Head and Neck cancer: body image, social relations and nutritional status in suffering patients

Background: The risk of increasing depression and social isolation in patients affected by head and neck cancer weigh heavily on the functional aspects. The risk of nutritional deficiency increases, due both to a premorbid lifestyle with poor eating habits, smoking abuse, alcohol consumption and side effects of cancer treatment too. People with head and neck cancer are at risk of developing behavioral processes revealing the existence of a body image disorder. The aim of this monocentric observational prospective study is to evaluate the impact of head and neck cancer on body image, nutritional status and social relations. Materials and methods: A monocentric observational prospective study has been conducted on a convenience sample of 30 patients, consecutively recruited from the Oncology Department of Novara Hospital; the 'EORTC QLQ C30 and EORTC QLQ H&N-35 were administered in the period included between 03/01 and 08/31/2015. The tools provide 3 scores in response to the inputs, one for each area analyzed. For each area were calculated: mean score, standard deviation and 25th, 50th, 75th percentile. The quantitative continuous variables were converted in categorical ones, assigning an identification code number (0 ≤ 25th percentile; 1 if 25th ≤ X ≤ 75th; 2 ≥ 75th percentile) in order to calculate the distribution. Results: Sample demographic characteristics are comparable with literature consulted, indicating that the risk of head and neck cancer is 7 times higher in males than females, and that the most affected age group is from 50 to 70 years old. From the analysis of the 'EORTC QLQ C30, the results were comparable with those reported in literature; a substantial difference has been found in the global measure of perceived health status, which seems to be much poorer in the sample analyzed. Results could be attributed to the advanced stage of the disease (80% stg III-IV). The analysis of EORTC QLQ H & N 35 shows a negative impact on each analyzed area, in particular on body image. The literature indicate that a 75% of patients affected by head and neck cancer are concerned with their body image. Conclusions: The results of this study indicate that in head and neck cancer patients alterations in nutritional status, psychosocial implications, including the altered perception of body image, are problems that should not be underestimated; nevertheless they should be managed by nurse staff as any other side effect related to anticancer treatments.