coverage. Future research in diverse contexts is necessary to investigate the barriers and facilitators of global HPV vaccination. Full article
(This article belongs to the Special Issue Psychosocial Effects of Head and Neck Cancer)
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30 pages, 363 KiB  
Review
De-Escalation Strategies for Human Papillomavirus-Associated Oropharyngeal Squamous Cell Carcinoma—Where Are We Now?
by Jennifer A. Silver, Sena Turkdogan, Catherine F. Roy, Thavakumar Subramaniam, Melissa Henry and Nader Sadeghi
Curr. Oncol. 2022, 29(5), 3668-3697; https://doi.org/10.3390/curroncol29050295 - 18 May 2022
Cited by 14 | Viewed by 3705
Abstract
The prevalence of oropharyngeal squamous cell carcinoma has been increasing in North America due to human papillomavirus-associated disease. It is molecularly distinct and differs from other head and neck cancers due to the young population and high survival rate. The treatment regimens currently [...] Read more.
The prevalence of oropharyngeal squamous cell carcinoma has been increasing in North America due to human papillomavirus-associated disease. It is molecularly distinct and differs from other head and neck cancers due to the young population and high survival rate. The treatment regimens currently in place cause significant long-term toxicities. Studies have transitioned from mortality-based outcomes to patient-reported outcomes assessing quality of life. There are many completed and ongoing trials investigating alternative therapy regimens or de-escalation strategies to minimize the negative secondary effects while maintaining overall survival and disease-free survival. The goal of this review is to discuss the most recent advancements within the field while summarizing and reviewing the available evidence. Full article
(This article belongs to the Special Issue Psychosocial Effects of Head and Neck Cancer)
10 pages, 567 KiB  
Review
Moving beyond Definitive Therapy: Increasing Physical Activity in Survivors of Cancers of the Head and Neck
by Anthony D. Nehlsen, Kunal K. Sindhu, Brianna M. Jones, Eric J. Lehrer, Jared P. Rowley and Richard L. Bakst
Curr. Oncol. 2022, 29(2), 1213-1222; https://doi.org/10.3390/curroncol29020103 - 17 Feb 2022
Cited by 2 | Viewed by 2395
Abstract
As chemotherapeutic, radiation, and surgical techniques have improved, there has been a dramatic improvement in survival in patients diagnosed with cancers of the head and neck. As a result, a heightened focus on survivorship by clinicians will increasingly prove necessary. In particular, medical [...] Read more.
As chemotherapeutic, radiation, and surgical techniques have improved, there has been a dramatic improvement in survival in patients diagnosed with cancers of the head and neck. As a result, a heightened focus on survivorship by clinicians will increasingly prove necessary. In particular, medical care teams will have to pay special attention to mitigating the long-term sequelae of definitive cancer treatments, many of which act as barriers to exercise. This is unfortunate, as the benefits of exercise in patients with cancer have become increasingly recognized. In this review, we discuss the potential benefits of and barriers to exercise in survivors of cancers of the head and neck. We also review existing exercise guidelines and strategies by which clinicians can promote exercise in this unique patient population. Full article
(This article belongs to the Special Issue Psychosocial Effects of Head and Neck Cancer)
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Other

37 pages, 741 KiB  
Systematic Review
Health-Related Quality of Life following Total Thyroidectomy and Lobectomy for Differentiated Thyroid Carcinoma: A Systematic Review
by Vivianne Landry, Elizabeth Siciliani, Melissa Henry and Richard J. Payne
Curr. Oncol. 2022, 29(7), 4386-4422; https://doi.org/10.3390/curroncol29070350 - 21 Jun 2022
Cited by 12 | Viewed by 5348
Abstract
Health-related quality of life (HrQoL) is a major concern for patients with differentiated thyroid carcinoma (DTC). We aimed to systematically review the literature comparing HrQol following total thyroidectomy (TT) and hemithyroidectomy (HT) in DTC patients. A systematic review of publications indexed in Medline, [...] Read more.
Health-related quality of life (HrQoL) is a major concern for patients with differentiated thyroid carcinoma (DTC). We aimed to systematically review the literature comparing HrQol following total thyroidectomy (TT) and hemithyroidectomy (HT) in DTC patients. A systematic review of publications indexed in Medline, Embase, and EBM reviews—Cochrane Central Register of Controlled Trials, which evaluated HrQoL following thyroid surgery for DTC, was conducted. Of 2507 identified records, 25 fulfilled the inclusion criteria. Our results suggest that patients undergoing TT may suffer more impairment in physical and social HrQoL than patients undergoing HT. Psychological-related HrQoL and long-term global HrQoL are, however, equivalent in both groups, which highlights the multidimensional nature of HrQoL and the importance of a multitude of factors aside from treatment modalities and related morbidities, such as the experience of receiving a cancer diagnosis, the fear of cancer recurrence, and other psychosocial factors. Addressing postoperative HrQoL when discussing therapeutic options with patients is an integral part of patient-centered care and informed shared decision-making, and should be approached in a holistic manner, accounting for its physical, psychological, and social aspects. This review supplies evidence regarding HrQoL following thyroid surgery, which can be employed in such decisions. Full article
(This article belongs to the Special Issue Psychosocial Effects of Head and Neck Cancer)
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7 pages, 210 KiB  
Commentary
Psychosocial Implications of COVID-19 on Head and Neck Cancer
by Sarah M. Dermody and Andrew G. Shuman
Curr. Oncol. 2022, 29(2), 1062-1068; https://doi.org/10.3390/curroncol29020090 - 13 Feb 2022
Cited by 3 | Viewed by 2076
Abstract
The COVID-19 pandemic has fundamentally changed healthcare access, delivery, and treatment paradigms throughout oncology. Patients with head and neck cancer comprise an especially vulnerable population due to the nature of their disease and the transmission mechanism of the SARS-CoV-2 virus. The consequences of [...] Read more.
The COVID-19 pandemic has fundamentally changed healthcare access, delivery, and treatment paradigms throughout oncology. Patients with head and neck cancer comprise an especially vulnerable population due to the nature of their disease and the transmission mechanism of the SARS-CoV-2 virus. The consequences of triage decisions and delays in care have serious psychosocial implications for patients. The development of structured psychosocial support programs, coupled with clear and consistent communication from treating physicians, can help mitigate perceptions of abandonment and distress that may accompany delays in care. As the unpredictability of the pandemic’s course continues to burden both providers and patients, we must be proactive in addressing the psychosocial implications of these delays in care. Full article
(This article belongs to the Special Issue Psychosocial Effects of Head and Neck Cancer)
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