Background: Head and neck cancer (HNC) survivors experience significant symptom burden as a result of tumor location and treatment received. These symptoms may negatively impact quality of life (QOL) and compromise dietary intake into the post-treatment survivorship phase. Few studies have examined how symptoms are associated with quality of life in HNC survivors beyond the acute phase of care.
Purpose: The objective of this research was to examine associations between perceived symptom-related barriers to eating and quality of life (QOL) in post-treatment head and neck cancer (HNC) survivors who participated in a dietary intervention trial.
Methods: This was an exploratory analysis of 23 post-treatment HNC survivors who had previously participated in a 12-week randomized dietary intervention trial to assess the feasibility of increasing cruciferous (CV) and green leafy vegetable (GLV) intake. For this analysis, both treatment groups were combined into one. Participants completed a pre-intervention survey that assessed HNC-specific QOL (FACT-HN) and ranked self-perceived symptom-related barriers to eating on a 5-point Likert scale (1 = “never” to 5 = “very often”). A summary score for all symptom-related barriers was computed (maximum of 80 points) and Pearson correlations between the summary score and QOL were examined. Pearson correlations were also examined between scores for individual symptom-related barriers and QOL.
Results: A lower symptom-related barrier summary score was significantly correlated with improved physical, emotional, and functional QOL (p < 0.01 for all). Lower individual symptom-related barrier scores for dry mouth, food does not taste good, feeling full too quickly, choking, phlegm production in mouth, difficulty swallowing, and lack of appetite were significantly associated with improved physical QOL (p < 0.05 for all). Symptom-related barrier summary score was not correlated with overall QOL.
Conclusions: In this analysis of post-treatment HNC survivors, the degree of perceived symptom related barriers was associated with reduced QOL in several domains. Many individual perceived symptom related barriers were positively correlated with the physical domain of QOL. Although this was a small and exploratory secondary data analysis, these results suggest that perceived symptom related barriers and reduced QOL may be unmet needs in this survivor population and a larger study is warranted.
Funding for the original study was provided by a NIH/NCI Cancer Prevention and Control Training Grant: R25 CA047888 and a Research Enhancement Project Grant from the University of Alabama at Birmingham Center for Palliative and Supportive Care.NIH/NCI Cancer Prevention and Control Training GrantR25 CA047888Research Enhancement Project Grant from the University of Alabama at Birmingham Center for Palliative and Supportive CareOpe
