Worldwide oral and oropharyngeal cancer is the 6th most common cancer. Treatment often affects the individuals’ ability to eat, speak and interact with others and so is associated with significant physical and psychological burdens. This review aimed to describe the quality of life (QoL) outcomes and support needs in patients with oral cancer along the cancer trajectory.
The Cochrane, Embase, PubMed, CINAHL, Scopus, Web of Science and PsycINFO databases were searched for original studies that described patient-reported QoL outcomes that were translatable to support needs in patients with oral cancer. Only English language articles were considered. The Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies was used to assess the methodological quality. For data synthesis, ‘support needs’ were defined as a QoL issue that had the potential to be improved by the provision of an action or resource. For each study, the relative impact on QoL for the reported support need along with its prevalence was categorized and reported in table form.
- 31 studies were included, the majority (21) were cross-sectional, 7 were prospective, 2 case-controls, and one retrospective chart review. The quality of 5 studies were rated as strong, 8 as moderate and 18 as weak.
- Support needs related to coping with the burden of radiotherapy in both psychosocial and physical aspects, swallowing dysfunction, dry mouth and oral functional deficits. Issues of depression, anxiety and malnutrition were identified as having a significant impact on QoL.
The authors concluded
Oral cancer support needs are highly subjective and varied in severity across the cancer continuum. Support needs that may warrant further investigation include management of changes to oral health and functioning, swallowing and nutritional compromise and psychological effects of cancer and treatment.
Comment
As the authors note ‘oral cancer diagnosis and treatment is associated with considerable functional and psychosocial deficits for those with the disease.’ The heterogeneity of the study designs, instruments used to measure QoL and populations from a range of head and neck cancer sites (oral cavity, oropharynx, hypopharynx and larynx) add to the difficulties on summarising the evidence available. Added to that the authors note limitations in the quality of reporting also there were more studies related to QoL changes with radiotherapy and chemotherapy than there were in relation to the effects of surgery. The authors also highlight the the questionnaires used might underestimate all the support requirements of this group of patients.
Links
Moore KA, Ford PJ, Farah CS. Support needs and quality of life in oral cancer: a systematic review. Int J Dent Hygiene Accepted 16 July 2013 DOI: 10.1111/idh.12051
