Factors that affect quality of life for older people with head and neck cancer: A systematic review.

PURPOSE: Quality of life is a critical aspect in the management of older head and neck cancer patients. It needs to be considered alongside survival benefit, treatment burden, and longer-term outcomes. The purpose was to undertake a systematic review of empirical peer-reviewed studies with a primary focus on factors impacting quality of life for older head and neck cancer patients. METHODS: A systematic review, searching 5 electronic databases (PsychoINFO, MEDLINE, CINHAL, Embase, and Scopus) using PRISMA methodology was conducted. Data was appraised using the Newcastle-Ottawa scale and a narrative synthesis performed. RESULTS: Only 10 papers fulfilled the inclusion criteria. Two main themes emerged: 1) Impact of head and neck cancer on quality of life domains and 2) quality of life in treatment decision-making. CONCLUSIONS: In an era of progressive personalised care, there is an evident need for more qualitative and quantitative studies focusing on quality of life for older head and neck cancer patients. However, older head and neck cancer patients experience notable differences, especially with poorer physical functioning and greater eating and drinking challenges. Quality of life impacts older patients decision-making, treatment planning and intensifies post-treatment support.

The experience among patients with multiple dental loss as a consequence of treatment for head and neck cancer: A qualitative study.

OBJECTIVES: To explore the experience among patients with multiple dental loss as a consequence of treatment for head and neck cancer. METHODS: Semi-structured qualitative interviews were conducted with a purposive sample of fifteen people with head and neck cancer, who had multiple teeth removed as part of their tumour resection or extracted pre-radiotherapy. The interviews were digitally recorded and transcribed for analysis by two researchers, independently. RESULTS: The interview data were categorised into four themes: 1. Pretreatment experience of being informed that teeth had to be removed, 2. Impact of dental loss post-treatment, 3. Coping with dental loss, and 4. Getting dentures and implants. Patients receiving primary radiotherapy felt the time between being informed of requirement for dental extractions and actual extractions was short. Dental loss was detrimental to all patients in terms of eating, speaking, socially and their intimate lives. CONCLUSIONS: Patients whose primary treatment was surgery, appeared more accepting of dental loss. Whereas, those having primary radiotherapy, there seemed to be a focus on prevention of radiotherapy-induced complications, with limited choices and recognition on post-treatment dental functionality. This study showed the negative impact of dental loss on patients' quality of life. CLINICAL SIGNIFICANCE: Dentists should be aware of the post-treatment implications of dental loss on patients' lives; presenting this, as well as the clinical advantages for extractions, to aid decision-making. Patients should be informed of the lack of conclusive research evidence regarding pre-radiotherapy dental extraction. There should also be clear pathways regarding post-treatment dental-related rehabilitation.