Head and neck cancer (HNC) ranks among the world’s most prevalent cancers with nearly 890,000 new cases annually. Although overall incidence has decreased due to decreases in tobacco use, the rise of HPV-associated oropharyngeal tumors has led to an increase incidence rate in younger patients. Treatment strategies can be curative but often exact a heavy toll in terms of functional, physical, and psychosocial morbidity. Surgical treatment of HNC, given its anatomical location, can cause significant functional impairments that are unique to this malignancy. Dysphagia, dysarthria, chronic pain, and malnutrition represent key functional impairments that can substantially impact patients’ activities of daily living. These functional morbidities are often interrelated, and the impact on certain anatomical areas can cause impairments that affect a patient’s activities of daily living including communicating, eating, and breathing. Aside from the functional impairment caused by HNC treatment, cosmetic changes can be particularly debilitating. Cosmetic morbidity such as scarring, disfigurement, and lymphedema further impact quality-of-life issues by affecting self-image and social interactions. Psychosocial comorbidities including anxiety, depression, and suicidality are also elevated in HNC. Patients with HNC are at a much higher risk of depression and suicide compared to the general population. This makes identification and management of these morbidities even more vital to patient care and outcomes. A multidisciplinary team that integrates oncologists, reconstructive surgeons, speech-language pathologists, nutritionists, and mental health professionals would best optimize both physical and emotional well-being. By addressing the extensive morbidity that accompanies HNC, clinicians can help translate survival gains into meaningful long-term recovery.

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Morbidity of Head and Neck Cancer

  • Jad Zeitouni,
  • Daniel Spangler,
  • Yusuf Dundar

摘要

Head and neck cancer (HNC) ranks among the world’s most prevalent cancers with nearly 890,000 new cases annually. Although overall incidence has decreased due to decreases in tobacco use, the rise of HPV-associated oropharyngeal tumors has led to an increase incidence rate in younger patients. Treatment strategies can be curative but often exact a heavy toll in terms of functional, physical, and psychosocial morbidity. Surgical treatment of HNC, given its anatomical location, can cause significant functional impairments that are unique to this malignancy. Dysphagia, dysarthria, chronic pain, and malnutrition represent key functional impairments that can substantially impact patients’ activities of daily living. These functional morbidities are often interrelated, and the impact on certain anatomical areas can cause impairments that affect a patient’s activities of daily living including communicating, eating, and breathing. Aside from the functional impairment caused by HNC treatment, cosmetic changes can be particularly debilitating. Cosmetic morbidity such as scarring, disfigurement, and lymphedema further impact quality-of-life issues by affecting self-image and social interactions. Psychosocial comorbidities including anxiety, depression, and suicidality are also elevated in HNC. Patients with HNC are at a much higher risk of depression and suicide compared to the general population. This makes identification and management of these morbidities even more vital to patient care and outcomes. A multidisciplinary team that integrates oncologists, reconstructive surgeons, speech-language pathologists, nutritionists, and mental health professionals would best optimize both physical and emotional well-being. By addressing the extensive morbidity that accompanies HNC, clinicians can help translate survival gains into meaningful long-term recovery.