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The life experience of nutrition impact symptoms during treatment for head and neck cancer patients: a systematic review and meta-synthesis

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Abstract

Purpose

In the literature, there is limited research about the changed meaning of food, the eating and the eating experience during treatment in patients with head and neck cancer. This systematic review includes findings from a qualitative research synthesis to gain a deeper understanding of the influence and experiences of dysphagia, dysgeusia, oral mucositis and xerostomia in head and neck cancer patients (HNC) and suggests recommendations for care practice.

Method

A systematic review and meta-synthesis techniques were adopted to identify, appraise and synthesize the relevant literature regarding the experience of nutritional symptoms of HNC patients conducted according to the PRISMA guidelines. Several electronic databases such as PubMed, CINAHL, Scopus, PsycINFO and the Cochrane Library databases were searched.

Results

A systematic search yielded 121 papers, of which 12 met the inclusion criteria. A thematic account of shared nutritional symptom experiences reported across studies is highlighted and presented. Eight major themes covering three key supportive care domains were identified: impact of symptoms (symptoms during treatment, symptoms working together, affecting daily living activities and physical changes, symptoms and food changes), changing social networks and support (social life restrictions, support of peers), nutritional concerns and strategies (coping strategies, professional support).

Conclusions

Dysphagia, dysgeusia, oral mucositis and xerostomia negatively affected the patients’ quality of life throughout the period of treatment. The patients’ nutritional symptom experiences do not occur in isolation. Therefore, acknowledging the patients’ eating difficulties and challenges can guarantee appropriate management and support to best manage symptoms in a timely manner.

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References

  1. Torre L, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A (2015) Global cancer statistics, 2012. CA Cancer J Clin 65:87–108

    Article  PubMed  Google Scholar 

  2. Stewart BWKP, Wild, CP (2015) World cancer report 2014. Lyon, France: 9 International Agency for Research on Cancer. World Health Organisation

  3. Vermorken JB, Specenier P (2010) Optimal treatment for recurrent/metastatic head and neck cancer. Ann Oncol 21(Suppl 7):vii252–vii261

    PubMed  Google Scholar 

  4. Brockstein BE (2011) Management of recurrent head and neck cancer: recent progress and future directions. Drugs 71:1551–1559

    Article  CAS  PubMed  Google Scholar 

  5. Jager-Wittenaar H, Dijkstra PU, Vissink A, van Oort RP, van der Laan BF, Roodenburg JL (2011) Malnutrition in patients treated for oral or oropharyngeal cancer-prevalence and relationship with oral symptoms: an explorative study. Support Care Cancer 19:1675–1683

    Article  PubMed  Google Scholar 

  6. Dechaphunkul T, Martin L, Alberda C, Olson K, Baracos V, Gramlich L (2013) Malnutrition assessment in patients with cancers of the head and neck: a call to action and consensus. Crit Rev Oncol Hematol 88:459–476

    Article  PubMed  Google Scholar 

  7. Munshi A, Pandey MB, Durga T, Pandey KC, Bahadur S, Mohanti BT (2003) Weight loss during radiotherapy for head and neck malignancies: what factors impact it? Nutr Cancer 47:136–140

    Article  PubMed  Google Scholar 

  8. Denis F, Garaud P, Bardet E, Alfonsi M, Sire C, Germain T, Bergerot P, Rhein B, Tortochaux J, Calais G (2004) Final results of the French head and neck oncology and radiology group randomized trial comparing radiotherapy alone with concomitant radiochemotherapy in advanced stage oropharynx carcinoma. J Clin Oncol 22:69–76

    Article  PubMed  Google Scholar 

  9. Speksnijder CM, van der Glas HW, van der Bilt A, van Es RJ, van der Rijt E, Koole R (2010) Oral function after oncological intervention in the oral cavity: a retrospective study. J Oral Maxillofac Surg 68:1231–1237

    Article  PubMed  Google Scholar 

  10. Kubrak C, Olson K, Jha N, Jensen L, McCargar L, Seikaly H, Harris J, Scrimger R, Parliament M, Baracos VE (2010) Nutrition impact symptoms: key determinants of reduced dietary intake, weight loss, and reduced functional capacity of patients with head and neck cancer before treatment. Head Neck 32:290–300

    PubMed  Google Scholar 

  11. Kubrak C, Olson K, Jha N, Scrimger R, Parliament M, McCargar L, Koski S, Baracos VE (2013) Clinical determinants of weight loss in patients receiving radiation and chemoirradiation for head and neck cancer: a prospective longitudinal view. Head Neck 35:695–703

    Article  PubMed  Google Scholar 

  12. Ganzer H, Rothpletz-Puglia P, Byham-Gray L, Murphy BA, Touger-Decker R (2015) The eating experience in long-term survivors of head and neck cancer: a mixed-methods study. Support Care Cancer 23:3257–3268

    Article  PubMed  Google Scholar 

  13. van den Berg MG, Rütten H, Rasmussen-Conrad EL, Knuijt S, Takes RP, van Herpen CM, Wanten GJ, Kaanders JH, Merkx MA (2014) Nutritional status, food intake, and dysphagia in long-term survivors with head and neck cancer treated with chemoradiotherapy: a cross-sectional study. Head Neck 36:60–65

    Article  PubMed  Google Scholar 

  14. van den Berg MG, Rasmussen-Conrad EL, Gwasara GM, Krabbe PF, Naber AH, Merkx MA (2006) A prospective study on weight loss and energy intake in patients with head and neck cancer, during diagnosis, treatment and revalidation. Clin Nutr 25:765–772

    Article  PubMed  Google Scholar 

  15. Vissink A, Jansma J, Spijkervet FK, Burlage FR, Coppes RP (2003) Oral sequelae of head and neck radiotherapy. Crit Rev Oral Biol Med 14:199–212

    Article  CAS  PubMed  Google Scholar 

  16. Ottosson S, Laurell G, Olsson C (2013) The experience of food, eating and meals following radiotherapy for head and neck cancer: a qualitative study. J Clin Nurs 22:1034–1043

    Article  PubMed  Google Scholar 

  17. Raber-Durlacher JE, Brennan MT, Verdonck-de Leeuw IM, Gibson RJ, Eilers JG, Waltimo T, Bots CP, Michelet M, Sollecito TP, Rouleau TS, Sewnaik A, Bensadoun RJ, Fliedner MC, Silverman S Jr, Spijkervet FK (2012) Swallowing dysfunction in cancer patients. Support Care Cancer 20:433–443

    Article  PubMed  Google Scholar 

  18. Ganzer H, Touger-Decker R, Parrot J, Murphy B, Epstein J, Huhmann M (2013) Symptom burden in head and neck cancer: impact on energy and protein. Support Care Cancer 21:495–503

    Article  PubMed  Google Scholar 

  19. Rütten H, Pop LA, Janssens GO, Takes RP, Knuijt S, Rooijakkers AF, van den Berg M, Merkx MA, van Herpen CM, Kaanders JH (2011) Long-term outcome and morbidity after treatment with accelerated radiotherapy and weekly cisplatin for locally advanced head-and-neck cancer: results of a multidisciplinary late morbidity clinic. Int J Radiat Oncol Biol Phys 81:923–929

    Article  PubMed  Google Scholar 

  20. Rabinovitch R, Grant B, Berkey BA, Raben D, Ang KK, Fu KK, Cooper JS, Radiation Therapy Oncology Group (2006) Impact of nutrition support on treatment outcome in patients with locally advanced head and neck squamous cell cancer treated with definitive radiotherapy: a secondary analysis of RTOG trial 90-03. Head Neck 28:287–296

    Article  PubMed  Google Scholar 

  21. McQuestion M, Fitch M, Howell D (2011) The changed meaning of food: physical, social and emotional loss for patients having received radiation treatment for head and neck cancer. Eur J Oncol Nurs 15:145–151

    Article  PubMed  Google Scholar 

  22. George J, Yom S, Wang S (2014) Improved outcomes in adjuvant radiotherapy for oral cavity carcinoma at an academic center: a matched-pair analysis. Laryngoscope 124:1603–1608

    Article  PubMed  Google Scholar 

  23. Pimentel M, Filho M, Araujo M, Gomes D, Costa DAL (2014) Evaluation of radioprotective effect of pilocarpine ingestion on salivary glands. Anticancer Res 34:1993–1999

    CAS  PubMed  Google Scholar 

  24. Bressan V, Stevanin S, Bianchi M, Aleo G, Bagnasco A, Sasso L (2016) The effects of swallowing disorders, dysgeusia, oral mucositis and xerostomia on nutritional status, oral intake and weight loss in head and neck cancer patients: a systematic review. Cancer Treat Rev 45:105–119

    Article  PubMed  Google Scholar 

  25. Ogama N, Suzuki S, Umeshita K, Kobayashi T, Kaneko S, Kato S, Shimizu Y (2010) Appetite and adverse effects associated with radiation therapy in patients with head and neck cancer. Eur J Oncol Nurs 14:3–10

    Article  PubMed  Google Scholar 

  26. Ogama N, Suzuki S (2012) Adverse effects and appetite suppression associated with particle beam therapy in patients with head and neck cancer. Jpn J Nurs Sci 9:28–37

    Article  PubMed  Google Scholar 

  27. Ganzer H, Touger-Decker R, Byham-Gray L, Murphy BA, Epstein JB (2015) The eating experience after treatment for head and neck cancer: a review of the literature. Oral Oncol 51:634–642

    Article  PubMed  Google Scholar 

  28. Molassiotis A, Rogers M (2012) Symptom experience and regaining normality in the first year following a diagnosis of head and neck cancer: a qualitative longitudinal study. Palliat Support Care 10:197–204

    Article  PubMed  Google Scholar 

  29. Polit DF, Beck CT (2013) Essentials of nursing research: appraising evidence for nursing practice, 8th edn. Lippincott Williams & Wilkins, Philadelphia

    Google Scholar 

  30. Mason JM (2012) Qualitative health research: creating a new discipline. Left Coast Press Inc, Walnut Creek (CA), pp 17–22

  31. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Open Med 3:e123–e130

    Article  Google Scholar 

  32. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP et al (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 339:b2700

    Article  PubMed  PubMed Central  Google Scholar 

  33. Paterson B, Thorne S, Canam C, Jillings C (2001) Meta-study of qualitative health research: a practical guide to meta-analysis and meta-synthesis. Sage Publications, Thousand Oaks, pp 19–121

    Book  Google Scholar 

  34. Sandelowski M, Barroso J (2006) Handbook for synthesizing qualitative research. Springer Publishing Company, New York, pp 44–50

    Google Scholar 

  35. Atkins S, Lewin S, Smith H, Engel M, Fretheim A, Volmink J (2008) Conducting a meta-ethnography of qualitative literature: lessons learnt. BMC Med Res Methodol 8:21

    Article  PubMed  PubMed Central  Google Scholar 

  36. Thomas J, Harden A (2008) Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Methodol 8:45

    Article  PubMed  PubMed Central  Google Scholar 

  37. Dixon-Woods M, Shaw RL, Agarwal S, Smith JA (2004) The problem of appraising qualitative research. Qual Saf Health Care 13:223–225

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Lundgren I, Begley C, Gross MM, Bondas T (2012) ‘Groping through the fog’: a metasynthesis of women’s experiences on VBAC (vaginal birth after caesarean section). BMC pregnancy and childbirth 12:1

    Article  Google Scholar 

  39. Tong A, Sainsbury P, Craig J (2007) Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care 19:349–357

    Article  PubMed  Google Scholar 

  40. Vaismoradi M, Wang IL, Turunen H, Bondas T (2016) Older people’s experiences of care in nursing homes: a meta-synthesis. Int Nurs Rev 63:111–121

    Article  PubMed  Google Scholar 

  41. Walsh D, Downe S (2006) Appraising the quality of qualitative research. Midwifery 22:108–119

    Article  PubMed  Google Scholar 

  42. Evans D (2002) Systematic reviews of interpretive research: interpretive data synthesis of processed data. Aust J Adv Nurs 20:22–26

    PubMed  Google Scholar 

  43. Nund RL, Ward EC, Scarinci NA, Cartmill B, Kuipers P, Porceddu SV (2014) The lived experience of dysphagia following non-surgical treatment for head and neck cancer. Int J Speech Lang Pathol 16:282–289

    Article  PubMed  Google Scholar 

  44. Nund RL, Ward EC, Scarinci NA, Cartmill B, Kuipers P, Porceddu SV (2014) Survivors’ experiences of dysphagia-related services following head and neck cancer: implications for clinical practice. Int J Lang Commun Disord 49:354–363

    Article  PubMed  Google Scholar 

  45. Larsson M, Hedelin B, Athlin E (2003) Lived experiences of eating problems for patients with head and neck cancer during radiotherapy. J Clin Nurs 12:562–570

    Article  PubMed  Google Scholar 

  46. McLaughlin L, Mahon SM (2014) Taste dysfunction and eating behaviors in survivors of head and neck cancer treatment. Medsurg Nurs 23(165–70):184

    Google Scholar 

  47. Wilson PR, Herman J, Chubon SJ (1991) Eating strategies used by persons with head and neck cancer during and after radiotherapy. Cancer Nurs 14:98–104

    Article  CAS  PubMed  Google Scholar 

  48. Tong MC, Lee KY, Yuen MT, Lo PS (2011) Perceptions and experiences of post-irradiation swallowing difficulties in nasopharyngeal cancer survivors. Eur J Cancer Care (Engl) 20:170–178

    Article  CAS  Google Scholar 

  49. Patterson JM, McColl E, Wilson J, Carding P, Rapley T (2015) Head and neck cancer patients’ perceptions of swallowing following chemoradiotherapy. Support Care Cancer 23:3531–3538

    Article  PubMed  Google Scholar 

  50. Pateman KA, Ford PJ, Batstone MD, Farah CS (2015) Coping with an altered mouth and perceived supportive care needs following head and neck cancer treatment. Support Care Cancer 23:2365–2373

    Article  CAS  PubMed  Google Scholar 

  51. Cartmill B, Cornwell P, Ward E, Davidson W, Porceddu S (2012) Long-term functional outcomes and patient perspective following altered fractionation radiotherapy with concomitant boost for oropharyngeal cancer. Dysphagia 27:481–490

    Article  PubMed  Google Scholar 

  52. Alvarez-Buylla Blanco M, Herranz González-Botas J (2011) Quality of life evolution in patients after surgical treatment of laryngeal, hypopharyngeal or oropharyngeal carcinoma. Acta Otorrinolaringol Esp 62:103–112

    Article  PubMed  Google Scholar 

  53. Wissinger E, Griebsch I, Lungershausen J, Byrnes M, Travers K, Pashos CL (2014) The humanistic burden of head and neck cancer: a systematic literature review. PharmacoEconomics 32:1213–1229

    Article  PubMed  Google Scholar 

  54. Lang H, France E, Williams B, Humphris G, Wells M (2013) The psychological experience of living with head and neck cancer: a systematic review and metasynthesis. Psycho Oncol 22:2648–2663

    Article  Google Scholar 

  55. Haisfield-Wolfe ME, McGuire DB, Soeken K, Geiger-Brown J, De Forge B, Suntharalingam M (2012) Prevalence and correlates of symptoms and uncertainty in illness among head and neck cancer patients receiving definitive radiation with or without chemotherapy. Support Care Cancer 20:1885–1893

    Article  PubMed  Google Scholar 

  56. Eades M, Chasen M, Bhargova R (2009) Rehabilitation: longterm physical and functional changes following treatment. Semin Oncol Nurs 25:222–230

    Article  PubMed  Google Scholar 

  57. Morgan MA, Small BJ, Donovan KA, Overcash J, McMillan S (2011) Cancer patients with pain: the spouse/partner relationship and quality of life. Cancer Nurs 34:13–23

    Article  PubMed  PubMed Central  Google Scholar 

  58. Bennion AE, Molassiotis A (2013) Qualitative research into the symptom experiences of adult cancer patients after treatments: a systematic review and meta-synthesis. Support Care Cancer 21:9–25

    Article  CAS  PubMed  Google Scholar 

  59. Ravasco P, Monteiro-Grillo I, Vidal PM, Camilo ME (2005) Dietary counseling improves patient outcomes: a prospective, randomized, controlled trial in colorectal cancer patients undergoing radiotherapy. J Clin Oncol 23:1431–1438

    Article  PubMed  Google Scholar 

  60. Graffigna G, Vegni E, Barello A, Olson K, Bosio CA (2011) Studying the social construction of cancer-related fatigue experience: the heuristic value of Ethnoscience. Patient Educ Couns 82:402–409

    Article  PubMed  Google Scholar 

  61. Dodd MJ, Miaskowski C, Paul SM (2001) Symptom clusters and their effect on the functional status of patients with cancer. Oncol Nurs Forum 28:465–470

    CAS  PubMed  Google Scholar 

  62. Kirshbaum MN, Olson K, Pongthavornkamol K, Graffigna G (2013) Understanding the meaning of fatigue at the end of life: an ethnoscience approach. Eur J Oncol Nurs 17:146–153

    Article  PubMed  Google Scholar 

  63. Brockbank S, Miller N, Owen S, Patterson JM (2015) Pretreatment information on dysphagia: exploring the views of head and neck cancer patients. J Pain Symptom Manag 49:89–97

    Article  Google Scholar 

  64. Semple CJ, Dunwoody L, Kernohan W, McCaughan E, Sullivan K (2008) Change and challenges to patients’ lifestyle patterns following treatment for head and neck cancer. J Adv Nurs 63:85–93

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Health Sciences, University of Genoa, Via Pastore 1, 16132, Genoa, Italy

    Valentina Bressan, Annamaria Bagnasco, Giuseppe Aleo, Gianluca Catania, Milko P. Zanini & Loredana Sasso

  2. School of Nursing and Midwifery, Trinity College Dublin, 24 D’Olier Street, Dublin, Ireland

    Fiona Timmins

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  1. Valentina Bressan
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  2. Annamaria Bagnasco
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Correspondence to Valentina Bressan.

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Bressan, V., Bagnasco, A., Aleo, G. et al. The life experience of nutrition impact symptoms during treatment for head and neck cancer patients: a systematic review and meta-synthesis. Support Care Cancer 25, 1699–1712 (2017). https://doi.org/10.1007/s00520-017-3618-7

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  • DOI: https://doi.org/10.1007/s00520-017-3618-7

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