A qualitative study of head and neck cancer

Abstract

The findings presented contribute to quality of life (QOL) research by highlighting the significance of factors affecting the communication by patients with primary-stage squamous cell carcinoma of the head and neck cancer (SCCHN) of their experiences of suffering after treatment to their clinicians. Qualitative research methodology based on open-ended interviews with 18 survivors of American Joint Committee on Cancer primary stage I and II SCCHN were used. The interviews were transcribed verbatim and thematically analyzed. Three important themes emerged: (1). a diminished self (2). fears of addiction, and (3). hopelessness and the loss of meaning in life after SCCHN. The findings indicate that SCCHN patients under-report their experiences mainly due to fear. As a consequence, and perhaps due to a failure on the part of clinicians and patients to adequately address such fears, SCCHN patients may experience greater psychological morbidity, becoming increasingly fatalistic about biomedicine's ability to restore them to health after cancer despite being "cured", or to relieve related symptoms. This qualitative study provides a perspective as to why such under-reporting occurs, thereby potentially enhancing clinician-patient communication and the QOL of SCCHN patients who present with curable disease.

Managing Chronic Pain in Cancer Survivorship: Communication Challenges and Opportunities as Described by Cancer Survivors

“…-81 year old, female, breast cancer survivor cancer survivors and patients receiving cancer treatment have reported similar feelings of perceived injustice and painrelated distress resulting in a lost sense of identity, reduced quality of life, and persistent worry about the future, even after becoming disease free. 10,18,30,31 Similar to another study, 8 participants in our study reported sometimes feeling dismissed by providers when presenting with pain. They described inadequate pain assessment and some participants described minimizing their own pain for fear of being dismissed or seen as complaining to providers who may have saved their lives.…”

“…One prior qualitative study reported a similar finding, where patients on active cancer treatment feared being fully forthcoming with their providers about their pain, potentially leading to incomplete pain management. 10 Since providers may not know that their patients have persistent or significant pain after cancer treatment, they may not prioritize its assessment during survivorship encounters. Some participants in our study described the use of the 0-10 pain score as a vital sign to assess pain but felt it did not fully capture the multidimensional aspects of their chronic pain.…”

“…8 There are several factors that may contribute to incompletely managed chronic pain in general. These include concerns about opioid addiction (particularly in the context of the ongoing overdose crisis), [9][10][11] limited access to multimodal pain treatment, 12 and limited provider training in managing chronic pain. [13][14][15] Patients may also under-report chronic pain to their providers during clinical encounters.…”

“…[13][14][15] Patients may also under-report chronic pain to their providers during clinical encounters. 10 These challenges may be exacerbated in the cancer survivorship context, where care is often fragmented. 16 In addition, providers may underappreciate the prevalence of chronic pain following completion of cancer treatment and may feel that managing opioids or other narcotics is outside their expertise.…”

TAK1 mRNA Expression in the Tumor Tissue of Locally Advanced Head and Neck Cancer Patients

“…At least 90% are diagnosed as squamous cell carcinomas (Moore et al 2004). Patients with locally advanced HNSCC enclose a bad prognostic group with less than 30% of surviving patients five years since finishing treatment, despite the improvements in surgery and new therapeutic approaches.…”