Rehabilitation: Long-Term Physical and Functional Changes Following Treatment
Section snippets
Survival Rates In Head and Neck Cancer
Squamous cell carcinoma of the head and neck is common worldwide.19 Males are affected significantly more than females, at a ratio ranging from 2:1 to 4:1.20 In the year 2007, there was an estimated 4,350 new cases diagnosed in Canada, with approximately 1,600 deaths attributable to head and neck squamous cell cancer.21 In the United States, there is an annual incidence of approximately 70,620 newly diagnosed cases (15,180 deaths).22 National Cancer Institute reports indicate that 61% of
Physical and Functional Changes
Curative treatments for head and neck cancers are frequently associated with disfigurement and dysfunction that could become permanent. Treatments can contribute to loss of sensory-motor and/or expressive-communicative functions related to speaking, eating, breathing, and physical appearance. Table 1 summarizes the impact of physical and functional changes after treatment for head and neck cancer. Morton reported that more physical and somatic dysfunction is experienced after combined rather
Cancer Cachexia
Cancer cachexia is defined by an aberrant energy and protein balance driven by a variable combination of reduced food intake and hypermetabolism.64 Over its course, cachexia is associated with functional impairment and fatigue. A defining feature is the ongoing loss of skeletal muscle mass, which is not fully reversed by conventional nutritional support. Cachexia is classified as either primary or secondary, depending on its cause. Primary cachexia is principally caused by a tumor-induced
Rehabilitation and Nursing Implications
Cancer rehabilitation is defined as a process whereby the individual within his environment is assisted to obtain optimal (physical, social, psychological, and vocational) functioning within the limits of his disease and situation.73 There are many variations of care models in practice that deliver critical, effective, ongoing, and supportive care required by patients with cancer of the head and neck.74, 75, 76, 77, 78, 79 An integrated cancer rehabilitation team approach may be indicated,
Conclusion
For some patients, recovery following treatment for head and neck cancer is smooth and occurs largely independent of the health services support. These individuals are encouraged to make healthy lifestyle choices, and adhere to scheduled follow-up appointments. Other individuals and family caregivers encounter a range of difficulties of differing degrees of complexity. Some treatment effects and conditions cannot be completely resolved despite the best possible interventions and rehabilitative
Acknowledgment
The authors would like to thank the following for their assistance in preparing and reviewing this manuscript: Judith Ritchie, N, PhD, Andréanne Saucier, MSc, CON(C), Myriam Skrutkowski, N, MSc CON(C), and Elizabeth Beaubien.
Margaret Eades, N, MSc(A), CON(C): Clinical Nurse Specialist (CNS)-Oncology, McGill University Health Centre-Clinical Co-Administrator and CNS Cancer Nutrition and Rehabilitation Program, McGill University Health Centre, Royal Victoria Hospital site, Montreal, Qc.
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Validation of the University of Washington Quality of Life Chinese Version (UWQOL-C) for head and neck cancer patients in Taiwan
2017, Journal of the Formosan Medical AssociationCitation Excerpt :Psychometric validity is often established with classical test theory, which relies on internal consistency, reliability, and both content and construct validity. Content validity of a translated scale is established by demonstrating that the translated items reflect the most relevant items of a cancer patient's QOL; typically through focus groups of patients as well as experts.21–24 Construct validity would be supported by proving hypothesized associations between the scale of interest and related constructs.
Margaret Eades, N, MSc(A), CON(C): Clinical Nurse Specialist (CNS)-Oncology, McGill University Health Centre-Clinical Co-Administrator and CNS Cancer Nutrition and Rehabilitation Program, McGill University Health Centre, Royal Victoria Hospital site, Montreal, Qc.
Martin Chasen, MBCHB FCP(SA) MPhil (Pall Med): Medical Oncologist and Palliative Care Physician - Clinical Director, Cancer Nutrition and Rehabilitation Program, McGill University Health Centre: Royal Victoria Hospital site and McGill University, Montreal, Qc.
Ravi Bhargava, MD: Clinical Research Associate, Cancer Nutrition and Rehabilitation Program, McGill University Health Centre: Royal Victoria Hospital site, Montreal, Qc.