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Immediate post-treatment supportive care needs of patients newly diagnosed with head and neck cancer

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Abstract

Objective

This study aimed at identifying supportive care needs of patients with head and neck cancer (HNC-P) immediately post-treatment, finding early predictors of unmet needs, and contrasting how immediate post-treatment needs differed from needs in longer-term survivorship.

Methods

Prospective longitudinal study of 223 consecutive adults (313 approached; 72% participation) newly diagnosed with a first occurrence of primary HNC. Patients completed the Supportive Care Needs Survey–Short Form (SCNS), the Structured Clinical Interview for DSM-IV, and other outcomes. Medical chart reviews were conducted.

Results

A total of 68% of patients (n = 145/223) completed the SCNS. The multiple linear regression indicated that when controlled for medical variables, patients presented higher levels of unmet needs when they presented with higher level of anxiety upon HNC diagnosis (p = 0.03), higher neuroticism (p = 0.03), and more stressful life events in the year pre-diagnosis (p = 0.01). Patients immediately post-treatment had a wider variety of unmet needs compared with those in extended survivorship, with psychological unmet needs most prevalent at both time points. Immediately post-treatment, patients needed more support regarding pain (p = 0.04) and worries about treatment results (p = 0.05), whereas patients in longer-term survivorship needed more support regarding anxiety (p = 0.02), changes in sexual relationships (p = 0.04), and fear of death and dying (p = 0.001).

Conclusion

This study identifies areas needing further development to improve quality of care for HNC-P in the immediate post-treatment period, as well as early determinants of unmet needs. HNC clinics may want to routinely screen for anxiety, neuroticism, and burden from other life events, to pro-actively address needs upon treatment completion and alleviate disease burden.

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Acknowledgements

We wish to thank the following residents and medical students for their valuable time and dedication: Sonalia Amarasekera, Cassie Chaloux, Nadege Dollonne-Rohrbacher, Clara-Bolster Foucault, Judy Fung, Goda Galinyte, Deniz Keskinel, Dr. Marco Mascarella, Camille Texier, and Nabila Zuberi.

Funding

This study has been possible through funding from the Fonds de recherche Québec-Santé (FRQS) #24910, also awarding the Principal Investigator a Clinician-Scientist Salary Award.

Author information

Authors and Affiliations

  1. Faculty of Medicine, Department of Oncology, McGill University, Montreal, Canada

    Melissa Henry, Zeev Rosberger & Michael Hier

  2. Department of Oncology, Jewish General Hospital, Montreal, Canada

    Melissa Henry

  3. Department of Otolaryngology–Head and Neck Surgery, Jewish General Hospital, Montreal, Canada

    Melissa Henry, Michael Hier, Alex Mlynarek, Martin Black, Christina MacDonald, Gabrielle Chartier & Saul Frenkiel

  4. Department of Otolaryngology–Head and Neck Surgery, McGill University, Montreal, Canada

    Melissa Henry, Michael Hier, Anthony Zeitouni, Karen Kost, Alex Mlynarek, Keith Richardson, Martin Black & Saul Frenkiel

  5. Lady-Davis Institute for Medical Research, Jewish General Hospital, 3755 Côte Ste. Catherine Road, Pavilion E room E-872, Montreal, Quebec, H3T 1E2, Canada

    Melissa Henry, Maria Cherba, Claudia Woronko & Zeev Rosberger

  6. Faculty of Medicine, McGill University, Montreal, Canada

    Ali Alias

  7. Department of Communication, Université de Montréal, Montreal, Canada

    Maria Cherba

  8. Department of Psychology, McGill University, Montreal, Canada

    Zeev Rosberger

  9. Department of Otolaryngology, McGill University Health Centre–Head and Neck Surgery, Montreal, Canada

    Anthony Zeitouni, Karen Kost, Alex Mlynarek, Keith Richardson & Saul Frenkiel

  10. Department of Nursing, Jewish General Hospital, Montreal, Canada

    Christina MacDonald & Gabrielle Chartier

Authors
  1. Melissa Henry
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  2. Ali Alias
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  3. Maria Cherba
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  9. Alex Mlynarek
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  10. Keith Richardson
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  11. Martin Black
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  14. Saul Frenkiel
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Corresponding author

Correspondence to Melissa Henry.

Ethics declarations

This study received ethics approval from McGill University’s Faculty of Medicine IRB (#A05-B24-10B), as well as from recruiting hospitals.

Conflict of interest

The authors declare that they have no conflict of interest.

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Henry, M., Alias, A., Cherba, M. et al. Immediate post-treatment supportive care needs of patients newly diagnosed with head and neck cancer. Support Care Cancer 28, 5557–5567 (2020). https://doi.org/10.1007/s00520-020-05368-2

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  • DOI: https://doi.org/10.1007/s00520-020-05368-2

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