Head and Neck Cancer Quality of Life Instruments

Treatment end points for patients with malignant disease have historically been refl ected by objective tumor response, overall survival, and/or disease-free survival. However, over the past three decades, with the introduction of multimodality treatments and the increasing number of cancer survivors, has come the growing awareness and concern for the psychosocial needs of patients with cancer. The loss of health and/ or the consequences of treatment can result in physical or functional impairment, disruption of social and family interactions, and psychological distress, all of which affect quality of life (QOL). As a result, health-care interventions must be judged not only by their impact on survival, but also on QOL. Extending survival does not always correlate with improvements in QOL, and conversely, specifi c treatments may not necessarily prolong life but may enhance its quality. Understanding the patient's perception of his/her disease, and its treatment and symptoms, is critical to comprehensive cancer care, patient education, and the informed evalua tion of therapeutic options.

For patients with head and neck cancer (HNC) in particular, appreciation of the full impact of the disease and its treatment is critical. Because the majority of patients with HNC are diagnosed with advanced stage disease, treatment tends to be aggressive with signifi cant acute and long-term effects. Both the disease and the consequences of therapy interfere with basic human functions, including eating, speaking, and breathing. Such impairment has a marked influ-ence on day-to-day activities and QOL.