The proposed four year, multi-institutional study will prospectively examine performance outcome, quality of life (QL) outcome and patient priorities in patients with stage II-IV head and neck cancer undergoing primary surgical treatment or primary organ preserving chemoradiotherapy. The following groups will be included: a) oral cavity/oropharyngeal patients undergoing surgical resection; b) patients undergoing total laryngectomy and c) patients (oral cavity, pharynx, oropharynx, nasopharynx, larynx) undergoing chemoradiotherapy. Documentation of patient preferences vis a vis possible treatment effects, as well as determination of perceived quality of life outcome, is critical to comprehensive evaluation of treatment and rehabilitation approaches. In particular, the value that patients place on specific functions or alternatively, the negative appraisal attached to specific impairments, may influence treatment choice, patient education or counseling, and ultimately psychosocial adjustment.
The specific aims of the study are to: 1. Determine rate and degree of recovery of function, mood and overall QL by group and time from completion of treatment and identify times of greatest difficulty for patients. 2. Determine relationship between performance in areas of eating and speaking, and overall mood and quality of life. 3. Identify patients at greatest risk for poor functional and QL outcomes. Sociodemographic characteristics (including alcohol and psychiatric history, social support), disease and treatment parameters, and patients' priorities will be examined. 4. Compare functional and QL outcomes between groups with similar disease site and stage, but receiving different primary treatment modalities. 5. Evaluate patients' priorities regarding potential disease and treatment sequelae; determine whether these rankings change over time as patients experience effects of disease and treatment; determine the relationship between priority rankings and actual function (eating, speaking, overall status). 6. Compare the priorities of patients with head and neck cancer to those of other patients and non-patient controls. A total of 500 patients will be assessed at four points in time: pretreatment, 3 months post completion of treatment, 6 and 12 months post completion of treatment. Assessment will include the PPS-HN (Performance Status Scale for Head and Neck Cancer), the FACT-H&N (Functional Assessment of Cancer Therapy Scale - Head and Neck, the Patient's Priorities Ranking Scale, as well as the collection of relevant medical, personal and social demographic data.
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