People surviving head and neck cancer (HNC) face many obstacles to good quality of life. One such obstacle is social avoidance. After treatment, people with HNC report avoiding activities like social events, and may have difficulty returning to work or engaging in everyday activities like dining out or seeing friends. However, the reasons for this avoidance are unknown. Because of the location of their tumors, people with HNC commonly receive treatments that alter their appearance and communication ability. One possible reason for social avoidance may be that HNC patients develop symptoms of Social Anxiety Disorder, a debilitating condition marked by disruptive fear and anxiety about being embarrassed or rejected by other people, as a result of their disfiguring treatment. Another possibility is that only those HNC patients with a pre-cancer history of social anxiety actually develop social avoidance post-treatment. A third possibility is that HNC patients avoid social situations for reasons that have little to do with anxiety (perhaps because of fatigue, loss of interest, or need to stay away from germs). We propose to:,1) use well-established diagnostic tools and clinical interviews to investigate the relationship between anxiety and avoidance in a cross-sectional sample of HNC patients, divided into groups based on type of treatment (significantly impairing, like surgery, or less impairing, like chemotherapy/radiation); 2) investigate the relationship between any pre-cancer psychiatric diagnosis and post-treatment anxiety and avoidance; 3) investigate the effect of social anxiety and/or avoidance on quality of life; and 4) examine the specificity of these relationships to HNC by comparing HNC patients to lung cancer patients. We believe that a better understanding of the relation of appearance, social anxiety, avoidance, and quality of life in HNC patients will allow us to develop educational and psychotherapeutic treatment strategies to most effectively help them achieve the best possible quality of life.
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| Haman, Kirsten L (2008) Psychologic distress and head and neck cancer: part 1--review of the literature. J Support Oncol 6:155-63 |
