1. Depression among Head & Neck Cancer Patients Undergoing Curative Radiotherapy Wajeeha H Rizvi1, Anam Siddiqui1, Sarah Jamshed2 Saad Bin Jamil1, Arif Jamshed3 1SMC Dow University of Health Sciences, Karachi, Pakistan; 2 Aga Khan University Medical College, Karachi, Pakistan; 3 Shaukat Khanum Memorial Cancer Hospital, Lahore, Pakistan
INTRODUCTION
Head and neck cancer (HANC) is the 6th most common cancer worldwide. South Asian countries, including Pakistan have a high prevalence of HANC.
Although early-stage HANC have high cure rates, up to 50 – 70 % of HANC patients present with advanced disease
Cancer diagnosis typically affects an individual both physically and psychologically. Fear and grief of not only suffering from pain, disruption of daily life style and treatment associated debilitation, but also of high cancer mortality rates can be devastating for the patient.1,2
The patient with HANC is prone to psychological distress immediately following diagnosis and during the treatment phase. Even after successful definitive therapy, HANC patients face tremendous impacts on quality of life.
In the west % of patients with HANC suffer from depression during treatment, whereas literature from developing countries is sparse.3
This purpose of this study is to determine the levels of depression among HANC patients undergoing curative radiotherapy in a developing country.
METHODS
A survey was conducted on HANC patients undergoing curative radiotherapy at Shaukat Khanum Memorial Hospital and Research Centre (SKMCH & RC).
All 35 patients undergoing radical radiation in February 2010 for HANC at SKMCH & RC radiation department were enrolled.
3. Data was collected by medical students using a structured questionnaire, based on the Zung Self Rating Depression Scale (ZSRDS).4 Seventy three percent of the patients were illiterate.
4. Males (60%) : Females (40%). Median age of patients was 50 years (range 21-75). Ten (29%) were < 40 years and 25 (71%) of the patients were > 40 years.
5. Site of disease was; oral cavity 31%, nasopharynx 20%, hypopharynx 11%, parotid gland 11%, larynx 9%, Para nasal sinus 9%, oropharynx 3% and others 6%.
AJCC Stage was I/II in 13 (37%) and III/IV in 22 (63%) cases. Nineteen (54%) patients were receiving concomitant chemoradiation and 15 (46%) were on radiation alone.
RESULTS
With ZSRDS criteria the percentage of patients with
normal, mild, moderate and severe depression was
86%, 4%, 1% and 0% respectively.
CONCLUSION
In contrast to other reports depression levels among HANC patients undergoing treatment was considerably lower in our population.
Inadequate understanding pertaining to the gravity of the disease along with poor literacy rate may explain the conflicting result.
This emphasizes the need for further studies assessing depression among these patients.
REFERENCES
Massie MJ, Holland JC. Depression and the cancer patient. J Clin Psychiatry.1990;51:Suppl 7:1217.
Mermelstein HT, Lesko L. Depression in patients with cancer. Psycho-Oncology. 1992;1:
Sehlen S, Lenk M, Herschbach P, Aydemir U, Dellian M, Schymura B, Hollenhorst H, Duhmke E. Depressive symptoms during and after radiotherapy for head and neck cancer. Head Neck. 2003;25:
Zung WW (1965) A self-rating depression scale. Archives of General Psychiatry 12: 63-70