Even when their cancers are cured or in remission, patients with head and neck cancers face multiple challenges that can impinge on their quality of life (QOL). These patients cannot easily mask effects of their treatments: Surgery can result in speech dysfunction and/or facial disfigurement, and even organ-sparing chemoradiation treatments produce dysphagia, dry mouth, and dental damage. As they adjust to the new normal of life after cancer treatment, many head and neck cancer patients may become anxious, isolated, and depressed. With any change comes loss, said Jacqueline Zahora, LCSW, an oncology social worker with the New York-based cancer support organization Cancer Care. A lot of these patients are grieving for the way they used to be, or the way they used to look, or the way they used to be able to interact with the world.
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January 2007Whereas the first goal of treatment for head and neck cancers is to cure the cancer, the second is to mitigate side effects, said Mike Yao, MD, Assistant Professor and Program Director of the Department of Otolaryngology, Head and Neck Surgery at the University of Illinois in Chicago. Whether part of the treatment team or as referring physicians, ENT specialists can apprise themselves of the challenges facing patients and the array of medical and psychosocial supports available to them.
Counseling before Treatment
It is important, said William I. Wei, MD, Professor of Surgery, and W. Mong Chair in Otorhinolaryngology at the University of Hong Kong, to tell patients of all possible side effects before treatment begins. Standard treatments for cancers of the larynx and pharynx usually entailed a laryngectomy and resultant loss of normal speech. Now, with targeted chemoradiation, organ preservation is accomplished. But the organ preservation comes with a price: Sometimes function is affected.