Pilot Telephone Intervention to Improve Survivorship Care in Patients with Head and Neck Cancer

Thanh P Ho, Mary Jewison, Kathryn J Ruddy and Katharine AR Price

Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
Department of Medical Oncology, Mayo Clinic, Rochester, Minnesota, USA

^*Correspondance to: Katharine Price 

 PDF  Full Text DOI: 10.25107/2474-1647.1795

Abstract

Background: Multimodality treatment for Head and Neck Cancer (HNC) is associated with significant impact on quality of life and underscores the importance of comprehensive survivorship care.Objective: A pilot phone intervention was conducted in HNC survivors to improve coordination of care by addressing core problems: dysphagia, lymphedema, neck pain, fatigue, emotional distress, financial concerns, and nicotine dependency.Methods: Patients who had completed curative intent therapy for HNC were identified. One month prior to an upcoming appointment, patients were called by a nurse who asked about common longterm side effects and offered services and additional appointments as indicated.Results: Forty-eight patients (38 males, 79%) with a median age of 60 years (range 41 to 78) were contacted. Most were stage IVA HNC (34 patients, 92%), squamous cell carcinoma (44, 92%) and located in the oropharynx (28, 58%). Patients were contacted between 6 to 77 months from definitive therapy, with conversations ranging from 3 to 30 minutes. Common symptoms included neck pain (52%), dysphagia (46%), and lymphedema (19%). Fatigue (33%) and emotional/ psychological concerns (27%) were also noted. Financial matters (10%) and smoking cessation (4%) were infrequently reported. Ultimately, 31% of conversations led to referrals or other interventions resulting in a change in management.Limitations: The sample size was small, and no direct patient outcomes were reported.Conclusion: This study demonstrates the need for comprehensive and coordinated survivorship care for patients with HNC.

Keywords

Head and neck cancer; Survivorship; Dysphagia; Lymphedema; Fatigue; HPV; Oropharynx

Cite the article

Ho TP, Jewison M, Ruddy KJ, Price KAR. Pilot Telephone Intervention to Improve Survivorship Care in Patients with Head and Neck Cancer. Clin Surg. 2017; 2: 1795.