Advance Directives in Patients With Head and Neck Cancer - Status Quo and Factors Influencing Their Creation

Abstract Background: Advance Care Planning (ACP) including living wills (LWs) and durable powers of attorney for healthcare (DPAHCs) is a highly relevant topic aiming to increase patient autonomy and reduce medical overtreatment. Data from patients with head and neck cancer are not currently available. Methods: In this single center cross-sectional study, we evaluated patients during their regular follow-up consultations at Germany’s largest tertiary referral center for head and neck cancer, regarding the frequency, characteristics, and influencing factors for the creation of advance directives (ADs) using a validated questionnaire tailored to our cohort. The advance directives included living wills, durable powers of attorney for healthcare, and combined documents (CDs). Results: Four hundred and forty-six patients were surveyed from 07/01/2019 to 12/31/2019 (response rate=65.9%). The mean age was 62.4 years (SD 11.9), 26.9% were women (n=120). 46.4% of patients (n=207) reported having authored at least one advance directive. These documents included 16 durable powers of attorney for healthcare (3.6%), 75 living wills (16.8%), and 116 combined documents (26.0%). In multinominal regression analysis, older age (OR≤0.231, 95% CI 0.097-0.548; p<0.001), regular medication (OR=1.862, 95% CI 1.048-3.308; p=0.034), and the marital status (“married”: OR=2.395, 95% CI 1.074-5.337; p=0.033; and “permanent partnership”: OR=4.526, 95% CI 1.100-18.625; p=0.036) emerged as significant factors increasing the likelihood of having an advance directive. In contrast, the stage of disease, the therapeutic regimen, the ECOG status, and the time from initial diagnosis did not correlate with the presence of any type of advance directive. Conclusion: Less than half of head and neck cancer patients had created an advance directive. Older and comorbid patients who were married or in a permanent partnership had a higher likelihood of having an advance directive. This is the first study investigating the current situation in head and neck oncology and providing evidence to identify a patient population in need of appropriate support.

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Patterns of stress coping and depression among patients with head and neck cancer: A Japanese cross-sectional study

Psycho-Oncology ◽

10.1002/pon.4549 ◽

2017 ◽

Vol 27 (2) ◽

pp. 556-562 ◽

Cited By ~ 3

Author(s):

Kanako Ichikura ◽

Aya Yamashita ◽

Taro Sugimoto ◽

Seiji Kishimoto ◽

Eisuke Matsushima

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Cross Sectional Study ◽

Stress Coping ◽

Sectional Study ◽

Cross Sectional

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Subjective and objective appearance of head and neck cancer patients following microsurgical reconstruction and associated quality of life─A cross-sectional study

Journal of Cranio-Maxillofacial Surgery ◽

10.1016/j.jcms.2018.05.024 ◽

2018 ◽

Vol 46 (8) ◽

pp. 1275-1284 ◽

Cited By ~ 5

Author(s):

Katinka Kansy ◽

Jürgen Hoffmann ◽

Obada Alhalabi ◽

Nicole Mistele ◽

Kolja Freier ◽

...

Keyword(s):

Quality Of Life ◽

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Microsurgical Reconstruction

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Cancer Cachexia Affects Patients with Head and Neck Cancer in All Stages of Disease: A Prospective Cross-Sectional Study

Nutrition and Cancer ◽

10.1080/01635581.2020.1869792 ◽

2021 ◽

pp. 1-8

Author(s):

Obed Solís-Martínez ◽

Karolina Álvarez-Altamirano ◽

Diana Cardenas ◽

Yanelly Trujillo-Cabrera ◽

Vanessa Fuchs-Tarlovsky

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Cancer Cachexia ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

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Compared characteristics of current vs. past smokers at the time of diagnosis of a first-time lung or head and neck cancer: a cross-sectional study

BMC Cancer ◽

10.1186/s12885-018-4253-5 ◽

2018 ◽

Vol 18 (1) ◽

Author(s):

Corinne Vannimenus ◽

◽

Hélène Bricout ◽

Olivier Le Rouzic ◽

François Mouawad ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

First Time

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Quality of life among head and neck cancer treated patients in South India: A cross-sectional study

Journal of Oral Biology and Craniofacial Research ◽

10.1016/j.jobcr.2021.02.002 ◽

2021 ◽

Vol 11 (2) ◽

pp. 215-218

Author(s):

Manali Deb Barma ◽

Meignana Arumugham Indiran ◽

Pradeep Kumar R ◽

Arthi Balasubramaniam ◽

M.P Santhosh Kumar

Keyword(s):

Quality Of Life ◽

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

South India ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

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Assessment of hospital anxiety and depression in newly diagnosed head and neck cancer patients in cancer institutes — A cross-sectional study

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11i4.3971 ◽

2020 ◽

Vol 11 (4) ◽

pp. 7811-7816

Author(s):

Sushanthi S ◽

Meignana Arumugham Indiran ◽

Pradeep Kumar Rathinavelu ◽

Arthi Balasubramaniam

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Cross Sectional Study ◽

Anxiety And Depression ◽

Newly Diagnosed ◽

Sectional Study ◽

Hospital Anxiety ◽

Cross Sectional

Individuals often encounter psychological distress after a diagnosis of cancer, especially head and neck cancer (HNC). Worries regarding restricted functions, facial disfigurement, waiting time for investigation and duration of hospital stay for treatment make them feel awful. Often this feeling goes unnoticed and is underestimated. We aimed to assess the prevalence of the dreadful feeling in terms of anxiety and depression in newly diagnosed head and neck cancer patients. A cross-sectional study was conducted in two cancer-treating institutions in South India. About 357 freshly diagnosed HNC patients participated in the study. Pre-validated Hospital Anxiety and Depression Scale (HADS) was used to assess the anxiety and depression levels. Descriptive statistics was done to report socio-demographic, clinical variables and mean scores. Independent t-test and correlation test were done for comparison and association, respectively. Mean depression score for males and females was 11.481, 11.865, respectively. Mean anxiety score for males was 11.708 and 11.792 for females. There was a strong positive correlation between depression and anxiety score (0.864) among patients. There was no statistically significant difference in the mean anxiety and depression scores among gender, socioeconomic status, marital status and cancer stages (p>0.05). Newly diagnosed HNC patients had an abnormal level of anxiety and depression, which needs special attention and care during treatment for a better outcome.

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A Cross Sectional Study On The Quality Of Life After Ablative Surgery Of Head And Neck Cancer In a Caucasian Population

Annals of Dentistry ◽

10.22452/adum.vol9no1.1 ◽

2002 ◽

Vol 9 (1) ◽

pp. 1-6

Author(s):

K.Y. Dong ◽

M.S. Chan ◽

S.T. Ong

Keyword(s):

Quality Of Life ◽

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Cross Sectional Study ◽

Caucasian Population ◽

Sectional Study ◽

Cross Sectional ◽

Ablative Surgery

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Multicenter Assessment of Antibiotic Prophylaxis Spectrum on Surgical Infections in Head and Neck Cancer Microvascular Reconstruction

Otolaryngology ◽

10.1177/0194599818756299 ◽

2018 ◽

Vol 159 (1) ◽

pp. 59-67 ◽

Cited By ~ 7

Author(s):

Michael P. Veve ◽

Joshua B. Greene ◽

Amy M. Williams ◽

Susan L. Davis ◽

Nina Lu ◽

...

Keyword(s):

Risk Factors ◽

Head And Neck Cancer ◽

Antibiotic Prophylaxis ◽

Head And Neck ◽

Neck Cancer ◽

Tertiary Care ◽

Surgical Site Infections ◽

Cross Sectional Study ◽

Microvascular Reconstruction ◽

Cross Sectional

Objective To characterize and identify risk factors for 30-day surgical site infections (SSIs) in patients with head and neck cancer who underwent microvascular reconstruction. Study Design Cross-sectional study with nested case-control design. Setting Nine American tertiary care centers. Subjects and Methods Hospitalized patients were included if they underwent head and neck cancer microvascular reconstruction from January 2003 to March 2016. Cases were defined as patients who developed 30-day SSI; controls were patients without SSI at 30 days. Postoperative antibiotic prophylaxis (POABP) regimens were categorized by Gram-negative (GN) spectrum: no GN coverage, enteric GN coverage, and enteric with antipseudomonal GN coverage. All POABP regimens retained activity against anaerobes and Gram-positive bacteria. Thirty-day prevalence of and risk factors for SSI were evaluated. Results A total of 1307 patients were included. Thirty-day SSI occurred in 189 (15%) patients; median time to SSI was 11.5 days (interquartile range, 7-17). Organisms were isolated in 59% of SSI; methicillin-resistant Staphylococcus aureus (6%) and Pseudomonas aeruginosa (9%) were uncommon. A total of 1003 (77%) patients had POABP data: no GN (17%), enteric GN (52%), and antipseudomonal GN (31%). Variables independently associated with 30-day SSI were as follows: female sex (adjusted odds ratio [aOR], 1.6; 95% CI, 1.1-2.2), no GN POABP (aOR, 2.2; 95% CI, 1.5-3.3), and surgical duration ≥11.8 hours (aOR, 1.9; 95% CI, 1.3-2.7). Longer POABP durations (≥6 days) or antipseudomonal POABP had no association with SSI. Conclusions POABP without GN coverage was significantly associated with SSI and should be avoided. Antipseudomonal POABP or longer prophylaxis durations (≥6 days) were not protective against SSI. Antimicrobial stewardship interventions should be made to limit unnecessary antibiotic exposures, prevent the emergence of resistant organisms, and improve patient outcomes.

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Dysphagia and its impact on the quality of life of head and neck cancer patients: institution-based cross-sectional study

BMC Research Notes ◽

10.1186/s13104-020-05440-4 ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Tseganesh Asefa Yifru ◽

Sezer Kisa ◽

Negalign Getahun Dinegde ◽

Niguse Tadele Atnafu

Keyword(s):

Quality Of Life ◽

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Low Income ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Swallowing Problems

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.

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