The Impact of Swallowing Function Pre- and Post Head & Neck Cancer Treatment Jo Patterson Research Associate / Macmillan SALT University of Newcastle /

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Presentation transcript:

The Impact of Swallowing Function Pre- and Post Head & Neck Cancer Treatment Jo Patterson Research Associate / Macmillan SALT University of Newcastle / Sunderland Royal Hospital Mike Drinnan Principal Medical Physicist, Freeman Hospital, Newcastle upon Tyne

Outline Background –Outcomes for swallowing focussed on biomechanical function –Dysphagia associated with poorer QOL –Development of dysphagia specific questionnaires Aim Describe swallowing difficulties in head and neck cancer from the patients’ perspective

Methods Convenience sample (SALT) pre- 6, 12 months Exclusions –Tumour recurrence –Palliative patients

Measurement tool SWAL-QOL 2002 (44 items, 11 domains) general burden*(fatigue) food selection*(sleep) eating duration(communication) eating desire fear of eating mental health* social function* symptom frequency

Data Sample N=65 (49 males; 16 females) Age 32-80y mean 60y median 62y Oral (31) oropharyngeal (30) NPC (4) T1-2 (35) T3-4 (30) Surgery (10) surgery & radiotherapy (36) chemoradiotherapy (13) radiotherapy (6) 35 completed pre & post SWAL-QOL Analysed using ANOVA

Pre-treatment

Females had lower scores T3-4 tumour group worse than T1-2 Oropharyngeal patients worse than oral Nasopharyngeal patients reported few problems

6 months post treatment

Post-treatment Males reporting more problems T1-2 group reporting more symptoms at 6m, more mental health & social issues at 12m Orals – problems with chewing Oropharyngeals – choking / sticking Combined modality treatment worse than single modality

Discussion Type of treatment Tumour site Tumour size Time post treatment Gender Age Nodal disease

Limitations Biased sample Reduced questionnaire Small sample Functional status Some patients found questionnaire difficult

Conclusions Assessment from different perspectives Keep assumptions in check Clinician’s priorities vs patient priorities Rehabilitate symptoms and perceptions

Acknowledgements Head and neck cancer patients at Sunderland Royal Hospital Research Development Capacity Grant – Department of Health

12 months post treatment