Top

Published in:

01-08-2012 | Original Article

Prevalence and correlates of symptoms and uncertainty in illness among head and neck cancer patients receiving definitive radiation with or without chemotherapy

Authors: Mary Ellen Haisfield-Wolfe, Deborah B. McGuire, Karen Soeken, Jeanne Geiger-Brown, Bruce De Forge, Mohan Suntharalingam

Published in: Supportive Care in Cancer | Issue 8/2012

Abstract

Purpose

This repeated measures, prospective study was designed to explore and describe symptom dimensions, depressive symptoms, and uncertainty in newly diagnosed oropharyngeal and laryngeal cancer patients during and 1 month following treatment.

Materials and methods

A non-probability sample of 21 oropharyngeal and laryngeal cancer patients receiving definitive radiation completed the Memorial Symptom Assessment Scale, Beck Depression Inventory, and Mishel's Uncertainty in Illness Scale at treatment initiation, and at 5, 9, and 12 weeks.

Results

A common pattern of 11 symptoms, which changed as treatment progressed, was problematic for patients. Physical symptoms increased by 50% at week 5 and 9. Depression was experienced by 24% of patients. Uncertainty was found to be high at all time points and unexpectedly remained unchanged over time (p = 0.73). Positive correlations (p < 0.05) were found among number of symptoms, symptom distress, and depressive symptoms. Uncertainty was correlated (p < 0.05) statistically only to symptom distress.

Conclusion

This study is the first to identify uncertainty in illness among oropharyngeal and laryngeal cancer patients and found it to be higher than for other cancer populations. Findings provide insights into the uncertainty of living through treatment and provide information for patient care. The consistent pattern of high levels of uncertainty during and 1 month after treatment suggests that the uncertainty related to acute illness could extend into chronic uncertainty which may interfere with a cancer survivor's adaption to daily living after treatment. Further research is needed to investigate other variables that influence uncertainty during treatment as well as 1 to 6 months after treatment for head and neck cancer.

Chen SC, Yu WP, Chu HC, Tsai MC, Liao CT (2010) Prevalence and correlates of supportive care needs in oral cancer patients with and without anxiety during the diagnostic period. Cancer Nurs 33:280–289PubMedCrossRef

Mallack I, Waldron JN (2009) Radiation therapy for head and neck cancers. Semin Oncol Nurs 25:193–202CrossRef

Eades M, Chasen M, Bhargova R (2009) Rehabilitation: long-term physical and functional changes following treatment. Semin Oncol Nurs 25:222–230PubMedCrossRef

Rose P, Yates P (2001) Quality of life experienced by patients receiving radiation treatment for cancers of head and neck. Cancer Nurs 24:255–263PubMedCrossRef

Scharloo M, Baatenburg de Jong R, Langeveld TP, van Velsen-Verkaik E, Doorn-op den Akker M, Kaptein A (2010) Illness cognitions in head and neck squamous cell carcinoma: predicting quality of life outcome. Support Care Cancer 18:1137–1145PubMedCrossRef

Mehanna H, Paleri V, West CML, Nutting C (2010) Head and neck cancer—part 1: epidemiology, presentation, and prevention. BMJ 341:c4684. doi:10.1136/bmj/c4684 PubMedCrossRef

Kurtin S (2009) Systemic therapies for squamous cell carcinoma of the head and neck. Support Care Cancer 18:183–192

Mishel M (1984) Perceived uncertainty and stress in illness. Res Nurs Health 7:171CrossRef

Rhodes VA, Watson PM (1987) Symptom distress—the concept: past and present. SONU 3:242–247

10.

Haisfield-Wolfe ME, McGuire DB, Soeken K, Geiger-Brown J, De Forge B (2009) A systematic review of prevalence and correlates of depression among head and neck cancer patients: implications for research. ONF 36:E107–E125, ISSN: 0190-535XCrossRef

11.

Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S (1994) Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from The National Co-Morbidity Survey. Arch Gen Psychiatry 51:8–19PubMedCrossRef

12.

Mishel M (1988) Uncertainty in illness. J Nurs Scholarsh 20:225–232CrossRef

13.

Lazarus RS, Folkman S (1984) Stress, appraisal and coping. Guilford, New York

14.

Bailey D, Mishel MH, Belyea M, Stewart J, Moher J (2004) Uncertainty intervention for watchful waiting in prostate cancer. Cancer Nurs 27:339–346PubMedCrossRef

15.

Christman N (1990) Uncertainty and adjustment during radiotherapy. Nurs Res 39:17–20PubMedCrossRef

16.

Sherman A, Simonton S (2010) Advances in quality of life research among head and neck cancer patients. Curr Oncol Rep 12:208–215PubMedCrossRef

17.

Sayed S, Manikantan K, Lhode S, Elmiyeh B, Kazi R (2009) Perspective on quality of care following total laryngectomy. Gomale Italiano di Medicina del Lavoro ed Ergonomia 31(SUPPL):B21–B24

18.

Chawla S, Mohanti BK, Rahshak M, Saxena S, Rath GK (1999) Temporal assessment of quality of life of head and neck cancer patients receiving radical radiotherapy. Qual Life Res 8:73–78PubMedCrossRef

19.

Lai Y, Chang JT, Keefe FJ, Chiou CF, Chen SC, Feng SC et al (2003) Symptom distress, catastrophic thinking, and hope in nasopharyngeal carcinoma patients. Cancer Nurs 26:485–493PubMedCrossRef

20.

Hsu T, Lu M, Tsou T, Lin C (2003) The relationship of pain, uncertainty and hope in Taiwanese lung cancer patients. J Pain Symptom Manage 26:835–842PubMedCrossRef

21.

Dillman DA (2000) Mail and internet surveys: the tailored design methods, 2nd edn. John Wiley & Sons, New York

22.

Portenoy RK, Thaler HT, Kornblith AB, McCarthy Lepore J, Frielander-Klar H, Kiyasu E (1994) The Memorial Symptom Assessment Scale: an instrument for the evaluation of symptom prevalence, characteristics and distress. Eur J Cancer 30A:1326–1336PubMedCrossRef

23.

Chang V, Hwang S, Feurman M, Kasimis B, Thaler HT (2000) The Memorial Symptom Assessment Scale Short Form (MSAS-SF). Cancer 89:1162–1171PubMedCrossRef

24.

Beck AT, Steer RA, Brown GK (1996) The Beck Depression Inventory, 2nd edn. Houghton Mifflin, Boston

25.

Mishel M (1981) The measurement of uncertainty in illness. Nurs Res 30:258–263PubMedCrossRef

26.

Mishel M (1997) Uncertainty in Illness Scales Manual. University of North Carolina, School of Nursing, Chapel Hill

27.

Lough ME, Lindsey AM, Shinn JA, Stotts NA (1987) Impact of symptom frequency and symptom distress on self reported quality of life in heart transplant recipients. Heart Lung J Crit Care 16:193–200

28.

Rhodes VA, Watson PM, Johnson MH (1984) Development of reliable and valid measures of nausea and vomiting. Cancer Nurs 7:33–41PubMedCrossRef

29.

Rhodes VA, Watson PM (1987) Symptom distress the concept: past and present. Semin Oncol Nurs 3:242–247PubMedCrossRef

30.

Bansal M, Mohanti BK, Shaha AR, Chaudhry R, Bahadur S, Shukla NK (2004) Radiation related morbidities and their impact on quality of life in head and neck cancer patients receiving radical radiotherapy. Qual Life Res 13:481–488PubMedCrossRef

31.

Sehlen S, Lenk M, Herschbach P, Aydemir U, Dellian M, Schymura B (2003) Depressive symptoms during and after radiotherapy for head and neck cancer. Head Neck 25:1004–1018PubMedCrossRef

32.

de Leeuw J, deGraeff A, Ros W, Winnubst JA (2001) Prediction of depression 6 months to 3 years after treatment of head and neck cancer. Head Neck 23:892–898PubMedCrossRef

33.

Chen SC, Lai Y-H, Liao CT, Chang JT, Lin CC (2010) Unmet information needs and preferences in newly diagnosed and surgically treated oral cancer patients. Oral Oncol 45:946–952CrossRef

34.

Haman KL (2008) Psychologic distress and head and neck cancer: Part 1 Review of the literature. J Support Oncol 6:155–163PubMed

35.

Archer J, Hutchison I, Korszun A (2008) Mood and malignancy: head and neck cancer and depression. J Oral Path Med 37:255–270CrossRef

36.

Frank-Stromberg M, Olsen SJ (2004) Clinical health-care research, 3rd edn. Jones & Bartlett, Boston

37.

Chen ML, Chang HK (2004) Physical symptom profiles of depressed and non-depressed patients with cancer. J Palliat Med 18:712–718CrossRef

38.

Wellam F, Yu K, Degner L (2008) Uncertainty after treatment for prostate cancer: definition, assessment and management. CJON 5(12):749–755

39.

McMillan SC, Tofthagaen C, Morgan MA (2008) Relationships among pain, sleep disturbances, and depressive symptoms in outpatients from a comprehensive cancer center. ONF 35:603–611CrossRef

40.

Duffy SA, Ronis DL, Valenstein M, Fowler KE, Lambert MT, Bishop C (2007) Depressive symptoms, smoking, drinking, and quality of life among head and neck cancer patients. Psychosomatics 48:142–148PubMedCrossRef

41.

Brouwers MC, Sorrentino RM (1993) Uncertainty orientation and protection motivation theory. Am Psychiatr Assoc 65:102–112

42.

Semple CJ, Dunwoody L, Kernohan WG, McCaughan E (2009) Development and evaluation of a problem-focused psychosocial intervention for patient with head and neck cancer. Support Care Cancer 17:379–388PubMedCrossRef

43.

Detrapon M, Sirapo-ngam Y, Mishel MH, Sitthimongkol Y, Vorapongsathorn T (2009) Testing of uncertainty in illness theory to predict quality of life among Thais with head and neck cancer. Nurs Res 13:1–14

44.

Xiao C (2010) The state of science in the study of cancer symptom clusters. Eur J Oncol Nurs 14:417–434PubMedCrossRef

45.

Noquez AE (2008) Cancer related symptom clusters. Doctoral (Ph.D.) Dissertation, University of San Diego, 118 pp

46.

Verdonck-de Leeuw IM, Erenstein SE, Van der Linden M, Kuik DJ, deBree R, Leemans CR (2007) Distress in spouses and patients after treatment for head and neck cancer. Laryngoscope 117:239–241CrossRef

47.

Mehanna H, West C, Nutting C, Paleri V (2010) The post radiation neck: evaluating responses to treatment and recognizing response to treatment and recognizing complications. Adv J Rad 195:W164–W171

48.

Murphy B (2009) Advances in quality of life and symptom management for head and neck patients. Curr Opin Oncol 21:242–247PubMedCrossRef

Title: Prevalence and correlates of symptoms and uncertainty in illness among head and neck cancer patients receiving definitive radiation with or without chemotherapy
Authors: Mary Ellen Haisfield-Wolfe
Deborah B. McGuire
Karen Soeken
Jeanne Geiger-Brown
Bruce De Forge
Mohan Suntharalingam
Publication date: 01-08-2012
Publisher: Springer-Verlag
Published in: Supportive Care in Cancer / Issue 8/2012
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-011-1291-9

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 8/2012

Quality of the supportive and palliative oncology literature: a focused analysis on randomized controlled trials

Implementation of institutional antiemetic guidelines for low emetic risk chemotherapy with docetaxel: a clinical and cost evaluation

Role of antioxidants in buccal mucosa cells and plasma on the incidence and severity of oral mucositis after allogeneic haematopoietic cell transplantation

Preliminary development of a lymphedema symptom assessment scale for patients with head and neck cancer

Erratum to: The nutritional risk in oncology: a study of 1,453 cancer outpatients

Illness appraisal, religious coping, and psychological responses in men with advanced cancer

Keynote webinar | Spotlight on antibody–drug conjugates in cancer