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A systematic review of psychological interventions for patients with head and neck cancer

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Abstract

Aim

The purpose of this systematic review is to identify psychological interventions that have been effective at improving quality of life and reducing psychological distress (depression and anxiety) in patients with head and neck cancer.

Methods

All relevant peer-reviewed articles published between March 1980 and March 2017 were identified through an electronic search of five databases: Medline, Embase, PsycINFO, Scopus, and Academic Search Complete. Risk of bias was independently assessed by two reviewers using the Crowe Critical Appraisal Tool (CCAT). Following this, a narrative synthesis of the findings was completed.

Results

Twenty-one unique intervention studies were identified. Interventions tested included cognitive behavioural therapy (CBT), psychoeducation, meditation/mindfulness, group therapy, and telehealth initiatives. Ten studies utilised a randomised controlled design. Five of these investigated CBT and three examined psychoeducation, with the greatest empirical support found for these intervention types. However, the majority of studies were underpowered to detect significant effects and did not examine whether improvements in quality of life and psychological well-being were sustained over time.

Conclusions

Further research is needed to investigate the effects of psychological interventions among patients with head and neck cancer, using randomised controlled designs, adequately powered samples, and long-term follow-up. This would allow evidence-based recommendations to be made regarding the most appropriate interventions to implement in clinical practice.

Trial registration

CRD42017069851

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References

  1. Oskam IM, Verdonck-de Leeuw IM, Aaronson NK, Witte BI, de Bree R, Doornaert P, Langendijk JA, René Leemans C (2013) Prospective evaluation of health-related quality of life in long-term oral and oropharyngeal cancer survivors and the perceived need for supportive care. Oral Oncol 49:443–448

    Article  PubMed  Google Scholar 

  2. Mehanna HM, Morton RP (2006) Deterioration in quality-of-life of late (10-year) survivors of head and neck cancer. Clin Otolaryngol 31:204–211

    Article  CAS  PubMed  Google Scholar 

  3. Morton RP, Izzard ME (2003) Quality-of-life outcomes in head and neck cancer patients. World J Surg 27:884–889

    Article  PubMed  Google Scholar 

  4. Ojo B, Genden EM, Teng MS, Milbury K, Misiukiewicz KJ, Badr H (2012) A systematic review of head and neck cancer quality of life assessment instruments. Oral Oncol 48:923–937

    Article  PubMed  PubMed Central  Google Scholar 

  5. Hammerlid E, Silander E, Hornestam L, Sullivan M (2001) Health-related quality of life three years after diagnosis of head and neck cancer—a longitudinal study. Head Neck 23:113–125

    Article  CAS  Google Scholar 

  6. Funk GF, Karnell LH, Christensen AJ (2012) Long-term health-related quality of life in survivors of head and neck cancer. Arch Otolaryngol Head Neck Surg 138:123–133

    Article  Google Scholar 

  7. Ghazali N, Roe B, Lowe D, Tandon S, Jones T, Brown J, Shaw R, Risk J, Rogers SN (2017) Screening for distress using the distress thermometer and the University of Washington Quality of Life in post-treatment head and neck cancer survivors. Eur Arch Otorhinolaryngol 274:2253–2260

    Article  PubMed  Google Scholar 

  8. Bjordal K, Kaasa S (1995) Psychological distress in head and neck cancer patients 7-11 years after curative treatment. Br J Cancer 71:592–597

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Pirl WF, Fann JR, Greer JA, Braun I, Deshields T, Fulcher C, Harvey E, Holland J, Kennedy V, Lazenby M, Wagner L, Underhill M, Walker DK, Zabora J, Zebrack B, Bardwell WA (2014) Recommendations for the implementation of distress screening programs in cancer centers: report from the American Psychosocial Oncology Society (APOS), Association of Oncology Social Work (AOSW), and Oncology Nursing Society (ONS) joint task force. Cancer 120:2946–2954

    Article  PubMed  Google Scholar 

  10. Holland JC (1982) Psychological aspects of cancer. In: Holland JF, Frei E (eds) Cancer medicine. Oxford University Press, New York, pp 1175–1203

    Google Scholar 

  11. Fawzy FI, Fawzy NW, Arndt LA, Pasnau RO (1995) Critical review of psychosocial interventions in cancer care. Arch Gen Psychiatry 52:100–113

    Article  CAS  PubMed  Google Scholar 

  12. Beck JS (2011) Cognitive behaviour therapy: basics and beyond, 2nd edn. Guilford Press, New York

    Google Scholar 

  13. Grossman P, Niemann L, Schmidt S, Walach H (2004) Mindfulness-based stress reduction and health benefits. A meta-analysis. J Psychosom Res 57:35–43

    Article  PubMed  Google Scholar 

  14. Hart SL, Hoyt MA, Diefenbach M, Anderson DR, Kilbourn KM, Craft LL (2012) Meta-analysis of efficacy of interventions for elevated depressive symptoms in adults diagnosed with cancer. J Natl Cancer Inst 104:990–1004

    Article  PubMed  PubMed Central  Google Scholar 

  15. Jacobsen PB, Jim HS (2008) Psychosocial interventions for anxiety and depression in adult cancer patients: achievements and challenges. CA Cancer J Clin 58:214–230

    Article  PubMed  Google Scholar 

  16. Williams S, Dale J (2006) The effectiveness of treatment for depression/depressive symptoms in adults with cancer: a systematic review. Br J Cancer 94:372–390

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Stanton AL (2006) Psychosocial concerns and interventions for cancer survivors. J Clin Oncol 24:5132–5137

    Article  PubMed  Google Scholar 

  18. Tatrow K, Montgomery GH (2006) Cognitive behavioral therapy techniques for distress and pain in breast cancer patients: a meta-analysis. J Behav Med 29:17–27

    Article  PubMed  Google Scholar 

  19. Howren MB, Christensen AJ, Karnell LH, Funk GF (2013) Psychological factors associated with head and neck cancer treatment and survivorship: evidence and opportunities for behavioral medicine. J Consult Clin Psychol 81:299–317

    Article  PubMed  Google Scholar 

  20. Semple C, Parahoo K, Norman A, McCaughan E, Humphris G, Mills M (2013) Psychosocial interventions for patients with head and neck cancer. Cochrane Database Syst Rev (7):CD009441. https://doi.org/10.1002/14651858.CD009441.pub2

  21. Luckett T, Britton B, Clover K, Rankin NM (2011) Evidence for interventions to improve psychological outcomes in people with head and neck cancer: a systematic review of the literature. Support Care Cancer 19:871–881

    Article  CAS  PubMed  Google Scholar 

  22. Pollard A, Burchell JL, Castle D, Neilson K, Ftanou M, Corry J, Rischin D, Kissane DW, Krishnasamy M, Carlson LE, Couper J (2017) Individualised mindfulness-based stress reduction for head and neck cancer patients undergoing radiotherapy of curative intent: a descriptive pilot study. Eur J Cancer Care 26. https://doi.org/10.1111/ecc.12474

  23. Boxleitner G, Jolie S, Shaffer D, Pasacreta N, Bai M, McCorkle R (2017) Comparison of two types of meditation on patients’ psychosocial responses during radiation therapy for head and neck cancer. J Altern Complement Med 23:355–361

    Article  PubMed  Google Scholar 

  24. Crowe M, Sheppard L (2011) A review of critical appraisal tools show they lack rigor: alternative tool structure is proposed. J Clin Epidemiol 64:79–89

    Article  PubMed  Google Scholar 

  25. Crowe M, Sheppard L (2011) A general critical appraisal tool: an evaluation of construct validity. Int J Nurs Stud 48:1505–1516

    Article  PubMed  Google Scholar 

  26. Crowe M, Sheppard L, Campbell A (2012) Reliability analysis for a proposed critical appraisal tool demonstrated value for diverse research designs. J Clin Epidemiol 65:375–383

    Article  PubMed  Google Scholar 

  27. Allison PJ, Edgar L, Nicolau B, Archer J, Black M, Hier M (2004) Results of a feasibility study for a psycho-educational intervention in head and neck cancer. Psychooncology 13:482–485

    Article  CAS  PubMed  Google Scholar 

  28. Allison PJ, Edgar L, Nicolau B, Archer J, Black M, Hier M (2004) Teaching head and neck cancer patients coping strategies: results of a feasibility study. Oral Oncol 40:538–544

    Article  CAS  PubMed  Google Scholar 

  29. Chen SC, Huang BS, Lin CY, Fan KH, Chang JT, Wu SC et al (2017) Psychosocial effects of a skin camouflage program in female survivors with head and neck cancer: a randomized controlled trial. Psychooncology 26:1376–1383

    Article  PubMed  Google Scholar 

  30. D’Souza V, Blouin E, Zeitouni A, Muller K, Allison PJ (2013) An investigation of the effect of tailored information on symptoms of anxiety and depression in head and neck cancer patients. Oral Oncol 49:431–437

    Article  PubMed  Google Scholar 

  31. Duffy SA, Ronis DL, Valenstein M, Lambert MT, Fowler KE, Gregory L, Bishop C, Myers LL, Blow FC, Terrell JE (2006) A tailored smoking, alcohol, and depression intervention for head and neck cancer patients. Cancer Epidemiol Biomark Prev 15:2203–2208

    Article  Google Scholar 

  32. Fiegenbaum W (1981) A social training program for clients with facial disfigurations: a contribution to the rehabilitation of cancer patients. Int J Rehabil Res 4:501–510

    Article  CAS  PubMed  Google Scholar 

  33. Hammerlid E, Persson LO, Sullivan M, Westin T (1999) Quality-of-life effects of psychosocial intervention in patients with head and neck cancer. Otolaryngol Head Neck Surg 120:507–516

    Article  CAS  PubMed  Google Scholar 

  34. Hansson E, Carlstrom E, Olsson LE, Nyman J, Koinberg I (2017) Can a person-centred-care intervention improve health-related quality of life in patients with head and neck cancer? A randomized, controlled study. BMC Nurs 16:9

    Article  PubMed  PubMed Central  Google Scholar 

  35. Humphris G, Rogers SN (2012) AFTER and beyond: cancer recurrence fears and a test of an intervention in oral and oropharyngeal patients. Soc Sci Dentist 2:29–38

    Google Scholar 

  36. Kangas M, Milross C, Taylor A, Bryant RA (2013) A pilot randomized controlled trial of a brief early intervention for reducing posttraumatic stress disorder, anxiety and depressive symptoms in newly diagnosed head and neck cancer patients. Psychooncology 22:1665–1673

    Article  PubMed  Google Scholar 

  37. Katz MR, Irish JC, Devins GM (2004) Development and pilot testing of a psychoeducational intervention for oral cancer patients. Psychooncology 13:642–653

    Article  PubMed  Google Scholar 

  38. Kilbourn KM, Anderson D, Costenaro A, Lusczakoski K, Borrayo E, Raben D (2013) Feasibility of EASE: a psychosocial program to improve symptom management in head and neck cancer patients. Support Care Cancer 21:191–200

    Article  PubMed  Google Scholar 

  39. Petruson KM, Silander EM, Hammerlid EB (2003) Effects of psychosocial intervention on quality of life in patients with head and neck cancer. Head Neck 25:576–584

    Article  PubMed  Google Scholar 

  40. Pfeifer MP, Keeney C, Bumpous J, Schapmire TJ, Studts JL, Myers J, Head B (2015) Impact of a telehealth intervention on quality of life and symptom distress in patients with head and neck cancer. J Commun Support Oncol 13:14–21

    Article  CAS  Google Scholar 

  41. Richardson AE, Tennant G, Morton RP, Broadbent E (2017) A self-regulatory intervention for patients with head and neck cancer: pilot randomized trial. Ann Behav Med 51:629–641

    Article  PubMed  Google Scholar 

  42. Semple CJ, Dunwoody L, Kernohan WG, McCaughan E (2009) Development and evaluation of a problem-focused psychosocial intervention for patients with head and neck cancer. Support Care Cancer 17:379–388

    Article  PubMed  Google Scholar 

  43. Vakharia KT, Ali MJ, Wang SJ (2007) Quality-of-life impact of participation in a head and neck cancer support group. Otolaryngol Head Neck Surg 136:405–410

    Article  PubMed  Google Scholar 

  44. van den Brink JL, Moorman PW, de Boer MF, Hop WC, Pruyn JF, Verwoerd CD et al (2007) Impact on quality of life of a telemedicine system supporting head and neck cancer patients: a controlled trial during the postoperative period at home. J Am Med Inform Assoc 14:198–205

    Article  PubMed  PubMed Central  Google Scholar 

  45. van der Meulen IC, de Leeuw JR, Gamel CJ, Hafsteinsdottir TB (2013) Educational intervention for patients with head and neck cancer in the discharge phase. Eur J Oncol Nurs 17:220–227

    Article  PubMed  Google Scholar 

  46. van der Meulen IC, May AM, Ros WJ, Oosterom M, Hordijk GJ, Koole R et al (2013) One-year effect of a nurse-led psychosocial intervention on depressive symptoms in patients with head and neck cancer: a randomized controlled trial. Oncologist 18:336–344

    Article  PubMed  PubMed Central  Google Scholar 

  47. van der Meulen IC, May AM, de Leeuw JR, Koole R, Oosterom M, Hordijk GJ et al (2014) Long-term effect of a nurse-led psychosocial intervention on health-related quality of life in patients with head and neck cancer: a randomised controlled trial. Br J Cancer 110:593–601

    Article  PubMed  Google Scholar 

  48. Vilela LD, Nicolau B, Mahmud S, Edgar L, Hier M, Black M, Franco EL, Allison PJ (2006) Comparison of psychosocial outcomes in head and neck cancer patients receiving a coping strategies intervention and control subjects receiving no intervention. J Otolaryngol 35:88–96

    Article  PubMed  Google Scholar 

  49. Humphris G, Ozakinci G (2008) The AFTER intervention: a structured psychological approach to reduce fears of recurrence in patients with head and neck cancer. Br J Health Psychol 13:223–230

    Article  PubMed  Google Scholar 

  50. Hoffman SG, Asnaani A, Vonk IJJ, Sawyer AT, Fang A (2012) The efficacy of cognitive behavioral therapy: a review of meta-analyses. Cogn Ther Res 36:427–440

    Article  Google Scholar 

  51. Campbell CL, Campbell LC (2012) A systematic review of cognitive behavioral interventions in advanced cancer. Patient Educ Couns 89:15–24

    Article  PubMed  PubMed Central  Google Scholar 

  52. Li M, Fitzgerald P, Rodin G (2012) Evidence-based treatment of depression in patients with cancer. J Clin Oncol 30:1187–1196

    Article  PubMed  Google Scholar 

  53. Cramer H, Lauche R, Paul A, Dobos G (2012) Mindfulness-based stress reduction for breast cancer—a systematic review and meta-analysis. Curr Oncol 19:e343–e352

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Haller H, Winkler MM, Klose P, Dobos G, Kummel S, Cramer H (2017) Mindfulness-based interventions for women with breast cancer: an updated systematic review and meta-analysis. Acta Oncol 56:1665–1676

    Article  PubMed  Google Scholar 

  55. Bashshur RL, Shannon GW, Krupinski EA, Grigsby J, Kvedar JC, Weinstein RS, Sanders JH, Rheuban KS, Nesbitt TS, Alverson DC, Merrell RC, Linkous JD, Ferguson AS, Waters RJ, Stachura ME, Ellis DG, Antoniotti NM, Johnston B, Doarn CR, Yellowlees P, Normandin S, Tracy J (2009) National telemedicine initiatives: essential to healthcare reform. Telemed J E Health 15:600–610

    Article  Google Scholar 

  56. Moher D, Pham B, Lawson ML, Klassen TP (2003) The inclusion of reports of randomised trials published in languages other than English in systematic reviews. Health Technol Assess 7:1–90

    Article  CAS  PubMed  Google Scholar 

  57. Henry M, Habib LA, Morrison M, Yang JW, Li XJ, Lin S, Zeitouni A, Payne R, MacDonald C, Mlynarek A, Kost K, Black M, Hier M (2014) Head and neck cancer patients want us to support them psychologically in the posttreatment period: survey results. Palliat Support Care 12:481–493

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand

    Amy E. Richardson

  2. Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand

    Elizabeth Broadbent

  3. Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand

    Randall P. Morton

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  1. Amy E. Richardson
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Correspondence to Amy E. Richardson.

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Richardson, A.E., Broadbent, E. & Morton, R.P. A systematic review of psychological interventions for patients with head and neck cancer. Support Care Cancer 27, 2007–2021 (2019). https://doi.org/10.1007/s00520-019-04768-3

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