Self-Reported Health Scores In Year After Head And Neck Cancer May Predict Long-Term Survival
After being diagnosed with head and neck cancer, changes in the physical health status of patients appear to predict survival at five years, according to a report released on September 15, 2008 in Archives of Otolaryngology — Head & Neck Surgery, one of the JAMA/Archives journals.
The TNM staging system of cancer is based on the tumor, the level of involvement of the lymph nodes, and the magnitude of any distance spread. When predicting whether cancer patients will die, the TNM system is an effective predictive method, according to the background information in the article.
However, this system only includes information about other medical conditions, without consideration of the patient’s health status overall. The authors point out this potential weakness in the system: “These factors may have a meaningful effect on the management of patients with head and neck cancer from the initial assessment through treatment selection and management of complications,” the authors write.
To investigate the potential of these other factors on proper management of head and neck cancers, Mark J. Jameson, M.D., Ph.D., and colleagues examined 403 patients who were diagnosed with head and neck cancer between 1995 and 2005. Each participant was assessed of general physical health when they were diagnosed, which was repeated in three, six, nine, and 12 months later, with 5 years of follow up.
Scores on the health assessments decreased over time in all patients for the first three months. No subsequent recovery was seen for those who died in the second or third year. Some recovery was seen for those who died in the fourth or fifth year. Those who survived five years or longer nearly showed full recovery by the twelfth month.
This indicates that this self-reported general health measure “captures prognostic information related to cancer state,” according to the authors. “It seems intuitive that a patient’s perception of well-being would fluctuate (e.g., during intensive cancer therapy vs. after recovery from successful treatment), and it seems possible that this fluctuation may be predictive of long-term outcome. This study demonstrates that the change in self-reported health status during the first year is predictive of long-term outcome (i.e., five-year survival).”
Thus, a general heath and well-being measure may be a useful addition to patient care for those with head and neck cancer — and this is especially true for the first year. The authors conclude: “It has the benefits of refining prognosis and identifying patient needs that may not be clinically obvious in a brief encounter but may have substantial effect on quality of life… Further study is warranted to determine how to best integrate data from patient-reported health assessment into patient care.”
First-Year Trends in Self-reported General Health Predict Survival in Patients With Head and Neck Cancer
Mark J. Jameson, MD, PhD; Lucy Hynds Karnell, PhD; Alan J. Christensen, PhD; Gerry F. Funk, MD
Arch Otolaryngol Head Neck Surg. 2008;134(9):958-964.
Written by Anna Sophia McKenney