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Quality of Life Surveys from Head and Neck Cancer Survivors: The Need for a Standard

Posted by Swathi on Oct 5, 2016 in Writing Assignment 2 | No Comments

Swathi Mettela

MHC Science Forward

Professor Kowach

26 September 2016

Quality of Life Surveys from Head and Neck Cancer Survivors: The Need for a Standard

Head and neck cancers (HNC) currently make up 3% of all cancers in the United States. The American Cancer Society estimates over 60,000 new HNC cancer cases and over 500,000 HNC survivors in the U.S. this year. Studies are often conducted to evaluate the extent of physical and psychosocial survivorship issues in HNC survivors. As these issues are not always quantitatively measurable, quality of life surveys are completed by the survivor to establish a numerical value for their overall wellness. While this subjective surveying method has become necessary when determining someone’s quality of life, the results of these surveys are being misused to draw inaccurate conclusions about survivorship issues in HNC survivors.

In a 2001 study the health related quality of life was measured in HNC survivors three years removed from their last treatment. Three different quality of life surveys (SF-36 health survey, EORTC QLQ-C30 version 1.0, and EORTC QLQ-H&N35) were used to evaluate a survivor’s overall quality of life. SF-36 health survey consists of 8 divisions of health: “physical health, role limitations due to physical problems, bodily pain, general health, vitality , social functioning, role limitations due to emotional problems, mental health and perceived change of health during the last year.” EORTC QLQ-C30 version 1.0 evaluates the survivor’s quality of life using five functioning scales (physical functioning, role functioning, emotional functioning, cognitive functioning, and social functioning), three symptom scales (fatigue, nausea and vomiting, and pain), and a global health scale. EORTC QLQ-H&N35 is a tomr specific survey comprised of seven subscales: pain, swallowing, senses, speech, social eating, social contact, and sexuality. (Hammerlid)

Figure 1.Question 1 on SF-36 shows how survivors subjectively quantify their health

In 2004 similar research was conducted to examine the quality of life of HNC survivors. In this study, four subjective surveys (UWQOL, PSS-HN, FACT-G, and FACT-H&N) were used to determine someone’s overall quality of life. UWQOL evaluates a survivor’s quality of life within the time span of the last seven days. PSS-HN is completed by the physician and examines three aspects of life: Normalcy of Diet, Eating in Public, and Understandability of Speech. FACT-G and FACT-H&N both refer to quality of four aspects of life (physical well-being, social/family well-being, emotional well-being, and functional well-being) in the last seven days. (Campbell)

Although there are established surveys in academia and medicine to measure a survivor’s quality of life after HNC, having multiple standards is just as ineffective as having no standard.

Citations:

Bjordal, K., De Graeff, A., Fayers, P. M., Hammerlid, E., van Pottelsberghe, C., Curran, D., … &

Söderholm, A. L. (2000). A 12 country field study of the EORTC QLQ-C30 (version 3.0)

and the head and neck cancer specific module (EORTC QLQ-H&N35) in head and neck

patients. European Journal of Cancer, 36(14), 1796-1807.

Brazier, J. E., Harper, R., Jones, N. M., O’cathain, A., Thomas, K. J., Usherwood, T., &

Westlake, L. (1992). Validating the SF-36 health survey questionnaire: new outcome

measure for primary care. Bmj, 305(6846), 160-164.

Campbell, B. H., Spinelli, K., Marbella, A. M., Myers, K. B., Kuhn, J. C., & Layde, P. M.

(2004). Aspiration, weight loss, and quality of life in head and neck cancer survivors.

Archives of Otolaryngology–Head & Neck Surgery,130(9), 1100-1103.

Hammerlid, E., & Taft, C. (2001). Health-related quality of life in long-term head and neck