Advancing Education, Research, and Quality of Care for the Head and Neck oncology patient.
Background: Depression is a prevalent and underdiagnosed problem in head and neck cancer (HNC) patients, with prior reports suggesting up to 50% of patients exhibiting signs and symptoms. While the impact of depression on quality of life of head and neck cancer patients has been well studied before, patient preferences regarding the management and treatment of mental health related symptoms remain unknown. The goal of this study was to evaluate patient-reported metrics regarding the management of mental health symptoms during their HNC care and survivorship.
Methods: A 29-item anonymous survey was formulated by multidisciplinary team at our institution and was exempt from Institutional Review Board review. Survey was disseminated using Qualtrics through the Head and Neck Cancer Alliance (HNCA) membership listserv. Inclusion criteria involved any person with a history of HNC diagnosis who was a voluntary recipient of the HNCA listserv. Survey was distributed on October 17th, 2024, and will remain open until January 1st, 2025.
Results: Here we report the preliminary findings of our study (from October 17-25, 2024). 32 respondents completed the survey thus far, 15 Male and 17 Female. Majority of the respondents were older than 65 (n = 19, 60%). Primary cancer sites varied, with the majority being oropharynx (n = 14, 43%) and oral cavity (n = 7, 22%). Twenty-two patients (68%) were treated with surgery, 27 (84%) had radiotherapy, and 20 (63%) also had chemotherapy. Sixteen (50%) of the patients had completed their cancer treatment and were in surveillance. Twenty-five percent endorsed a diagnosis of depression prior to their HNC diagnosis. Majority of patients denied having a discussion regarding SSRIs with their HNC treatment team (n = 25, 78%) and 69% of patients did not recall undergoing any form of depression screening. Only 12 patients (37%) felt their mental health and mood-related symptoms were adequately addressed, and importantly, 47% endorsed wanting their surgeon to take a more active role in addressing their mental health during HNC treatment.
Conclusion: Depression remains a prevalent and underrecognized problem in HNC patients. The preliminary results of our study reveal that patients do not feel that their mental health problems were adequately addressed by their care team and want more involvement from their surgeons in managing their mood-related symptoms. Our study highlights the need for more formal training and guidelines related to mental health symptoms in this patient population.