Dealing with the Vicissitudes and Abject Consequences of Head and Neck Cancer: A Vital Role for Psycho-Oncology

Abstract

Patients with head and neck cancer face important life-altering effects in appearance and function, affecting distress and quality of life and requiring the involvement of a multidisciplinary team. Psycho-oncology makes an important contribution to the field, as head and neck cancers carry a huge adaptational toll. To illustrate the value of this discipline, we report two cases of patients with advanced head and neck cancer for which the treatment-related body changes were of major significance. A commentary by the treating surgeons and psycho-oncologists precedes a general discussion about the clinical management of such patients. The article outlines strategies to address health literacy, doctor–patient communication, treatment decision-making, and emotional distress; placing the person at the center of oncological care. It calls for the broad application of principles of psychological first aid by healthcare professionals in oncology.

Efficacy of a Brief Cognitive Behavioral Therapy for Head and Neck Cancer Survivors with Body Image Distress: Secondary Outcomes from the BRIGHT Pilot Randomized Clinical Trial

“… 12 Although common among all HNC survivors, shame and stigma-related concerns are especially prevalent among HNC survivors with disfigurement and other visible differences. 6 Patients with facial disfigurement and BID limit social interaction and participation in social functions. 44 , 45 BID among HNC survivors is also associated with unemployment.…”

“… 4 , 5 BID results in devastating psychosocial morbidity and functional impairment. 6 In fact, HNC survivors with BID experience a 6-fold increase in moderate-severe depressive symptoms, an 8-fold increase in moderate-severe anxiety symptoms, and increased rates of social isolation and feelings of stigmatization. 4 , 7 - 13 As a result, BID among HNC survivors is associated with reduced quality of life (QOL) and may contribute to the two-fold higher rate of suicide mortality relative to other cancer survivors.…”