The quality of life of head and neck cancer patients: a review of the literature

There is an increasing awareness within the medical profession of the need to include quality of life as well as survival as an outcome measure. This paper reviews some of the evidence which assesses the quality of life of patients with cancer of the head and neck who have undergone surgery or radiotherapy. Although the aim of treatment is to prolong life, the evidence shows that the quality of life of patients can be severely impaired by treatment for cancers in the head and neck region. In general the findings are incomplete and there is an obvious need for further investigation of the quality of survival of these acutely ill patients. For example, the majority of the studies were retrospective, largely descriptive in nature, and mainly focused on functional disability and based on small samples. It is acknowledged that an adequate sample of head and neck cancer patients will always be difficult to recruit in numbers sufficient to provide statistical robustness. Nevertheless a prospective study using validated instruments could more accurately quantify the impact of treatment for head and neck cancers upon quality of life. Without appropriate measurement of the quality of life of patients with head and neck cancer, policy makers and clinicians making judgements about patient selection and treatment type will be doing so on the basis of beliefs and guesses.