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The holistic connection – integrative care in head and neck cancer

Worldwide head and neck cancer (HNC) is increasing owing to rising rates of tobacco use and human papillomavirus infection. There are over 800,000 new cases diagnosed annually with many thousands living with the side effects of treatment.

To support themselves through their journey, there is an ever-increasing number reaching to complementary therapies.1

  • 87% use one or more therapies2
  • 59% of radiation therapy patients use complementary therapies3

Integrative oncology emphasizes:

  • The innate ability of the body to heal itself
  • The importance of living a healthy lifestyle
  • Using a whole‐person, relationship-centered approach
  • Integration of conventional and complementary methods of treatment and prevention
  • The use of natural, less invasive interventions when possible

Head and neck cancer patients can have numerous unique side effects from treatment.

With the intense treatment regimens, which may include surgery, radiation therapy, chemotherapy, or a combination of all three, patients with HNC suffer adverse impacts to their swallowing, speaking, and quality-of-life. Integrative treatments can provide considerable relief for many of their symptoms and may offer a valuable component to their care.4

Dysphagia is one of the most common complication of HNC radiation treatment (~55% of patients)4, and one of the main predictors of quality-of-life post-treatment. It results from multiple factors including:4,5

  • Taste loss
  • Dry mouth (xerostomia)
  • Stricture
  • Fibrosis
  • Jaw movement restriction (trismus)
  • Dental issues

A well-integrated management plan including oral health experts and speech pathologists (supporting swallowing, eating and speech) can assist in compensating for treatment- and disease-associated morbidities and improve quality-of-life.4,5

Scott Larsen, MD, a head and neck surgeon at GenesisCare Fort Myers, says, "Head and neck cancer is a group of complex diseases each of which requires a different treatment approach. Patients’ symptoms and treatment side effects will vary based on the type of cancer and location as well as the overall treatment plan. Given this complexity, management of patients with head and neck cancer requires treatment from a multidisciplinary treatment team and not just one or two physicians. This treatment team can include a surgeon, radiation oncologist, medical oncologist, speech language pathologist, dentist, oncology nurse navigator, dietician, etc.

Medical data shows that patients treated by a cooperative multidisciplinary head and neck cancer team have better outcomes and quality of life after treatment.

Evidence also supports exercise as an important component for assisting HNC patients with cancer-related fatigue, functional capacity, mood, and recovery time for those receiving chemo-radiation treatment. Incorporating an exercise program that include aerobic and active-resistance exercise can improve a patient’s outcomes.6

Integrative care ensures an evidence-based approach to incorporate the best therapies for the patient – conventional or complementary - throughout all stages of their journey.7

References

  1. Bray F, et al. CA Cancer J Clin 2018; 68(6): 394-424.
  2. Judson P, et al. Integr Cancer Ther 2017; 16(1): 96-103.
  3. Muecke R, et al. Integr Cancer Ther 2015; 15(1): 10-16
  4. Nguyen CT, et al. Laryngoscope Investig Otolaryngol 2018; 3(5):364-371. 
  5. Sroussi HY, et al. Oral Maxillofac Surg Clin North Am 2018; 30(4):445-458.
  6. Samuel AR, et al. Support Care Cancer 2019; 27(10):3913-3920.
  7. Matovina C, et al. Otolaryngol Head Neck Surg 2017; 156(2):228-237.
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