Skip to main content
SpringerLink
Log in

Assessing quality of life in head and neck cancer

  • Review
  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Comprehensive assessment of the impact of head and neck cancer goes beyond traditional biomedical outcomes to include quality of life. This paper examines the methods used in reported studies on quality of life in head and neck cancer patients with respect to definitions, approaches to measurement, and types of findings. Analysis reveals little consensus in defining or assessing quality of life, although deficits in patient well-being were well-documented. A number of current efforts to develop and validate quality of life instruments specific to cancers of the head and neck have been reported. Future research should be sensitive to the issue of defining quality of life; a definition which includes both patient perceptions and objective functioning in a number of areas is advisable. Investigators should build on recent and ongoing efforts at instrument development and make afforts to incorporate quality of life assessment in clinical trials of cancer treatments. The distinctive aspects of head and neck cancer illustrate the importance of considering characteristics of the patient population in quality of life research and also the way that quality of life data can contribute to the multidisciplinary team of caregivers.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. SpilkerB, Ed. Quality of Life Assessments in Clinical Trials. New York: Raven Press, 1990.

    Google Scholar 

  2. Tchekmedyian NS, Cella DF, Eds. Quality of Life in Current Oncology Practice and Research (Special issue). Oncology 1990; 4.

  3. HollandsworthJG. Evaluating the impact of medical treatment on the quality of life: A 5-year update. Soc Sci Med 1988; 26: 425–434.

    Google Scholar 

  4. HarwoodAR. Supraglottic laryngeal carcinoma. Int J Radiat Oncol Biol Phys 1990; 18: 263–265.

    Google Scholar 

  5. HongWK, LippmanSM, ItriLM, et al. Prevention of second primary tumors with isotretinoin in squamous-cell carcinoma of the head and neck. N Engl J Med 1990; 323: 795–801.

    Google Scholar 

  6. Department of Veterans Affairs Laryngeal Cancer Study Group. Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med 1991; 324: 1685–1690.

    Google Scholar 

  7. SugarbakerPH, BarofskyI, RosenbergSA, et al. Quality of life assessment in patients in extremity sarcoma clinical trials. Surgery 1982; 91: 17–23.

    Google Scholar 

  8. GanzPA, SchagCAC, PolinskyML, et al. Rehabilitation needs and breast cancer: The first month after primary therapy. Breast Cancer Res Treat 1987; 10: 243–253.

    Google Scholar 

  9. PruynJFA, deJongPC, BosmanLJ, et al. Psychosocial aspects of head and neck cancer — a review of the literature. Clin Otolaryngol 1986; 11: 469–474.

    Google Scholar 

  10. BreitbardW, HollandJ. Psychosocial aspects of head and neck cancer. Sem Oncol 1988; 15: 61–69.

    Google Scholar 

  11. DrettnerB, AhlbomA. Quality of life and state of health for patients with cancer in the head and neck. Acta Otolaryngol (Stockh) 1983; 96: 307–314.

    Google Scholar 

  12. CellaDF, TulskyDS. Measuring quality of life today: Methodological aspects. Oncology 1990; 4: 29–38.

    Google Scholar 

  13. FietkauR, ThielHJ, IroH, et al. [Comparison between oral nutrition and enteral nutrition using a percutaneous endoscopy guided gastrostomy (PEG) in patients undergoing radiotherapy for head and neck tumors]. Strahlenther Onkol 1989; 165: 844–851.

    Google Scholar 

  14. BurnsL, ChaseD, GoodwinWJ Jr. Treatment of patients with Stage IV cancer: Do the ends justify the means? Otolaryngol Head Neck Surg 1987; 97: 8–14.

    Google Scholar 

  15. Lansky SB, List MA, Ritter-Sterr C, et al. Quality of life in head and neck cancer survivors. Proc Annu Meet Am Soc Clin Oncol 1989; 8: A656.

    Google Scholar 

  16. HarwoodAR, RawlinsonE. The quality of life of patients following treatment for laryngeal cancer. Int J Radiat Oncol Biol Phys 1983; 9: 335–338.

    Google Scholar 

  17. TeichgraeberJ, BowmanJ, GoepfertH. Functional analysis of treatment of oral cavity cancer. Arch Otolaryngol Head Neck Surg 1986; 112: 959–965.

    Google Scholar 

  18. CaldarolaF, SanlorenzoM, VigezziP. [Radical neck dissection in neoplasms of the oral cavity and cervicofacial area. Analysis of a case load]. Minerva Stomatol 1987; 36: 867–870.

    Google Scholar 

  19. KarimAB, KralendonkJH, NjoKH, et al. Radiation therapy for advanced (T3T4T0-N3M0) laryngeal carcinoma: The need for a change of strategy: A radiotherapeutic viewpoint. Int J Radat Oncol Phys 1987; 13: 1625–1633.

    Google Scholar 

  20. OnoI, KanekoT, EbiharaS, et al. [Quality of life in treated head and neck cancer patients]. Gan No Rinsho 1988; 34: 1065–1071.

    Google Scholar 

  21. FletcherAE. Measurement of quality of life in clinical trials of therapy. Recent Results Cancer Res 1988; 111: 216–230.

    Google Scholar 

  22. MortonRP, DaviesAD, BakerJ, et al. Quality of life in treated head and neck cancer patients: A preliminary report. Clin Otolaryngol 1984; 9: 181–185.

    Google Scholar 

  23. Mathias E, Smith D, Gonzalez F. Quality of life in patients with head and neck squamous cell carcinoma (HNSCC): A preliminary report. Proc Annu Meet Am Soc Clin Oncol 1988; 7: A1037.

    Google Scholar 

  24. StraussRP. Psychosocial responses to oral and maxillofacial surgery for head and neck cancer. J Oral Maxillofac Surg 1989; 47: 343–348.

    Google Scholar 

  25. DhillonRS, PalmerMR, PittamMR, et al. Rehabilitation after major head and neck surgery — the patients' view. Clin Otolaryngol 1982; 7: 319–324.

    Google Scholar 

  26. MaceriDR, LampeHB, MakielskiKH, et al. Conservation laryngeal surgery: A critical analysis. Arch Otolaryngol 1985; 111: 361–365.

    Google Scholar 

  27. PolcrovaA, TesarikJ.[Social adjustment of our patients following surgery for laryngeal cancer]. Acta Univ Palacki Olomuc Fac Med 1987; 116: 321–327.

    Google Scholar 

  28. Guthrie TH, Brubaker LH, Porubsky ES, et al. Circadian cisplatin (C), bleomycin (B) and 5-fluorauracil (F) in advanced squamous cell carcinoma of the head and neck (SCCH). Proc Annu Meet Am Soc Clin Oncol 1990; 9: A689.

  29. Stern JR, Keller AJ, Wenig BL. Evaluation of reconstructive techniques of oropharageal defects. Second International Conference on Head and Neck Cance. Boston, 1988 (abstract).

  30. ListMA, Ritter-SterrC, LanskySB. A performance status scale for head and neck cancer patients. Cancer 1990; 66: 564–569.

    Google Scholar 

  31. KarnofskyDA, BuchenalJH. The clinical evaluation of chemotherapeutic agents in cancer. In: MacleodCM, ed. a Evaluation of Chemotherapeutic Agents. New York: Columbia, 1949: 191–205.

    Google Scholar 

  32. Browman GP, Goodyear MD, Levine MN, et al. Evaluation of a quality of life/toxicity index for patients receiving radiation (RT) +/- chemotherapy for head and neck cancer (HNC). Proc Annu Meet Am Soc Clin Oncol 1989; 8: A1220.

    Google Scholar 

  33. Browman GP, Levine MN, Hodson, I, et al. A new quality of life (QL) index for head and neck cancer (HNC) patients (pts) receiving radical radiotherapy (RT). Proc Annu Meet Am Soc Clin Oncol 1988; 7: A597.

    Google Scholar 

  34. LevineMN, GuyattGH, GenM, et al. Quality of life in stage II breast cancer: An instrument for clinical trials. J Clin Oncol 1988; 6: 1798–1810.

    Google Scholar 

  35. GuyattGH, TownsendM, KellerJ, et al. Measuring functional status in chronic lung disease. Conclusions from a randomized control trial. Respir Med 1989; 83: 293–297.

    Google Scholar 

  36. GuyattGH, MitchellA, IrvineEJ, et al. A new measure of health status for clinical trials in inflammatory bowel disease. Gastroenterology 1989; 96: 804–810.

    Google Scholar 

  37. Llewellyn-ThomasHA, SutherlandHJ, HoggSA, et al. Linear analogue self-assessment of voice quality in laryngeal cancer. J Chron Dis 1984; 37: 917–924.

    Google Scholar 

  38. SutherlandHJ, Llewellyn-ThomasH, HoggSA, et al. Do patients and physicians agree on the assessment of voice quality in laryngeal cancer? J Otolarynol 1984; 13: 325–330.

    Google Scholar 

  39. Cella DF, Tulsky DS, Bonomi A, et al. The functional assessment of cancer therapy (FACT) scales: Incorporating disease-specificity and subjectivity into quality of life (QL) assessment. Proc Annu Meet Am Soc Oncol. 1990; 9: A1190.

    Google Scholar 

  40. SeifertE, BierH, GanzerU. [Assessment of the quality of life of patients with incurable head-neck tumors]. Laryngorhinootologie 1989; 68: 285–289.

    Google Scholar 

  41. McNeilBJ, WeichselbaumR, PaukerSG. Speech and survival: Tradeoffs between quality and quantity of life in laryngeal cancer. N Engl J Med 1981; 305: 982–987.

    Google Scholar 

  42. PlanteDA, PiccirilloJF, SoffermanRA. Decision analysis of treatment options in pyriform sinus carcinoma. Med Decis Making 1987; 7: 74–83.

    Google Scholar 

  43. VelanovichV. Choice of treatment for Stage I floor-of-mouth cancer. A decision analysis. Arch Otolaryngol Head Neck Surg 1990; 116: 951–956.

    Google Scholar 

  44. Croog SH. Current issues in the conceptualization and measurement of quality of life. Paper presented at the National Institutes of Health (Office of Science Policy and Legislation) Special Workshop on Quality of Life Assessment: Practice, Problems, & Promise, Bethesda, MD, October 15–17, 1990.

  45. SchipperH. Guidelines and caveats for quality of life measurement in clinical practice and research. Oncology 1990; 4: 51–57.

    Google Scholar 

  46. Gotay CC, Korn EL, McCabe MS, et al. Quality of life in cancer treatment protocols: Research issues in protocol development. JNCI 1992; (in press).

  47. AaronsonNK. Quality of life assessment in clinical trials: methodologic issues. Controlled Clin Trials 1989: 10: 195S-208S.

    Google Scholar 

  48. DonovanK, Sanson-FisherRW, RedmanS. Measuring quality of life in cancer patients. J Clin Oncol 1989; 7: 959–968.

    Google Scholar 

  49. BoydNF, SelbyPJ, SutherlandHJ, et al. Measurement of the clinical status of patients with breast cancer: Evidence for the validity of self-assessment with linear analogue scales. J Clin Epidemiol 1988; 41: 243–250.

    Google Scholar 

  50. vanKnippenbergFCE, deHaesJCJM. Measuring the quality of life of cancer patients: Psychometric properties of instruments. J Clin Epidemiol 1988; 41: 1043–1053.

    Google Scholar 

  51. BarofskyI, SugarbakerPH. Cancer. In: SpilkaB, ed. Quality of Life Assessments in Clinical Trials. New York: Raven Press, 1990: 419–439.

    Google Scholar 

  52. Andry G, Deraemaecker R, Guelinckx P, et al. Ultimate surgery for recurrent head and neck cancer. International Symposium for Physicians, Nurses and Social Workers on Supportive Care in Cancer Patients. St. Gallen, Switzerland, 1987.

  53. GelberRD, GelmanRS, GoldhirschA. A quality-of-life-oriented endpoint for comparing therapies. Biometrics 1989; 45: 781–795.

    Google Scholar 

  54. SlevinML, PlantH, LynchD, et al. Who should measure quality of life, the doctor or the patients? Br J Cancer 1988; 57: 109–112.

    Google Scholar 

  55. McDowellI, NewellC. Measuring Health: A guide to rating scales and questionnaires. New York: Oxford University Press, 1987.

    Google Scholar 

  56. SpitzerWO, DobsonAJ, HallJ et al. Measuring the quality of life of cancer patients. J Chron Dis 1981; 34: 585–597.

    Google Scholar 

  57. PriestmanTJ, BaumM. Evaluation of quality of life in patients receiving treatment for advanced cancer. Lancet 1976; i: 899–901.

    Google Scholar 

  58. SchipperH, ClinchJ, McMurrayA, et al. Measuring the quality of life of cancer patients: the Functional Living Index-Cancer: Development and validation J Clin Oncol 1984; 2: 472–483.

    Google Scholar 

  59. PadillaGV, PresantC, GrantMM, et al. Quality of life index for patients with cancer. Res Nurs Health 1983; 6: 117–126.

    Google Scholar 

  60. SchagCAC, HeinrichRL, GanzPA. The Cancer Inventory of Problem Situations: An instrument for assessing cancer patients' rehabilitation needs. J Psychosoc Oncol 1983; 1: 11–24.

    Google Scholar 

  61. GrogonoAW, WoodgateDJ. Index for measuring health. Lancet 1971; ii: 1024–1026.

    Google Scholar 

  62. LogemannJA. Swallowing and communication rehabilitation. Sem Oncol Nurs 1989; 5: 205–212.

    Google Scholar 

  63. AaronsonNK, BakkerW, StewartAL, et al. Multidimensional approach to the measurement of quality of life in lung cancer trials. In: AaronsonNK, BeckmannJH, BernheimJL, et al. eds. The Quality of Life of Cancer Patients. New York: Raven Press, 1987.

    Google Scholar 

  64. GoldhirschA, GelberRD, SimesRJ, et al. Costs and benefits of adjuvant therapy in breast cancer: A quality-adjusted survival analysis. J Clin Oncol 1989; 7: 36–44.

    Google Scholar 

  65. deHaesJCJM, vanKnippenbergFCE. Quality of life instruments for cancer patients: ‘Babel's Tower Revisited’. J Clin Epidemiol 1989; 42: 1239–1241.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The Emmes Corporation, 11325 Seven Locks Road, Suite 214, 20854, Potomac, MD, USA

    C. C. Gotay

  2. Cancer Therapy Evaluation Program, Division of Cancer Treatment, National Cancer Institute, Bethesda, MD, USA

    T. D. Moore

Authors
  1. C. C. Gotay
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T. D. Moore
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gotay, C.C., Moore, T.D. Assessing quality of life in head and neck cancer. Qual Life Res 1, 5–17 (1992). https://doi.org/10.1007/BF00435431

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00435431

Key words

Search

Navigation