Need for Clinical Intervention to Improve Communication in Head and Neck Cancer Survivors
Figure 1. Shows disfigurement after HNC treatment (Park)
Head and neck cancer (HNC) accounts for approximately 3% of cancers in the U.S. The American Cancer Society estimates over 60,000 new HNC cancer cases in the U.S. in 2016, and roughly 500,000 HNC survivors. Although deemed “cancer free,” these survivors must still cope with the physical and psychological consequences of treatment. A study conducted in 2011 interviewed the caregivers of 39 HNC patients on the topic of “Reading the Patient.” This qualitative study showed some common methods of communicating with the patient including “Giving Voice,” “Being There,” “Giving Control,” “Saving Face,” “Normalizing,” “Relieving Pain,” and “Giving Hope.” This study suggests that HNC patients need access to technology and care that eases nonverbal communication and helps them overcome issues such as disfigurement and body image. (McGrory) In a 2015 qualitative study, 14 HNC survivors were interviewed regarding communication changes after their HNC treatment. The responses fell into four different categories: “impairments in communication sub-systems,” “the challenges of communicating in everyday life,” “broad ranging effects of communication changes,” and “adaptations as a result of communication changes.” It was concluded that psychosocial side effects of treatment need to be accounted for when caring for a HNC patient. (Nund)
Some studies have also shown that HNC can result in both constructive and destructive consequences in terms of effective communication. In one instance, a 2012 interview study conducted on a sample of n=39 HNC survivors revealed that there were both positive (“going deeper into life”) and negative (“change in communication”) aspects of survivorship. In addition to causing functional deficits, HNC forces people to consider larger and deeper aspects of life as a result of difficult circumstances. (Fletcher) Research has shown that there are negative psychosocial and physical side effects of HNC treatment that clinicians must consider when coming up with a recovery plan.
References:
Dooks, P., McQuestion, M., Goldstein, D., & Molassiotis, A. (2012). Experiences of patients with laryngectomies as they reintegrate into their community. Supportive Care in Cancer, 20(3), 489-498.
Fletcher, B. S., Cohen, M. Z., Schumacher, K., & Lydiatt, W. (2012). A blessing and a curse: head and neck cancer survivors’ experiences. Cancer nursing, 35(2), 126-132.
McGrory, A. (2010). Communicating with head and neck cancer patients.ORL-head and neck nursing: official journal of the Society of Otorhinolaryngology and Head-Neck Nurses, 29(3), 7-11.
Nund, R. L., Rumbach, A. F., Debattista, B. C., Goodrow, M. N., Johnson, K. A., Tupling, L. N., … & Porceddu, S. V. (2015). Communication changes following non-glottic head and neck cancer management: The perspectives of survivors and carers. International journal of speech-language pathology,17(3), 263-272.
O’Brien, K., Roe, B., Low, C., Deyn, L., & Rogers, S. N. (2012). An exploration of the perceived changes in intimacy of patients’ relationships following head and neck cancer. Journal of clinical nursing, 21(17‐18), 2499-2508.
Park, M. (2010). Oral cancer’s toll cruel. Retrieved September 12, 2016, from
http://www.cnn.com/2010/HEALTH/02/19/george.karl.throat.cancer/
So, W. K., Choi, K. C., Chen, J. M., Chan, C. W., Fung, O. W., Wan, R. W., … & Bernice, W. L. (2014). Quality of life in head and neck cancer survivors at 1 year after treatment: the mediating role of unmet supportive care needs.Supportive Care in Cancer, 22(11), 2917-2926.
