Mental health comorbidities and cost/utilization outcomes in head and neck cancer patients

2019 ◽  
Vol 37 (3) ◽  
pp. 301-318
Author(s):  
Diana D. Jeffery ◽  
Lcdr Art Ambrosio ◽  
Laura Hopkins ◽  
Harry B. Burke
Keyword(s):  
Mental Health ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Cost Utilization ◽  
Health Comorbidities

Addressing distress in head and neck cancer patients: A quality improvement project.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 43-43
Author(s):  
Natalie Riblet ◽  
Karen Skalla ◽  
Alison Peterson ◽  
Auden McClure ◽  
Karen Homa ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Head And Neck Cancer ◽  
Quality Improvement ◽  
Mental Health Care ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Medical Oncology ◽  
Senior Leadership

43 Background: To better address the emotional needs of cancer patients by improving mental health care in Head and Neck Cancer (HNC) Medical oncology at Norris Cotton Cancer Center, Lebanon, NH, through implementing an evidence-based process for identifying and managing psychological distress. Methods: Using quality improvement methods, mental health care in HNC Medical Oncology was evaluated and revised November 2010 through April 2012. In January 2011, a two-component intervention was put into routine care including 1) the validated National Comprehensive Cancer Network (NCCN) distress thermometer (DT) and 2) a treatment decision algorithm. A licensed nursing assistant administered the DT and providers reviewed results as part of the clinical exam. Heightened distress was defined as a score of ≥ 4. Screening processes were improved through Plan-Do-Study-Act (PDSA) cycles. Results: Prior to January 2011, identification of distress was based on provider’s clinical assessment. Of 104 patients seen between November 2010 and January 2011, 25% (26) were diagnosed with psychological problems. Cause-effect diagraming suggested that lack of a formalized process for distress assessment contributed to missed diagnoses. Providers were unfamiliar with mental health resources. As reported in Psycho-Oncology 21(Suppl. 1): 51(2012) after implementing process changes, bi-weekly distress screening rates rose from 0% to 38% between January and July 2011. With additional PDSA cycles, these rates increased to 74% between October 2011 and April 2012. Similar to proposed benchmarks, 84% (47) of newly diagnosed patients (56) were assessed for distress. Furthermore, of 138 unique patients seen, 71% (98) were screened for distress and 47% (46) of these had heightened distress. Providers addressed the needs of all those identified. Improvement was attributed to the empowerment of staff and participation of senior leadership. Barriers included a heavy reliance on the presence of trained staff. Conclusions: Quality improvement methods can be applied to the cancer setting in order to create systems of care, which more reliably identify and address distress. Teams, however, must be invested in the work and receive support from senior leadership.

scholarly journals Is RAS the Link Between COVID-19 and Increased Stress in Head and Neck Cancer Patients?

2021 ◽  
Vol 9 ◽  
Author(s):  
Anem Iftikhar ◽  
Mohammad Islam ◽  
Simon Shepherd ◽  
Sarah Jones ◽  
Ian Ellis
Keyword(s):  
Mental Health ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Renin Angiotensin System ◽  
Negative Effects ◽  
Angiotensin Converting Enzyme 2 ◽  
Global Pandemic ◽  
Stress Burden

The COVID-19 pandemic emerged as a largely unexplained outbreak of pneumonia cases, in Wuhan City, China and rapidly spread across the world. By 11th March 2020, WHO declared it as a global pandemic. The resulting restrictions, to contain its spread, demanded a momentous change in the lifestyle of the general population as well as cancer patients. This augmented negative effects on the mental health of patients with head and neck cancer (HNC), who already battle with the stress of cancer diagnosis and treatment. The causative agent of COVID-19, SARS-CoV2, gains entry through the Angiotensin converting enzyme 2 (ACE2) receptor, which is a component of the Renin Angiotensin System (RAS). RAS has been shown to influence cancer and stress such that it can have progressive and suppressive effects on both. This review provides an overview of SARS-CoV2, looks at how the RAS provides a mechanistic link between stress, cancer and COVID-19 and the probable activation of the RAS axis that increase stress (anxiogenic) and tumor progression (tumorigenic), when ACE2 is hijacked by SARS-CoV2. The mental health crises brought about by this pandemic have been highlighted in many studies. The emerging links between cancer and stress make it more important than ever before to assess the stress burden of cancer patients and expand the strategies for its management.

Acute and Chronic Depressive Disorders in Head and Neck Cancer Patients

2020 ◽  
pp. 27-33
Author(s):  
Leonid Bardenshtein ◽  
Valeriy Leontiev ◽  
Aleksey Drobyshev ◽  
Aleksandr Tsimbalistov ◽  
Nikolay Malginov ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Depressive Disorders ◽  
Clinical Symptoms ◽  
Depression Prevalence ◽  
Patient Category ◽  
Antipsychotic Drug Treatment ◽  
Timely Administration

The review focuses on depressive disorders in cancer patients. The article summarizes the findings of domestic and foreign studies on depression prevalence, clinical symptoms and treatment in head and neck cancer patients. Early detection of affective disorder and timely administration of antipsychotic drug treatment is shown to be important for this patient category.

NUTRITION ASSESSMENT IN HEAD AND NECK CANCER PATIENTS PRE and POST CHEMORADIOTHERAPY.

2019 ◽  
Vol 2 (2) ◽  
Author(s):  
Piyush Kumar ◽  
Bhavya P Pateneedi ◽  
Dharam P Singh ◽  
Arvind K Chauhan
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Nutritional Risk ◽  
Total Leukocyte Count ◽  
Risk Indicator ◽  
Anthropometric Parameters ◽  
Skin Fold Thickness ◽  
Before And After

INTRODUCTION: Head and neck cancer patients are frequently malnourished at the time of diagnosis and prior to the beginning of treatment. Deterioration of the nutritional status results in an increase in chemo radiotherapy related toxicity and this may increase the prolonged treatment time, which has been associated with poor clinical outcome. The present study aims to do nutritional assessment before and after chemo radiotherapy in head and neck cancer patients. MATERIAL AND METHODS: The present study was undertaken at the Department of Radiation Oncology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly. In this study, 50 patients of Head and neck tumours were enrolled and their nutrition was assessed before and after chemoradiotherapy. Nutrition assessment was done using different laboratory parameters like haemoglobin, total leukocyte count, blood urea, serum creatinine and serum bilirubin. Anthropometric parameters used are Body mass index, Skin fold thickness, and Mid-arm circumference. Nutritional risk indicator and PG-SGA score is measured before and after chemoradiotherapy. All the parameters were assessed and analysed using different statistical tests- Chi-square test, Fisher Exact test and paired t test.RESULTS: Haemoglobin decrease was statistically significant during treatment (p less than 0.001) and the decrease in total leukocyte count during treatment was showing trend towards significance (p value-0.056). There was deterioration in other parameters like blood urea, serum creatinine and serum bilirubin but was not statistically significant. Anthropometric parameters- Body mass index, mid-arm circumference and skin fold thickness and percent body fat showed a significant change (p less than 0.00001). Nutritional risk indicator and PG-SGA class has decreased for majority of patients during treatment, the change is statistically significant (p less than 0.00001 and p=0.0251) respectively.CONCLUSION: The nutrition has important role to play in the management of head and neck cancers by chemo radiotherapy. It helps to reduce the complications and improve the tolerance of chemo radiotherapy, thus avoiding treatment breaks which may lead to failure of treatment.

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