Oral cancer constitutes a significant threat to health and well being. It is caused by a variety of environmental, genetic, viral, and behavioral factors including tobacco and alcohol use. Treatment poses threats to body image due to potentially disfiguring surgery. Threats of death and/or recurrence of disease, communication problems, and eating and breathing difficulties are also possible. In addition, treatment requires cessation of tobacco and alcohol use. These are significant stressors that are likely to affect psychological adjustment and quality of life. However, comprehensive psychosocial interventions have been applied to oral cancers. Despite the likelihood of significant distress associated with oral cancer and the recent success of group and individual interventions in enhancing adjustment and reducing stress, there are no systematic data bearing on these issues in oral cancer patients. The proposed research will complete development of a psychosocial intervention for oral cancer patients and will evaluate the effectiveness of this intervention in reducing stress, facilitating alcohol and tobacco cessation, reducing psychological distress, and enhancing quality of life. This study will be a randomized investigation for the psychosocial intervention for oral cancer patients involving comparison of a range of outcomes among intervention and control groups of oral cancer patients. Patients randomized to the experimental group will receive a seven-session psychosocial psychosocial intervention, beginning during post-surgery inpatient hospitalization. Patients in the control group will receive information about cancer of the oral cavity and its treatment in seven brief session with the same therapist who administers the intervention. All participants will complete a pre-intervention assessment and will provide similar data one and six months after the intervention and one year later. Evaluation of the intervention will be accomplished by comparing several psychological and medical outcomes of patients receiving the intervention and the control group of similar patients who receive information and standard care. Outcomes will include the measures of stress, anxiety, depress, smoking, smoking cessation, and quality of life. Disease related outcomes (e.g new evidence of disease) will also be monitored.
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