Flourishing in head and neck cancer survivors.


Journal

Cancer medicine
ISSN: 2045-7634
Titre abrégé: Cancer Med
Pays: United States
ID NLM: 101595310

Informations de publication

Date de publication:
07 2022
Historique:
revised: 11 01 2022
received: 27 10 2021
accepted: 19 01 2022
pubmed: 13 3 2022
medline: 7 7 2022
entrez: 12 3 2022
Statut: ppublish

Résumé

There is a growing cohort of head and neck cancer (HNC) patients affected by late- and long-term posttreatment side effects. Our study evaluates the relationship between the demographics, clinical characteristics, and posttreatment symptom burden with the subjective sense of flourishing among HNC survivors. A cross-sectional, single-center study of adult survivors of squamous cell cancer of the oral cavity, oropharynx, and larynx/hypopharynx who completed the Secure Flourishing Index (SFI) and patient-reported outcomes related to depression, anxiety, swallowing dysfunction, neck disability, and insomnia between November 2020 and April 2021. A total of 100, predominantly male (86%), survivors with an average age of 63.0 ± 9.6 were included in the study. Univariable analysis showed a significant association between higher flourishing scores and advanced age (95% CI: [0.011, 0.84], p = 0.0441), normal diet (95% CI: [5.79, 31.18], p = 0.0149), employment (95% CI: [1.24, 17.20], p = 0.0239), higher income (95% CI: [7.30, 27.72], p = 0.0248), and decreased reported difficulty paying for needs (95% CI: [-33.46, -18.88], p < 0.001). Flourishing was inversely associated with higher symptoms of depression (95% CI: [-2.23, -1.15], p < 0.001), anxiety (95% CI: [-1.92,-0.86], p < 0.001), swallowing dysfunction (95% CI: [-0.77, -0.26], p < 0.001), neck disability (95% CI: [-1.05, -0.35], p < 0.001), and insomnia (95% CI: [-1.12, -0.22], p = 0.004) in the multivariable analysis. Common late- and long-term side effects of HNC treatment and financial hardship are associated with lower levels of flourishing or a more negative perception of life after treatment. Results highlight the importance of symptom burden for survivors' overall evaluation of their quality of life.

Sections du résumé

BACKGROUND
There is a growing cohort of head and neck cancer (HNC) patients affected by late- and long-term posttreatment side effects. Our study evaluates the relationship between the demographics, clinical characteristics, and posttreatment symptom burden with the subjective sense of flourishing among HNC survivors.
METHODS
A cross-sectional, single-center study of adult survivors of squamous cell cancer of the oral cavity, oropharynx, and larynx/hypopharynx who completed the Secure Flourishing Index (SFI) and patient-reported outcomes related to depression, anxiety, swallowing dysfunction, neck disability, and insomnia between November 2020 and April 2021.
RESULTS
A total of 100, predominantly male (86%), survivors with an average age of 63.0 ± 9.6 were included in the study. Univariable analysis showed a significant association between higher flourishing scores and advanced age (95% CI: [0.011, 0.84], p = 0.0441), normal diet (95% CI: [5.79, 31.18], p = 0.0149), employment (95% CI: [1.24, 17.20], p = 0.0239), higher income (95% CI: [7.30, 27.72], p = 0.0248), and decreased reported difficulty paying for needs (95% CI: [-33.46, -18.88], p < 0.001). Flourishing was inversely associated with higher symptoms of depression (95% CI: [-2.23, -1.15], p < 0.001), anxiety (95% CI: [-1.92,-0.86], p < 0.001), swallowing dysfunction (95% CI: [-0.77, -0.26], p < 0.001), neck disability (95% CI: [-1.05, -0.35], p < 0.001), and insomnia (95% CI: [-1.12, -0.22], p = 0.004) in the multivariable analysis.
CONCLUSIONS
Common late- and long-term side effects of HNC treatment and financial hardship are associated with lower levels of flourishing or a more negative perception of life after treatment. Results highlight the importance of symptom burden for survivors' overall evaluation of their quality of life.

Identifiants

pubmed: 35277936
doi: 10.1002/cam4.4636
pmc: PMC9249981
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2561-2575

Informations de copyright

© 2022 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

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Auteurs

Alexandria Harris (A)

School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

Jinhong Li (J)

Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Karley Atchison (K)

Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

Christine Harrison (C)

Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

Daniel Hall (D)

Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.
Geriatric Research Educational and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.
Wolff Center, UPMC, Pittsburgh, Pennsylvania, USA.

Tyler VanderWeele (T)

Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA.
Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, Massachusetts, USA.

Jonas T Johnson (JT)

Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

Marci L Nilsen (ML)

Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Department of Acute and Tertiary Care, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

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