Research led by Dublin City University has found that survivors’ performance of key self-management skills after treatment for head and neck cancer has a strong link with their measurement of quality of life and also fears that their cancer may return.
Three hundred and ninety five head and neck cancer survivors participated in the latest study led by Prof Pamela Gallagher, DCU, investigating the relationship between self-management behaviours and quality of life (QoL) and fear of recurrence (FoR) following treatment for head and neck cancer (HNC).
The findings have been published online in the journal of Psycho-Oncology.
Results showed that practices which include positive and active engagement in daily life; constructive attitudes and approaches to the illness and the development of skills and techniques to cope with life after treatment were significantly associated with a higher quality of life and a lower fear of cancer returning.
Interestingly, the study also highlighted that excessive self-monitoring of one’s condition and “hyper-vigilance” such as obsessively checking for any signs or symptoms might have a negative impact on head and neck cancer survivors’ quality of life and levels of fear surrounding their cancer coming back.
Commenting on the findings Prof Pamela Gallagher said:
“There are limited health service resources available for head and neck survivors once primary treatment has ended. This means that survivors need to self-manage the often substantial physical, emotional and social consequences of their condition by themselves.
We have found that these individuals are resourceful and creative in how they manage these consequences.
However, there is a need to provide further support to these individuals, particularly in the period when they transition from the acute setting to self-managing their condition at home.”
The self-management strategies of cancer survivors are particularly important after primary treatment as they have less involvement with and less access to specialist health professionals.
In addition, the complexity of the consequences of cancers in the head and neck area and their treatment means that survivors need to use a wide variety of strategies to cope with physical, social and psychological challenges that emerge post-treatment.
Cancer of the head and neck is among the top ten most common cancers in Ireland with around 500 cases diagnosed in Ireland in 2017.
Common difficulties that arise for head and neck cancer patients after treatment include eating and communicating due to the effects of surgery or radiotherapy; facial disfigurement resulting from surgery which can lead to elevated distress levels.
In addition, a fear that the illness will return is quite high compared to other cancers and up to three quarters of survivors experience a fear of the illness returning.
In this latest study, all eligible participants in Ireland with a registered diagnosis of head and neck cancer were identified in association with the National Cancer Registry, and 272 males and 123 females took part in the population-based survey.
The majority of respondents had undergone surgery for head and neck cancer, or a combination of surgery and radiotherapy, and were within 12-24 months of finishing treatment.
The latest findings by the research team at Dublin City University builds on previous work in this area, (published in Psycho-Oncology in October 2018) .
The overall implication which has emerged from this programme of research is that bespoke self-management programmes are required to respond to the specific physical, emotional and social issues of head and neck cancer survivors, in order to help overcome the challenges that may arise in the aftermath of treatment.
This research was funded by the Irish Cancer Society and the Health Research Board in Ireland under Grant No: SRP13GAL, MRCG/2013/11.
Investigating the impact of self-management behaviours on quality of life and fear of recurrence in head and neck cancer survivors: a population based survey is published in the journal Psycho-Oncology E-publication 2019; doi: 10.1002/pon.5010. Research Team: Investigating the impact of self-management behaviours on quality of life and fear of recurrence in head and neck cancer survivors: a population based survey. Prof Pamela Gallagher (PI), Dr Simon Dunne, DCU; Dr Laura Coffey, Dr Deirdre Desmond, Dept of Psychology, Maynooth University; Prof Linda Sharp, Institute of Health and Society Newcastle University; Dr Claire Cullen, Carlow College; Dr. Jean O’Connor, National Cancer Registry Ireland, Cork; Dr Eleanor O’Sullivan, Cork University Dental School and Hospital; Prof Conrad Timon, Head and Neck Cancer Programme, St James’s Hospital, Dublin.
Barriers to active self-management following treatment for head and neck cancer: survivors’ perspectives published in Psycho-Oncology October 2018.