The nature and extent of body image concerns among surgically treated patients with head and neck cancer

Abstract

Objective The purpose of this study was to describe body image concerns for surgically treated patients with head and neck cancer and evaluate the relationship between body image concerns and quality of life outcomes. Methods Data were obtained from 280 patients undergoing surgical treatment for head and neck cancer. We used a cross-sectional design and obtained data from individuals at different time points relative to initiation of surgical treatment. Participants completed the Body Image Scale, the Functional Assessment of Cancer Therapy scale – Head and Neck version, and a survey designed for this study to evaluate disease-specific body image issues, satisfaction with care regarding body image issues, and interest in psychosocial intervention. Results Body image concerns were prevalent in the majority of participants with 75% acknowledging concerns or embarrassment about one or more types of bodily changes at some point during treatment. Significant associations were found between body image concerns and all major domains of quality of life. Age, gender, cancer type, time since surgery, and body image variables were significantly associated with psychosocial outcomes. A clear subset of participants expressed dissatisfaction with care received about body image issues and/or indicated they would have liked additional resources to help them cope with body image changes. Conclusions These data provide useful information to document wide-ranging body image difficulties for this population and provide important targets for the development of relevant psychosocial interventions.

Traditional and Rasch psychometric analyses of the Quality of Life in Adult Cancer Survivors (QLACS) questionnaire in shorter-term cancer survivors 15months post-diagnosis

“…Indeed, non-consenters to the ePOCS study (in which the QLACS data were collected) were more socioeconomically deprived than those who participated [37], and participants in the Avis development studies were relatively well-educated with low levels of unemployment. The appearance concerns and social avoidance floor effects may reflect the fact that this study and the development work included few or no patients with some of the diagnoses which may impact greatest on these domains, such as head and neck and bladder malignancies [58,59]. Although Avis et al [11] found appearance and social floor effects overall, the highest scores in (one or both of) these domains were obtained by the small proportion of head and neck and bladder patients in the sample.…”

Assessing the body image: relevance, application and instruments for oncological settings

“…Appearance changes (hair loss, edema due to inadequate lymphatic drainage, cortisone-induced swelling) can cause embarrassment, influence the choice of clothes, or even cause patients to avoid any interpersonal contact. Surgery-induced changes, involving both visible and invisible organs, often trigger a sense of incompleteness [25,26], which has a critical impact on many psychological variables [12,[27][28][29]. In addition, surgery often involves functional disorders (i.e.…”

Distress from changes in physical appearance and support through information provision in male cancer patients

“…In addition, to the best of our knowledge, no study has examined the effects of physical appearance changes that cannot be hidden from others with the exception of one study on physical appearance changes in head and neck cancer patients (5,9). This may be because problems in physical appearance are not emphasized as much in men as in women.…”

“…Such problems are usually reported in relation to body image and quality of life (3-5) using a sample of patients with a specific disease such as breast cancer (6,7) or head and neck cancer (5,(8)(9)(10). However, quantitative studies with a focus on appearance issues in cancer patients are limited (11).…”