PSYCHOSOCIAL PROBLEMS IN HEAD-AND-NECK CANCER-PATIENTS AND THEIR CHANGE WITH TIME SINCE DIAGNOSIS

Background: Little is known about the psychosocial effects of cancer survivors especially after the first stage of adjustment. The study was designed to provide information about the major psychological problems of head-and-neck cancer patients and their change with time since diagnosis. Patients and methods: The subjects were 55 head-and-neck cancer patients, 40 men and 15 women with disease stages I to IV, grade of tumors G1 to G3-4, and disease duration in the range of 3 months to 21 years. A questionnaire with multiple-choice and open-ended questions assessing adjustment in 14 domains (e.g., fears and worries concerning health, functioning in the family) was administered to patients and their partners or closest relatives as well as scales assessing anxiety, anger and depression. Results: The results showed that the domains that were most problem-laden included coping with health problems, fears, communication with the partner and social relations. Comparing the problems of patients in different time periods (0.5-1.5 years after diagnosis, 1.5-5 years, and over 5 years) showed that many medical problems decreased with time but most psychological ones including anxiety and anger deteriorated markedly. Conclusions: Head-and-neck cancer patients suffer from a broad range of psychosocial problems that become exacerbated with time. The deterioration in quality of life may reflect 'patient burnout' which could be decreased by acquiring adequate coping skills.