Cancer Rehabilitation

Kline‐Quiroz, Cristina; Nori, Phalgun; Stubblefield, Michael D.

doi:10.1016/j.mcna.2019.10.004

Cited by 21 publications

(19 citation statements)

References 78 publications

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“…Cancer rehabilitation is widely recognized as an essential element of survivorship and utilizes interventions that can improve, maintain, restore, or compensate for dysfunction. 4,7,37,60,[72][73][74][75][76][77][78] Nevertheless, repeating PRO and functional measures for patients who attend this clinic over time would provide novel information regarding beneficial effects. In view of the preliminary effectiveness of this interdisciplinary clinic, we continue to employ this model at our institution; in addition, we are initiating a prospective multiyear study examining the efficacy of this interdisciplinary functional surveillance model.…”

Section: Discussionmentioning

confidence: 99%

Identification and management of late dysfunction in survivors of head and neck cancer: Implementation and outcomes of an interdisciplinary quality of life (IQOL) clinic

et al. 2021

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Background Identifying and treating late dysfunction in survivors of head and neck cancer (HNC) is important; however, an effective way to do so is not established. Methods A quality improvement initiative altering our HNC survivorship clinic to include surveillance by rehabilitation providers was undertaken. The nature of dysfunction identified, along with the number and type of referrals to ancillary/support services were collected and compared to baseline. Results The baseline, single‐provider, clinic evaluated 61 patients and referred 2 (3%) to ancillary/support services. Fifty‐seven patients were evaluated in the interdisciplinary clinic, with 36 (63%) referred to at least one ancillary/support service for new/progressive dysfunction. Of 59 referrals made, 22 (37%) were for dysphagia, 17(29%) were for neck/shoulder dysfunction, and 28 (47%) were attended by the patient. Conclusion Many HNC survivors exhibit late dysfunction appropriate for referral to ancillary/support services. A survivorship clinic including surveillance by rehabilitation specialists may optimize identification of dysfunction.

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Section: Discussionmentioning

confidence: 99%

Identification and management of late dysfunction in survivors of head and neck cancer: Implementation and outcomes of an interdisciplinary quality of life (IQOL) clinic

et al. 2021

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“…Consequently, an increase in the incidence of medium/long-term side effects has been seen, whose presentation depends on the location and extent of the disease, the presence of metastases, as well as the type of treatments such as chemotherapy, radiotherapy, hormone therapy, immunotherapy or surgery. 6,9–12 Of the registered side effects, pain is one of the most prevalent 4,10 and presents one of the biggest impacts on patients’ quality of life. 13 The estimated prevalence of chronic pain in cancer survivors can be as high as 40%, 1,6,8,12,14 depending on the primary tumour location and performed treatment.…”

Section: Introductionmentioning

confidence: 99%

“…However, the presence of pain may also be unrelated to cancer or its treatment. 4,10 According to the World Health Organization’s International Classification of Diseases, 11th Edition (ICD-11), 20 chronic cancer–related pain can be caused by primary tumour or by metastases, referred as chronic cancer pain, or by its treatment, the latter referred as chronic post-cancer treatment pain. This pain persists or recurs for at least 3 months and presents no other better explanation from another mechanism.…”

Section: Introductionmentioning

confidence: 99%

Chronic pain, functionality and quality of life in cancer survivors

Gonçalves

Veiga

Araújo

2020

British Journal of Pain

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The increasing number of cancer survivors associated to a longer average life-span after diagnosis of an oncological disease facilitates the observation of deleterious long-term effects of both oncological disease and its treatment. Among these effects, chronic pain emerges as one of the most prevalent and, with its onset, there is a decrease in these patients’ functionality and quality of life. The main focus in oncological disease treatment has been tumour eradication and average life expectancy extension after diagnosis, neglecting these deleterious long-term effects. This study aims at assessing the prevalence and characteristics of chronic pain in cancer survivors as well as pain interference in their quality of life and functionality. The study selected cancer survivors (n = 85) after dismissal from oncology service to assess the presence and characteristics of chronic pain, their health-related quality of life (HRQoL) and pain-related disability through a combination of different questionnaires. Chronic pain prevalence was 23.5%. In total, 85% of patients reported neuropathic pain descriptors and 45% presented diagnostic criteria for neuropathic pain. Of these patients, 45% were followed-up for pain surveillance and 35% underwent analgesic medication. There was a median pain disability index of 20.50 (14.50–35.00) and an average HRQoL of 0.5338 in chronic pain patients and 0.8872 in patients without pain. We found that chronic pain was the main negative predictor of HRQoL and was associated with decreased functionality. This study also concluded that these patients often were not offered the appropriate long-term medical follow-up. These findings highlight a need to raise awareness among health professionals to the importance of timely diagnosis and treatment of pain and its impact on HRQoL and functionality of long-term cancer survivors as well as the need to change clinical practice in order to improve healthcare provided to these patients.

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“…Approximately half of HNC patients undergoing CCRT experience compromised swallow function, 1,23 characterized by oropharyngeal muscular weakness, reduced BOT function, limited posterior pharyngeal wall contraction, tissue fibrosis, neuropathies, and salivary gland dysfunction. 4,24,25 Patients with advanced oropharyngeal cancer are particularly at risk, given the inherent necessity of including structures critical to swallowing within the radiation field. To date, there is no accepted "gold standard" therapy for the treatment of post-CCRT dysphagia.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal Effects of Base of Tongue Concurrent Chemoradiation Therapy in a Pre‐Clinical Model

et al. 2022

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Background/Objectives Base of tongue (BOT) dysfunction is common following oropharyngeal concurrent chemoradiation therapy (CCRT). We present a clinically relevant animal model quantifying the effects of CCRT on tongue strength and elasticity over time. Methods Fifty‐three male and 53 female Sprague–Dawley rats were randomized to control or experimental groups. Experimental animals received cisplatin, 5‐fluorouracil, and 5 fractions of 7 Gy directed to the BOT. Controls received no intervention. At 2 weeks, 5 months, or 10 months after CCRT, animals underwent non‐survival surgery to measure twitch and tetanic tongue strength, which were analyzed using multivariate linear mixed effects models. Tongue displacement, a surrogate for tongue elasticity, was also determined via stress–strain testing and analyzed via a multivariate linear mixed effects model. Results Reporting the combined results of both sexes, the estimated experimental group mean peak twitch forces became more divergent over time compared to controls, being 8.3% lower than controls at 2 weeks post‐CCRT, 15.7% lower at 5 months, and 31.6% lower at 10 months. Estimated experimental group mean peak tetanic forces followed a similar course and were 2.9% lower than controls at 2 weeks post CCRT, 20.7% lower at 5 months, and 27.0% lower at 10 months. Stress–strain testing did not find CCRT to have a significant effect on tongue displacement across experimental timepoints. Conclusions This study demonstrates an increasing difference in tongue strength over time between controls and animals exposed to CCRT. Tongue elasticity was not significantly affected by CCRT, suggesting that changes in strength may not be caused by fibrosis. Level of Evidence NA Laryngoscope, 133:1455–1461, 2023

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Cancer Rehabilitation

Cited by 21 publications

References 78 publications

Identification and management of late dysfunction in survivors of head and neck cancer: Implementation and outcomes of an interdisciplinary quality of life (IQOL) clinic

Identification and management of late dysfunction in survivors of head and neck cancer: Implementation and outcomes of an interdisciplinary quality of life (IQOL) clinic

Chronic pain, functionality and quality of life in cancer survivors

Longitudinal Effects of Base of Tongue Concurrent Chemoradiation Therapy in a Pre‐Clinical Model

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