Patients with head and neck cancer report a decline in physical quality of life but improvement in mental quality of life in the year following initial treatment, according to an article in the March issue of Archives of Otolaryngology-Head & Neck Surgery.

"In addition to mortality, head and neck cancer and its treatment produce substantial reductions in health-related quality of life," the authors wrote. "The treatments tend to produce pain, disfigurement, eating problems and communication problems. Many patients become disabled, and about one third of patients continue to smoke and half are depressed."

In the current study, David L. Ronis, PhD, of the Veterans Affairs Ann Arbor Healthcare System and the University of Michigan School of Nursing, Ann Arbor, and colleagues studied 316 patients newly diagnosed with head and neck cancer at three otolaryngology clinics. Participants completed surveys with information about demographics, smoking status, alcohol problems, clinical and treatment variables and depression.

Their quality of life was assessed using established scales that measured physical and social functioning, eating and swallowing, communication, head and neck pain and emotional well-being. Patients were reassessed one year later to identify any changes in quality of life.

Smoking, symptoms of depression and co-occurring illnesses were associated with low quality of life scores at baseline. At one year, quality of life decreased for physical functioning measures and eating but improved for mental health.

Treatment factors, especially feeding tube placement, chemotherapy and radiation therapy, were associated with decreases in quality of life from the beginning of the study through one year. Baseline smoking and depressive symptoms also remained significant predictors of several quality of life scales at one year.

Physicians may be able to improve quality of life in patients with head and neck cancer by treating depression and by emphasizing the negative effects smoking can have on everyday life, the authors noted. In addition, "physicians should alert patients to the relative effects on quality of life one may experience with different treatments."