Skip to main content

Advertisement

SpringerLink
Log in

Gender-specific differences concerning psychosocial aspects and functional impairments that influence quality of life in oral cancer treatment

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

Patients with oral cancer have gender-specific differences with respect to health-related quality of life (HRQoL) and psychosocial variables (PV). The aim of the present study was to evaluate HRQoL and PV outcomes in patients treated for oral squamous cell carcinoma.

Methods

Data of 1234 patients were collected from a multicenter rehabilitation study of the German–Austrian–Swiss Cooperative Group on Tumours of the Maxillofacial Region (DÖSAK). Patient characteristics, oncological variables, post-treatment impairments, general quality of life (QoL), and PV (coping strategies, control beliefs, personal traits, perceived social support, depression, anxiety, and fear of tumor recurrence) were recorded.

Results

After treatment, HRQoL was similar between genders concerning general QoL, but men experienced significantly more treatment-related functional impairments influencing HRQoL. PV revealed gender-specific coping strategies, with women reporting significantly more “depressive coping,” “religiosity,” “fatalistic externality,” and higher “social burden.” Owing to their religious coping strategies, fatalistic attitude, and perceived higher social integration, women demonstrated superior disease acceptance, despite higher depression, anxiety, and lower psychosocial resilience. Conversely, men reported more introverted personal traits and lower social integration.

Conclusion

Interventions during oral cancer treatment should address PV and have gender-specific elements to improve HRQoL after therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Availability of data and material

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

References

  1. Lingen MW, Kalmar JR, Karrison T, Speight PM (2008) Critical evaluation of diagnostic aids for the detection of oral cancer. Oral Oncol 44:10–22. https://doi.org/10.1016/j.oraloncology.2007.06.011

    Article  PubMed  Google Scholar 

  2. Rivera C (2015) Essentials of oral cancer. Int J Clin Exp Pathol 8:11884–11894

    CAS  PubMed  PubMed Central  Google Scholar 

  3. Barnes B, Kraywinkel K, Nowossadeck E, Schönfeld I, Starker A, Wienecke A, Wolf U (2016) Bericht zum Krebsgeschehen in Deutschland 2016 [Report on Cancer in Germany 2016]. Berlin: Robert Koch-Institute. https://doi.org/10.17886/rkipubl-2016-014

  4. Honorato J, Rebelo MS, Dias FL, Camisasca DR, Faria PA, Azevedo e Silva G, Lourenço SQ, (2015) Gender differences in prognostic factors for oral cancer. Int J Oral Maxillofac Surg 44:1205–1211. https://doi.org/10.1016/j.ijom.2015.04.015

    Article  CAS  PubMed  Google Scholar 

  5. Kruse AL, Bredell M, Grätz KW (2011) Oral cancer in men and women: are there differences? Oral Maxillofac Surg 15:51–55. https://doi.org/10.1007/s10006-010-0253-6

    Article  PubMed  Google Scholar 

  6. Roberts JC, Li G, Reitzel LR, Wei Q, Sturgis EM (2010) No evidence of sex-related survival disparities among head and neck cancer patients receiving similar multidisciplinary care: a matched-pair analysis. Clin Cancer Res 16:5019–5027. https://doi.org/10.1158/1078-0432.CCR-10-0755

    Article  PubMed  PubMed Central  Google Scholar 

  7. Rogers SN (2010) Quality of life perspectives in patients with oral cancer. Oral Oncol 46:445–447. https://doi.org/10.1016/j.oraloncology.2010.02.021

    Article  PubMed  Google Scholar 

  8. Handschel J, Naujoks C, Hofer M, Krüskemper G (2013) Psychological aspects affect quality of life in patients with oral squamous cell carcinomas. Psychooncology 22:677–682. https://doi.org/10.1002/pon.3052

    Article  PubMed  Google Scholar 

  9. Greimel ER, Padilla GV, Grant MM (1998) Gender differences in outcomes among patients with cancer. Psychooncology 7:197–206. https://doi.org/10.1002/(SICI)1099-1611(199805/06)7:3%3c197::AID-PON303%3e3.0.CO;2-Q

    Article  CAS  PubMed  Google Scholar 

  10. Westin T, Jansson A, Zenckert C, Hällström T, Edström S (1988) Mental depression is associated with malnutrition in patients with head and neck cancer. Arch Otolaryngol Head Neck Surg 114:1449–1453. https://doi.org/10.1001/archotol.1988.01860240099032

    Article  CAS  PubMed  Google Scholar 

  11. Chandu A, Smith AC, Rogers SN (2006) Health-related quality of life in oral cancer: a review. J Oral Maxillofac Surg 64:495–502. https://doi.org/10.1016/j.joms.2005.11.028

    Article  PubMed  Google Scholar 

  12. Langius A, Björvell H, Lind MG (1994) Functional status and coping in patients with oral and pharyngeal cancer before and after surgery. Head Neck 16:559–568. https://doi.org/10.1002/hed.2880160611

    Article  CAS  PubMed  Google Scholar 

  13. Gellrich NC, Suarez-Cunqueiro MM, Bremerich A, Schramm A (2003) Characteristics of oral cancer in a central European population: defining the dentist’s role. J Am Dent Assoc, 134:307–338. https://doi.org/10.14219/jada.archive.2003.0159

  14. Gellrich NC, Bremerich A, Kugler J, Krüskemper G, Machtens E (1994) Assessment of life-quality after radical oral cancer treatment – an interdisciplinary approach. J Cancer Res Clin Oncol 120:86

    Google Scholar 

  15. Gellrich NC, Bremerich A, Kugler J, Krüskemper G, Hallner D, Machtens E (1994) Life quality in patients with oral cancer – a patients’ questionnaire. In: Vama AK (ed) Oral Oncology, vol III. Proceedings of the 3rd ICOOC 1994 Jan 22–25. Madras, India, pp 524–527

    Google Scholar 

  16. Holtmann H, Spalthoff S, Gellrich NC, Handschel J, Lommen J, Kübler NR, Krüskemper G, Rana M, Sander K (2017) Determinants for further wishes for cosmetic and reconstructive interventions in 1652 patients with surgical treated carcinomas of the oral cavity. Maxillofac Plast Reconstr Surg 39:26. https://doi.org/10.1186/s40902-017-0125-1

    Article  PubMed  PubMed Central  Google Scholar 

  17. Linsen SS, Gellrich NC, Krüskemper G (2018) Age and localization-dependent functional and psychosocial impairments and health related quality of life six months after OSCC therapy. Oral Oncol 81:61–68. https://doi.org/10.1016/j.oraloncology.2018.04.011

    Article  PubMed  Google Scholar 

  18. Spalthoff S, Zimmerer R, Jehn P, Gellrich NC, Handschel J, Krüskemper G (2017) Neck dissection’s burden on the patient: functional and psychosocial aspects in 1,652 patients with oral squamous cell carcinomas. J Oral Maxillofac Surg 75:839–849. https://doi.org/10.1016/j.joms.2016.09.037

    Article  PubMed  Google Scholar 

  19. Muthny FA (1996) Hinweise auf Bewertungsinstrumente zur Qualitätssicherung in der Rehabilitation-Blatt 6. Erfassung von Verarbeitungsprozessen mit dem Freiburger Fragebogen zur Krankheitsverarbeitung (FKV) [References for evaluation scales in quality assurance in rehabilitation--6. Assessment of coping processes with the Freiburg Questionnaire of Illness Coping]. Die Rehabilitation 35:IX-XVI.

  20. Lohaus A, Schmitt GM (1989) Kontrollüberzeugungen zu Krankheit und Gesundheit (KKG): Bericht über die Entwicklung eines Testverfahrens [Control beliefs concerning illness and health: Report about the development of a testing procedure]. Diagnostica 35:59–72

    Google Scholar 

  21. Krampen G (1981) IPC Fragebogen zu Kontrollüberzeugungen [IPC Questionnaire on Control Beliefs]. Hogrefe, Göttingen

    Google Scholar 

  22. Fydrich T, Geyer M, Hessel A, Sommer G, Brähler E (1999) Fragebogen zur Sozialen Unterstützung (F-SozU): Normierung an einer repräsentativen Stichprobe [Questionnaire on social support (F-SozU): Standardization on a representative sample]. Diagnostica 45:212–216. https://doi.org/10.1026//0012-1924.45.4.212

    Article  Google Scholar 

  23. Zerssen D (1976) “Typus-melancholicus” from a psychometric viewpoint (part 1). Z Klin Psychol Psychother 24:200–220

    CAS  PubMed  Google Scholar 

  24. Laux G (1972) Eine Untersuchung über die Angst bei zahnärztlichen Behandlungen [Study on anxiety during dental treatment]. ZWR 81:1078–1080

    CAS  PubMed  Google Scholar 

  25. No authors listed (1998) The Whoqol Group. The World Health Organization Quality of Life Assessment (WHOQOL): development and general psychometric properties Soc Sci Med 46:1569–1585. https://doi.org/10.1016/S0277-9536(98)00009-4

  26. Aubry K, Yachine M, Perez AF, Vivent M, Lerat J, Scomparin A, Bessède JP (2011) Transoral robotic surgery for head and neck cancer: a series of 17 cases. Eur Ann Otorhinolaryngol Head Neck Dis 128:290–296. https://doi.org/10.1016/j.anorl.2011.05.002

    Article  CAS  PubMed  Google Scholar 

  27. Kufta K, Forman M, Swisher-McClure S, Sollecito TP, Panchal N (2018) Pre-radiation dental considerations and management for head and neck cancer patients. Oral Oncol 76:42–51. https://doi.org/10.1016/j.oraloncology.2017.11.023

    Article  PubMed  Google Scholar 

  28. de Graeff A, de Leeuw JR, Ros WJ, Hordijk GJ, Blijham GH, Winnubst JA (2000) Pretreatment factors predicting quality of life after treatment for head and neck cancer. Head Neck 22:398–407. https://doi.org/10.1002/1097-0347(200007)22:4%3c398::aid-hed14%3e3.0.co;2-v

    Article  PubMed  Google Scholar 

  29. Bjordal K, Hammerlid E, Ahlner-Elmqvist M, de Graeff A, Boysen M, Evensen JF, Biörklund A, de Leeuw JR, Fayers PM, Jannert M, Westin T, Kaasa S (1999) Quality of life in head and neck cancer patients: validation of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-H&N35. J Clin Oncol 17:1008–1019. https://doi.org/10.1200/JCO.1999.17.3.1008

    Article  CAS  PubMed  Google Scholar 

  30. Hammerlid E, Bjordal K, Ahlner-Elmqvist M, Jannert M, Kaasa S, Sullivan M, Westin T (1997) Prospective, longitudinal quality-of-life study of patients with head and neck cancer: a feasibility study including the EORTC QLQ-C30. Otolaryngol Head Neck Surg 116:666–673. https://doi.org/10.1016/S0194-59989770246-8

    Article  CAS  PubMed  Google Scholar 

  31. Chandu A, Sun KC, DeSilva RN, Smith AC (2005) The assessment of quality of life in patients who have undergone surgery for oral cancer: a preliminary report. J Oral Maxillofac Surg 63:1606–1612. https://doi.org/10.1016/j.joms.2005.07.012

    Article  PubMed  Google Scholar 

  32. Schliephake H, Jamil MU (2002) Prospective evaluation of quality of life after oncologic surgery for oral cancer. Int J Oral Maxillofac Surg 31:427–433. https://doi.org/10.1054/ijom.2001.0194

    Article  CAS  PubMed  Google Scholar 

  33. Flexen J, Ghazali N, Lowe D, Rogers SN (2012) Identifying appearance-related concerns in routine follow-up clinics following treatment for oral and oropharyngeal cancer. Br J Oral Maxillofac Surg 50:314–320. https://doi.org/10.1016/j.bjoms.2011.05.005

    Article  CAS  PubMed  Google Scholar 

  34. Vickery LE, Latchford G, Hewison J, Bellew M, Feber T (2003) The impact of head and neck cancer and facial disfigurement on the quality of life of patients and their partners. Head Neck 25:289–296. https://doi.org/10.1002/hed.10206

    Article  PubMed  Google Scholar 

  35. Llewellyn CD, Weinman J, McGurk M, Humphris G (2008) Can we predict which head and neck cancer survivors develop fears of recurrence? J Psychosom Res 65:525–532. https://doi.org/10.1016/j.jpsychores.2008.03.014

    Article  PubMed  Google Scholar 

  36. Sherman AC, Simonton S, Adams DC, Vural E, Hanna E (2000) Coping with head and neck cancer during different phases of treatment. Head Neck 22:787–793. https://doi.org/10.1002/1097-0347(200012)22:8%3c787::aid-hed7%3e3.0.co;2-r

    Article  CAS  PubMed  Google Scholar 

  37. Usta YY (2012) Importance of social support in cancer patients. Asian Pac J Cancer Prev 13:3569–3572. https://doi.org/10.7314/apjcp.2012.13.8.3569

    Article  PubMed  Google Scholar 

  38. Lehmann R, Denissen JJ, Allemand M, Penke L (2013) Age and gender differences in motivational manifestations of the Big Five from age 16 to 60. Dev Psychol 49:365–383. https://doi.org/10.1037/a0028277

    Article  PubMed  Google Scholar 

  39. Morton RP (2003) Studies in the quality of life of head and neck cancer patients: results of a two-year longitudinal study and a comparative cross-sectional cross-cultural survey. Laryngoscope 113:1091–1103. https://doi.org/10.1097/00005537-200307000-00001

    Article  PubMed  Google Scholar 

  40. Bussell VA, Naus MJ (2010) A longitudinal investigation of coping and posttraumatic growth in breast cancer survivors. J Psychosoc Oncol 28:61–78. https://doi.org/10.1080/07347330903438958

    Article  PubMed  Google Scholar 

  41. Rotter JB (1966) Generalized expectancies for internal versus external control of reinforcement. Psychol Monogr 80:1–28. https://doi.org/10.1037/h0092976

    Article  CAS  PubMed  Google Scholar 

  42. Rajandram RK, Jenewein J, McGrath C, Zwahlen RA (2011) Coping processes relevant to posttraumatic growth: an evidence-based review. Support Care Cancer 19:583–589. https://doi.org/10.1007/s00520-011-1105-0

    Article  PubMed  PubMed Central  Google Scholar 

  43. van Laarhoven HW, Schilderman J, Bleijenberg G, Donders R, Vissers KC, Verhagen CA, Prins JB (2011) Coping, quality of life, depression, and hopelessness in cancer patients in a curative and palliative, end-of-life care setting. Cancer Nurs 34:302–314. https://doi.org/10.1097/NCC.0b013e3181f9a040

    Article  PubMed  Google Scholar 

  44. Keeley B, Wright L, Condit CM (2009) Functions of health fatalism: fatalistic talk as face saving, uncertainty management, stress relief and sense making. Sociol Health Illn 31:734–747. https://doi.org/10.1111/j.1467-9566.2009.01164.x

    Article  PubMed  Google Scholar 

  45. Shimizu K, Nakaya N, Saito-Nakaya K, Akechi T, Ogawa A, Fujisawa D, Sone T, Yoshiuchi K, Goto K, Iwasaki M, Tsugane S, Uchitomi Y (2015) Personality traits and coping styles explain anxiety in lung cancer patients to a greater extent than other factors. Jpn J Clin Oncol 45:456–463. https://doi.org/10.1093/jjco/hyv024

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank the DÖSAK, all patients, and the participating clinics for oral and maxillofacial surgery: Basel, Berlin (Steglitz), Berlin (Virchow), Bochum, Bonn, Dortmund, Duisburg, Düsseldorf, Erfurt, Erlangen, Essen, Frankfurt, Freiburg, Greifswald, Halle, Hannover, Heidelberg, Homburg-Saar, Innsbruck, Kiel, Cologne, Krefeld, Linz, Lübeck, Mainz, Marburg, Munich (LMU), Münster, Osnabrück, Recklinghausen, Regensburg, Rostock, Saarbrücken, Siegen, Suhl, Ulm, Würzburg, and Zürich. We also thank Editage (www.editage.com) for English language editing.

Author information

Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany

    Philipp Jehn, Alexander-Nicolai Zeller, Fabian Matthias Eckstein, Nils-Claudius Gellrich, Fritjof Lentge, Simon Spalthoff & Philippe Korn

  2. Department of Prosthodontics; Preclinical Education and Dental Material Science, University Hospital Bonn, Welschnonnenstr. 17, 53111, Bonn, Germany

    Sabine Swantje Linsen

  3. Department of Oral, Craniomaxillofacial and Facial Plastic Surgery, University Hospital of Leipzig, Liebigstr. 12, Leipzig, 04103, Germany

    Michael-Tobias Neuhaus

  4. Department of Medical Psychology, Ruhr University of Bochum, Universitätsstr. 150, Building MA 0/145, 44780, Bochum, Germany

    Gertrud Krüskemper

Authors
  1. Philipp Jehn
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sabine Swantje Linsen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alexander-Nicolai Zeller
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Fabian Matthias Eckstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michael-Tobias Neuhaus
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nils-Claudius Gellrich
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Gertrud Krüskemper
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Fritjof Lentge
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Simon Spalthoff
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Philippe Korn
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Writing—original draft preparation: Philipp Jehn. Data analysis and investigation: Philipp Jehn, Sabine Swantje Linsen, Alexander-Nicolai Zeller, Fabian Matthias Eckstein, Michael-Tobias Neuhaus, Fritjof Lentge. Methodology: Nils-Claudius Gellrich, Gertrud Krüskemper, Simon Spalthoff, Philippe Korn. Creation of tables: Alexander-Nicolai Zeller, Fabian Matthias Eckstein, Michael-Tobias Neuhaus. Writing—review and editing: Philipp Jehn, Sabine Swantje Linsen, Fabian Matthias Eckstein, Fritjof Lentge, Simon Spalthoff. Conceptualization: Nils-Claudius Gellrich, Gertrud Krüskemper, Philippe Korn. Supervision: Nils-Claudius Gellrich, Philippe Korn. All authors have reviewed the manuscript and agreed to the submission.

Corresponding author

Correspondence to Philipp Jehn.

Ethics declarations

Ethics approval

All procedures performed in the study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Institutional Review Board of Ruhr University of Bochum. No specific approval number was assigned to this study.

Consent to participate

All participants in the DÖSAK Rehab study provided written informed consent to participate in this study and agreed to the scientific use of their data.

Consent for publication

All participants in the DÖSAK Rehab study provided written informed consent for publication of their data.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jehn, P., Linsen, S.S., Zeller, AN. et al. Gender-specific differences concerning psychosocial aspects and functional impairments that influence quality of life in oral cancer treatment. Support Care Cancer 30, 4905–4915 (2022). https://doi.org/10.1007/s00520-022-06907-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-022-06907-9

Keywords

Search

Navigation