ABSTRACT
Cancer is uncommon in pregnancy, occurring in approximately one out of 1000 pregnancies, although it has been noted that one out of 118 women diagnosed with cancer is pregnant at the time of diagnosis. In the last 10 years, two oropharyngeal carcinomas, (1 squamous cell carcinoma and 1 adenoid cystic carcinoma) which developed during pregnancy, have been diagnosed and treated in our Department. No cases of oropharyngeal cancer, during pregnancy, have so far been reported in the literature with the exception of one case of oral cancer. This report focuses not only on the clinical history but also the management of oropharyngeal carcinoma during pregnancy, in terms of choice and timing of treatment. A scrupulous psycho-oncological analysis was also carried out in order to throw further light on psychological repercussions of head and neck cancer in the pregnant woman.
Subject(s)
Carcinoma, Adenoid Cystic/pathology , Carcinoma, Adenoid Cystic/psychology , Oropharyngeal Neoplasms/pathology , Oropharyngeal Neoplasms/psychology , Pregnancy Complications, Neoplastic/pathology , Pregnancy Complications, Neoplastic/psychology , Adult , Carcinoma, Adenoid Cystic/surgery , Depressive Disorder, Major/diagnosis , Depressive Disorder, Major/etiology , Female , Humans , Magnetic Resonance Imaging , Oropharyngeal Neoplasms/surgery , Pregnancy , Pregnancy Complications, Neoplastic/surgery , Severity of Illness IndexABSTRACT
Although management of malignant tumours of the mouth and salivary glands generally involves joint consultation with radiotherapists in dedicated oncology clinics, patients' preferences or psychological needs in this environment have not been investigated prospectively, particularly for those on long-term review after treatment. In this prospective study, therefore, psychometric data were collected from a series of 40 consecutive review patients by questionnaires completed on the day of consultation. The following established psychometric tests were used: the Hospital Anxiety and Depression Scale and the General Health Questionnaire. Patients' reactions to duration of consultation, advice given, opportunity to ask questions, and number of staff present were also investigated by a standard structured questionnaire. Forty-seven per cent of patients exhibited symptoms of psychiatric disturbance; 33% were anxious, and 15% were depressed, preoccupation with physical symptoms being the most frequent problem. Explanations of continuing physical symptoms were particularly highly valued because these were often wrongly interpreted by the patients as evidence of recurrence. No patient objected to the presence of students and only one to the presence of more than 10 members of staff. However, 18% requested one-to-one discussion in addition.
