Patients' concerns about appearance following treatment of oral and oropharyngeal cancer and the impact this has on their quality of life are critical factors for practitioners to keep in mind when working with these patients, according to a study in the British Journal of Oral and Maxillofacial Surgery (June 14, 2011).
U.K. researchers used the University of Washington Quality of Life (UW-QoL) questionnaire version 4 and the Patient Concerns Inventory (PCI), a self-administered questionnaire, to assess concerns about appearance among 204 cancer patients who attended routine follow-up clinics from August 2007 to mid-July 2009.
Fifty-seven percent of the patients were male, 68% had cancer of the oral cavity, 78% had clinical T1-T2 tumors, 19% had node-positive tumors, 44% had had radiotherapy since diagnosis, and 48% had had free-flap reconstructive surgery. They all completed the questionnaires using touchscreen computer technology at 454 clinic appointments.
Appearance was raised on the inventory at 9% (42/454) of clinics, and at 10% (47/454) it was indicated as a serious problem on the UW-QoL questionnaire. Concerns about appearance were raised on the inventory or were shown to be a serious problem on the UW-QoL in 14% (64/454) of patients. The main factors associated with those who reported concerns about appearance were age (younger patients), sex (female), T stage (III and IV), and site (oropharynx).
The UW-QoL and PCI tools complement the screening of oral cancer patients who have problems with facial disfigurement, the researchers concluded, noting that "failure to identify them can have serious clinical and psychosocial implications."
