Table 10.
Studies reporting on body image, pain, fatigue/sleep, and post-traumatic stress.
| Author | Year | No. | Location | Age | H&N Subsite | Treatment | Instrument | Study Design | Findings |
|---|---|---|---|---|---|---|---|---|---|
| Body Image | |||||||||
| Chen et al. (172) | 2020 | 154 | China | Mostly men, 40-65 years | Mostly thyroid, oral cavity, larynx | Surgery within past month | BIS HADS PSSS SCSQ |
Cross-sectional | Younger patients (<40y) had significantly higher BIS score (more dissatisfaction), which is associated with higher anxiety. |
| Clarke et al. (173) | 2014 | 49 | United Kingdom | Mean 60.4 years | HNSCC (stage III-IV, recurrent, or radiation failure) | Mixed | DAS24 HADS |
Cross-sectional: baseline and 9m | No correlation between age & DAS-24 score |
| Vilaseca et al. (174) | 2006 | 49 | USA | Mean 62.7 years (44-82 years) | Larynx | Total laryngectomy | UW-QOL | Cross-sectional | Younger patients more likely to express dissatisfaction with appearance |
| Zebolsky et al. (175) | 2021 | 103 | USA | Median 66 years | Mixed, mostly oral cavity and cutaneous | All involved microvascular reconstruction | ARPD SF scales of the FACE-Q |
Retrospective: median time of follow-up at time survey completed 13.5m | Age not significantly associated with ARPD or SF scores |
| Pain | |||||||||
| Cramer et al. (176) | 2018 | 175 | USA | Median 65 years | HNC survivors >/=1 y after diagnosis | Mixed | Pain and QOL assessed with multiple instruments | Retrospective | Patients <55y more likely than older patients to develop pain (odds ratio of 0.38 for 75+ vs <55) |
| Moye (177) | 2014 | 170 | USA | Mean 64.6 years (27-88 years) | HNC, esophageal, gastric, or colorectal cancer from the VA (40% H&N) |
Mixed | PROMIS PHQ-9 |
Prospective: 6m, 12m, & 18m | At 6m post-diagnosis, younger adults described higher levels of pain & of pain intensity. |
| Hassanein et al. (178) | 2001 | 68 | United Kingdom | Median 58 years | Oral cavity, oropharyngeal, maxillary sinus cancer, 6m to 6y post-treatment | Mixed | UW-QOL HADS MAC-Q SSQ6 |
Retrospective | Young pts (≤60) had more functional problems, highly significant for swallowing & shoulder pain, and significant for pain. |
| Fatigue/Sleep | |||||||||
| Hickok (179) | 2005 | 372 | USA | Mean age of HNC patients 61 years | Receiving RT for cancer (HNC, n=23) | RT | In-house 12-item symptom inventory | Prospective: inventory completed weekly for 5 weeks during RT | Age not predictive of fatigue severity at any time point |
| Rogers et al. (180) | 2008 | 58 | USA | Mean 60 years | Mixed | Mixed | FSI PSQI FACT-Cog |
Cross-sectional | Fatigue, sleep dysfunction, poorer cognitive function all associated with younger age (all statistically significant) |
| Santoso et al. (181) | 2020 | 560 | The Netherlands | Mean 63 years | Mixed, patients on prospective NET-QUBIC study | Mixed | PSQI | Cross-sectional, multi-center | Younger age significantly associated with poor sleep (p=.049) |
| PTSD | |||||||||
| Holtmaat et al. (182) | 2016 | 74 | The Netherlands | Median 61.2 years (41-83 years) | HNC survivors with psychological distress (HADS-Anxiety or -Depression >7) | Mixed | PTGI | Cross-sectional | Age not significantly related to PTGI score |
| Kangas et al. (183) | 2005 | 82 | United Kingdom | Not stated | New diagnosis of head & neck (n=56) or lung cancer | Mixed | ASDI EORTC QLQ-C30 Mini-MAC PDEQ BDI-II STAI-Y PTCI DUKE-SS |
Prospective: assessed for acute stress disorder at baseline, and for PTSD at 6 months post-diagnosis | Incidence of PTSD higher in younger patients (mean age for PTSD 49, vs 61 for no PTSD, p <.05) |
| Moschopoulou et al. (184) | 2018 | 93 | United Kingdom | Mean 66 years | HNC in follow-up stage and at least 2y out from diagnosis | Mixed | HADS ESSI ALTTIQ DAS24 QLQ-C30 PCL-C |
Cross-sectional | Negative association between PCL-C score and age (younger age is associated with posttraumatic stress syndrome) |
| Posluszny et al. (185) | 2014 | 42 | USA | Mean 55 years | Newly diagnosed HNC pts | Mixed | PCL-C | Prospective study of dyads (patient plus partner) | Age not related to PCL score |
| Richardson et al. (186) | 2016 | 91 | New Zealand | Not stated | Mixed | Mixed | FACT-H&N GHQ-12 PSS-SR Brief COPE |
Prospective; baseline & 6m | Age not significantly correlated with PTSD at diagnosis or follow-up |
ALTTIQ, Assessment of Life Threat and Treatment Intensity;ARPD, Appearance-Related Psychosocial Distress; ASDI, Acute Stress Disorder Inventory; BDI-II, Beck Depression Inventory-II; BIS, Body Image Scale; Brief COPE, Brief Coping Orientation to Problems Experienced Inventory DAS24, Derriford Appearance Scale-24; DUKE-SS, Duke-UNC Functional Social Support Scale; ESSI, ENRICHD Social Support Inventory; FACT-Cog, Functional Assessment of Cancer Therapy-Cognitive; FACT-H&N, Functional Assessment of Cancer Therapy-Head and Neck module; FSI, Fatigue Symptom Inventory H&N, head and neck; GHQ-12, General Health Questionnaire-12; HADS, Hospital Anxiety and Depression Scale; HNC, head and neck cancer; HNSCC, head and neck squamous cell carcinoma; MAC-Q, Memory Complaint Questionnaire; Mini-MAC, Mini-Mental Adjustment to Cancer; NET-QUBIC, Netherlands Quality of Life and Biomedical Cohort; PCL-C, PTSD Checklist-Civilian; PDEQ, peritraumatic dissociative experiences questionnaire PHQ-9, Patient Health Questionnaire-9; PROMIS, Patient Reported Outcomes Measurement Information System; PSSS, Perceived Social Support Scale; PSQI, Pittsburgh Sleep Quality Index; PSS-SR, Posttraumatic Symptom Scale Self-Report versionPTCI, Posttraumatic Concerns Inventory; PTGI, Post-Traumatic Growth Inventory; QLQ-C30, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30; SCSQ, Simplified Coping Style Questionnaire; SF, Social Functions; SI, Symptom Inventory; SSQ6, Social Support Questionnaire-Short Form; STAI-Y, State-Trait Anxiety Inventory-Y;UW-QOL, University of Washington Quality of Life Questionnaire; VA, Veterans’ Affairs.