Return to work in head and neck cancer survivors: a systematic review

Morales, Claudia Zecena; Lisy, Karolina; McDowell, Lachlan; Piper, Amanda J.; Jefford, Michael

doi:10.1007/s11764-022-01298-6

Cited by 10 publications

(13 citation statements)

References 79 publications

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“…The present study's results showed that working patients were less likely to receive postoperative adjuvant therapy which had a strong impact on HRQOL in univariate and multivariate analyses and affected working status. This nding is consistent with previous studies [11,15]. A possible reason for this is that radiotherapy and chemotherapy are administered in combination with surgery depending on the progression of HNC.…”

Section: Discussionsupporting

confidence: 93%

“…Similar results were indicated in a study investigating the association between functional dysfunction and working in patients with oral cancer [14]. In contrast, some previous studies reported that patients are anxious to work after treatment due to physical dysfunction, such as dysphasia and vocal impairment [4,11,15,16]. Therefore, healthcare providers should understand patients' physical distress to work and provide appropriate information such as a medical social worker and rehabilitation for physical and functional training.…”

Section: Discussionsupporting

confidence: 62%

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The impact of working on health-related quality of life in patients with head and neck cancers: a cross-sectional study

Takahashi,

Hirooka,

Sasaki

et al. 2023

Preprint

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Purpose: This study aimed to examine the impact of working on health-related quality of life (HRQOL) in patients with head and neck cancer (HNC) after surgery. Methods: Eighty outpatients with HNC were assessed using working status and the Functional Assessment of Cancer Therapy-Head and Neck version 4 (FACT-H&N). T-test/one-way analysis of variance were used to describe the mean FACT-H&N score and categorical variables. Univariate and multiple regression analyses were performed to determine the contribution of working on HRQOL. Results: The mean age was 58.7 ± 11.9 years, 63.8% were male, and the mean time since surgery was 12.3 ± 6.3 months. In the univariate analysis, working patients were younger (p = 0.019), had smaller T classification (p = 0.016), and were less likely to undergo adjuvant therapy (p = 0.007) and reconstruction (p = 0.003). Multiple regression analysis showed that working was positively associated with FACT-H&N (B = 10.81; p = 0.021). Conclusions: Working after HNC surgery may improve patients’ well-being, both functionally and physically. Moreover, management of treatment side effects and provision of rehabilitation to enable patients to work are required to achieve possible better HRQOL in patients with HNC. Therefore, healthcare professionals should deliver appropriate information and support patients to work.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 62%

The impact of working on health-related quality of life in patients with head and neck cancers: a cross-sectional study

Takahashi,

Hirooka,

Sasaki

et al. 2023

Preprint

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“…The importance of screening for psychosocial problems is generally accepted because of the high prevalence of e.g. depression and anxiety [ 25 ], and problems in the social domain like financial toxicity [ 26 , 27 ] and problems with return to work [ 28 ] in people with HNC. However, at the same time, high level evidence on how to solve these problems is still scarce [ 29 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

Organization of head and neck cancer rehabilitation care: a national survey among healthcare professionals in Dutch head and neck cancer centers

Passchier,

Beck,

Stuiver

et al. 2024

Eur Arch Otorhinolaryngol

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Purpose Head and neck cancer (HNC) treatment often leads to physical and psychosocial impairments. Rehabilitation can overcome these limitations and improve quality of life. The aim of this study is to obtain an overview of rehabilitation care for HNC, and to investigate factors influencing rehabilitation provision, in Dutch HNC centers, and to some extent compare it to other countries. Methods An online survey, covering five themes: organizational structure; rehabilitation interventions; financing; barriers and facilitators; satisfaction and future improvements, among HNC healthcare- and financial professionals of Dutch HNC centers. Results Most centers (86%) applied some type of rehabilitation care, with variations in organizational structure. A speech language therapist, physiotherapist and dietitian were available in all centers, but other rehabilitation healthcare professionals in less than 60%. Facilitators for providing rehabilitation services included availability of a contact person, and positive attitude, motivation, and expertise of healthcare professionals. Barriers were lack of reimbursement, and patient related barriers including comorbidity, travel (time), low health literacy, limited financial capacity, and poor motivation. Conclusion Although all HNC centers included offer rehabilitation services, there is substantial practice variation, both nationally and internationally. Factors influencing rehabilitation are related to the motivation and expertise of the treatment team, but also to reimbursement aspects and patient related factors. More research is needed to investigate the extent to which practice variation impacts individual patient outcomes and how to integrate HNC rehabilitation into routine clinical pathways.

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“…Given the increasing number of cancer survivors, there has been growing interest in elucidating the factors that promote and impede the RTW process. A systematic review conducted by Morales et al [ 26 ] addressed different clinical, physical, psychological, emotional, and social factors as well as employment- and work-related factors that could facilitate the RTW process in patients treated for HNC. Managing RTW is a multifaceted process in which nutrition is among the crucial aspects.…”

Section: Discussionmentioning

confidence: 99%

“…Due to patient travelling logistics in relation to the BIA assessments, the time point for assessment could vary during the day and it was not possible to secure a fasting morning measurement for all patients. Furthermore, the RTW process is complex and multifaceted [ 26 ]. The tumour site, treatment type, HRQoL, appearance, and employment factors are crucial for the RTW process [ 17 , 45 , 46 ].…”

Section: Discussionmentioning

confidence: 99%

Mapping the impact of malnutrition as defined by the Global Leadership Initiative on Malnutrition and nutrition impact symptoms on the possibility of returning to work after treatment for head and neck cancer

Einarsson,

Bokström,

Laurell

et al. 2023

Support Care Cancer

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Purpose This study aimed to investigate whether malnutrition or nutrition impact symptoms (NIS) affect the possibility of returning to work after treatment for head and neck cancer. Methods Patients of working age with head and neck cancer were followed up from treatment initiation to 3 months (n = 238), 1 year (n = 182), and 2 years (n = 130) after treatment completion. The observed decrease in the number of patients over time was due to retirement, lack of follow-up, or death. Returning to work was dichotomised as yes or no. Malnutrition was diagnosed 7 weeks after treatment initiation using the Global Leadership Initiative on Malnutrition (GLIM) criteria. This time-point corresponds to the end of chemoradiotherapy or radiotherapy (with or without prior surgery), except for patients who underwent exclusive surgery. NIS were scored on a Likert scale (1–5) at each follow-up using the Head and Neck Patient Symptom Checklist© (HNSC©). Nonparametric tests were used to analyse the ability of patients with/without malnutrition and high/low NIS scores to return to work. Results At 3 months, 1 year, and 2 years after treatment completion, 135/238 (56.7%), 49/182 (26.9%), and 23/130 (17.7%) patients had not returned to work. Patients with malnutrition at 7 weeks after treatment initiation were more likely to not return to work at 3 months than those without malnutrition, 70.5% compared to 47.1% (p < 0.001). At all three follow-up time-points, patients reporting high scores for a number of NIS had more often not returned to work, with this pattern being most distinct at 2 years. Conclusion Malnutrition according to the GLIM criteria at 7 weeks after treatment initiation and NIS assessed by the HNSC© at subsequent follow-ups were predictors of the return-to-work process after treatment for up to 2 years. Trial registration number ClinicalTrials.gov NCT03343236 (date of registration 17/11/2017).

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Return to work in head and neck cancer survivors: a systematic review

Cited by 10 publications

References 79 publications

The impact of working on health-related quality of life in patients with head and neck cancers: a cross-sectional study

The impact of working on health-related quality of life in patients with head and neck cancers: a cross-sectional study

Organization of head and neck cancer rehabilitation care: a national survey among healthcare professionals in Dutch head and neck cancer centers

Mapping the impact of malnutrition as defined by the Global Leadership Initiative on Malnutrition and nutrition impact symptoms on the possibility of returning to work after treatment for head and neck cancer

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