scholarly journals Dysphagia and Its Impact on Quality of Life of Head and Neck Cancer Patients: Institution Based Cross sectional Study

Author(s):  
Tseganesh Asefa Yifru ◽  
Sezer Kisa ◽  
Negalegn Getahun Dinegde ◽  
Niguse Tadele Atnafu

Abstract Objective: Assessing swallowing function using symptom-specific questionnaires on head and neck cancer (HNC) patients and supporting impaired swallowing to improve quality of life (QoL) of patients is recommended in different studies. However, there is no data that shows the effect of dysphagia on quality of life of Ethiopian patients. Hence, this study assessed the effect of dysphagia on quality of life domains of the MD Anderson Dysphagia inventory (MDADI) among head and neck cancer patients.Results: The study sample consisted of mostly male (53.90%), employed (70.6%), single (57.80 %) and completed some level of formal education (66.60 %) with mean age of 42.58 years (SD ± 14.08 years) and medical expense for about 69.6% of patients was covered by the government. Most of the patients were suffering from advanced stage HNC (59.80%) and squamous cell carcinoma (62.70%) and the most prevalent tumor location was nasal cavity/ nasopharyngeal carcinoma (40.20%). The mean MDADI composite score was 53.29 (SD± 15.85). Being female, low income, suffering from laryngeal/ hypo pharyngeal cancer, suffering from advanced tumor and those undergoing a single modality therapy were key determinants of poor QoL related to swallowing problems in HNC patients.

Head & Neck ◽  
2019 ◽  
Vol 41 (7) ◽  
pp. 2197-2207 ◽  
Author(s):  
Leen Van den Steen ◽  
Dirk Van Gestel ◽  
Olivier Vanderveken ◽  
Jan Vanderwegen ◽  
Cathy Lazarus ◽  
...  

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Tseganesh Asefa Yifru ◽  
Sezer Kisa ◽  
Negalign Getahun Dinegde ◽  
Niguse Tadele Atnafu

Abstract Objective Impaired swallowing is a primary medical concern in head and neck cancer (HNC) patients. Swallowing therapy and supportive care to relieve swallowing problems among HNC patients are recommended. However, no data shows the effect of dysphagia on the quality of life (QoL) among Ethiopian patients. This cross-sectional study aimed to assess swallowing function and its impact on QoL. Results The sample included 102 HNC patients who visited oncology clinics at Tikur Anbessa Specialized Hospital. Majority were male (53.90%), employed (70.6%), single (57.80%), and completed some level of formal education (66.60%) with a mean age of 42.58 years (SD ± 14.08). More than half of the patients (69.6%) medical expenses were covered by the government. Most were suffering from advanced stage HNC (59.80%), squamous cell carcinoma (62.70%), and the most prevalent tumor location was nasopharynx (40.20%). The mean MDADI score was 53.29 (SD ± 15.85). Being female, low income, suffering from laryngeal cancer, advanced tumor, and undergoing a single modality therapy were crucial determinants of poor QoL related to swallowing problems. It is recommended to assess swallowing related QoL of patients using a validated tool and be included in treatment protocols.


2015 ◽  
Vol 01 (01) ◽  
pp. 037-043 ◽  
Author(s):  
Rajender Kumar ◽  
Hitesh Gupta ◽  
Keshavanand Konwar ◽  
Ritesh Sharma ◽  
Anil Anand ◽  
...  

Abstract Introduction: Dysphagia is a very common problem associated with head and neck cancer patients. Inspite of best of technologies like Intensity Modulated Radiotherapy (IMRT) or Image Guided Radiotherapy (IGRT), Dysphagia remains a major problem in locally advanced head and neck cancer patients. Materials and Methods: We randomized 50 head and neck cancer patients, including all sites and stages into two groups, 25 patients in each group. In Group-A dysphagia prevention exercises were done from the day of the onset of radiation therapy and continued till 6 months, while in Group-B no dysphagia interventions were given. We analyzed rate of dysphagia, aspiration rate and its impact on quality of life. We used M.D. Anderson Dysphagia Inventory (MDADI) which is a validated and reliable questionnaire designed specifically for evaluating impact of dysphagia on quality of life (QOL) in head and neck cancer patients. American Speech language Hearing Association (ASHA) scale was used for assessing swallowing function. Penetration Aspiration Scale (PAS) was used to assess aspiration during swallowing with the help of Fiberoptic Endoscopic Evaluation of Swallowing (FEES). Results: Quality of life was significantly better in dysphagia preventive exercise arm (group - A). There was significant improvement in the MDADI score, from the baseline to 6 months in exercise arm (14 versus 7.76, p= 0.017). Swallowing function score was also in favour of exercise arm (6.44 versus 5.8, p=0.002). Patients in exercise arm were able to swallow much better by the end of 6 months post radiotherapy. Risk of silent aspiration as evaluated by PAS score at the end of three months was 36% (Group A = 16%, Group B = 20%). At the end of six months, it improved to 24% (Group A = 8%, Group B = 16%). There was a trend towards lesser incidence of aspiration in exercise arm, although it was not statistically significant (p=0.21). Conclusion: Results from this study demonstrated that swallowing exercises, if administered from first week of chemo-radiation and continued till 6 months, results in significant improvement in swallowing function and quality of life. Use of FEES helps in detection of silent aspiration at an early stage and reduces aspiration related morbidities.


Author(s):  
Annette C. Zuydam ◽  
Simon N. Rogers ◽  
Kate Grayson ◽  
Clare F. Probert

Abstract Introduction Chemoradiotherapy treatment for head and neck cancer (HNC) can have a major impact on swallowing function and health-related quality of life.The use of outcome measures in early detection of patients with swallowing problems provides the opportunity for targeting speech and language therapy (SLT) interventions to aid adaption and promote better clinical outcomes. Objective The purpose of the present study was to assess relationships between four outcomes measures over time, in a cohort of HNC patients, treated by (chemo-)radiotherapy. Methods Data were collected at 3 months and 12 months, on 49 consecutive patients with primary squamous cell cancer of the oropharynx, nasopharynx or hypopharynx stage T1–4, N0–2b, M0 disease. Results Out of 49 eligible patients, 45 completed assessment at 3 months and 20 at 12 months. The 3-month outcomes gave a strong indication of performance at 1 year. There were several strong correlations found between measures. The strongest was between the 3-month Performance Status Scale for Head and Neck Cancer (PSSHN) and the 12-month PSSHN (rs = 0.761, n = 17), the 12-month PSSHN and the 12-month Functional Oral Intake Scale (FOIS) (rs = 0.823, n = 20), and the 12-month University of Washington Head and Neck Quality of Life (UWQoL) swallow and the 12-month Water Swallow Test (WST) capacity (rs = 0.759, n = 17). Conclusion The UW-QoL swallow item and WST are easy to incorporate into routine care and should be used as part of a standard assessment of swallow outcome. These measures can serve to help screen patients for dysfunction and focus allocation of resources for those who would benefit from more comprehensive assessment and intervention by SLT.


2017 ◽  
Vol 123 (1) ◽  
pp. 44-47 ◽  
Author(s):  
Luciana Lastrucci ◽  
Silvia Bertocci ◽  
Vittorio Bini ◽  
Simona Borghesi ◽  
Roberta De Majo ◽  
...  

Author(s):  
Frederic Ivan L. Ting ◽  
Aylmer Rex B. Hernandez ◽  
Reno Eufemon P. Cereno ◽  
Irisyl B. Orolfo-Real ◽  
Corazon A. Ngelangel

<p class="abstract"><strong><span lang="EN-US">Background: </span></strong>In the management of head and neck cancer (HNC), assessment of quality of life (QoL) is imperative because of the potentially debilitating effect of treatment toxicities. Currently, there are no published data assessing the QoL in Filipino HNC patients, thus this study.</p><p class="abstract"><strong><span lang="EN-US">Methods: </span></strong>This cross-sectional study utilized the University of the Philippines - Department of Health Quality of Life scale. Patients with head and neck cancers at the University of the Philippines - Philippine General Hospital from February to September 2019 were invited to participate.  </p><p class="abstract"><strong><span lang="EN-US">Results: </span></strong>A total of 418 patients were included in the study with a mean age of 42 years old (range 18 to 73 years old). In general, Filipino head and neck cancer patients had moderate QoL (mean score of 4.59±0.79). All of the QoL domains (physical, emotional, cognitive, and related functions) had a score of 3-5 (moderate), except for the social status domain which had a mean score of 5.51±0.83 (high). Among socio-demographic factors, patients who are employed and with additional funding sources on top of their income have better global QoL (p&lt;0.01). Clinically, patients with higher stages of disease, fungating tumors, post-laryngectomy, have a feeding tube, with a tracheostomy, and had chemotherapy have lower global QoL (p&lt;0.01).</p><p class="abstract"><strong><span lang="EN-US">Conclusions: </span></strong>Filipino patients with head and neck cancers have an overall moderate quality of life, with high scores in the social domain. Patients with higher tumor burdens and have been exposed to chemotherapy have lower QoL scores, while patients with financial stability and aid have better QoL scores.</p><p class="abstract"><span lang="EN-US"> </span></p>


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