The Post-treatment Impact on Quality of Life, Body Image, and Occupational Concerns among Head and Neck Cancer Patients

Abstract

Introduction: Head and Neck Cancer (HNC) is the sixth most common cancer across globe, more common in Asian countries. HNC patients are at a significant risk of developing body image and functionality-related concerns, which in turn impact their overall Quality of Life (QoL). This study provides factual insights into the QoL of Indian male HNC patients three months after completing their treatment. Aim: To assess patients’ perceptions of self and overall QoL in context of body image and occupation. Materials and Methods: This mixed-method study included 32 male HNC patients and was conducted at a tertiary cancer centre in Ahmedabad, India, from March 2022 to April 2022. Patients who underwent surgery, with or without radiation therapy or chemotherapy, were included. The Functional Assessment of Chronic Illness Therapy-Head and Neck version (FACT-HN) and the Body Image Scale (BIS) were used as assessment tools. Qualitative responses were also recorded by the interviewer. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 23.0, including both parametric and non parametric tests. Results: The mean age was 45.50 years. The overall QoL of the HNC population was found to be positive, with a mean score of 117.88±12.72. Higher scores indicated better QoL (total score range: 0-148). Similar trends were observed across all domains. Analysis of variance was conducted for three groups: ‘3-11 months’, ‘1-3 years’, and ‘more than three years’. A significant difference in mean HNC scores between these groups (p-value=0.004) was observed, with ‘3-12 months’ (mean=108) and ‘more than three years’ (mean=124.6) showing notable differences. QoL between these two groups was compared using the Kruskal-Wallis test, revealing significant differences in their physical, social, and HNC-specific index (HNCS). Approximately 43% of patients reported returning to work within 3-4 months post-treatment, while 46% experienced reduced work hours due to concerns related to functionality and appearance. Conclusion: This data highlights the subjective impact of physical, social, and head and neck-specific QoL issues on patients, particularly in the immediate post-treatment phase, which may persist for upto three years in some cases. Over time, patients’ overall QoL improves post-treatment.

Keywords

• follow-up study
• head and neck surgery
• occupation.