A prospective examination of mask anxiety during radiotherapy for head and neck cancer and patient perceptions of management strategies.

Jodie L Nixon,Sandro V Porceddu,Bena Brown,Laurelie R Wall,Elizabeth Brown,Jane Turner,Anne Bernard,Elizabeth C Ward,Amanda E Pigott

doi:10.1002/jmrs.346

Abstract

IntroductionDistress related to wearing an immobilisation mask for radiotherapy treatment (RT) is a common experience for the person undergoing RT for head and neck cancer (HNC). Described as ‘mask anxiety’, there is little known about the patterns of this distress through the course of the treatment or what strategies are being used by people to help alleviate mask anxiety.MethodsThe study used a prospective cohort design to examine the patterns of patient–reported mask anxiety during the course of RT, using a modified Distress Thermometer (DT) and a survey to explore strategies patients used to assist their mask anxiety.ResultsThirty‐five participants, who identified as experiencing mask anxiety, were followed throughout RT treatment. At baseline, females were more likely to experience higher mask anxiety (P = 0.03). Across the course of treatment, mask anxiety significantly (P < 0.001) reduced within the total cohort. In 72% of participants, the level of initial distress was found to reduce over time. Only 22% experienced mask anxiety that remained constant. Few (6%) experienced an increase in mask anxiety across the course of RT. Participants reported relying on intervention from health professionals, self–taught strategies, music, visualisation and medication to manage their mask anxiety.ConclusionsDue to its high prevalence and variable patterns over time, it is recommended that routine screening for mask anxiety be implemented as standard care throughout the course of RT for HNC. Multiple, diverse strategies are being used by patients and studies are needed to develop effective interventions for managing mask anxiety.

Highlights

Distress related to wearing an immobilisation mask for radiotherapy treatment (RT) is a common experience for the person undergoing RT for head and neck cancer (HNC)
In the population with HNC, patient–reported distress before and after radiotherapy (RT) is prognostic for poorer survival,[3] with long–term challenges associated with physical functioning, fatigue and reduced social supports contributing to distress.[1,3,4,5,6]
Of the 250 participants treated for HNC during the study time frame, 35 participants met all eligibility criteria and consented to participate

Summary

Introduction

Distress related to wearing an immobilisation mask for radiotherapy treatment (RT) is a common experience for the person undergoing RT for head and neck cancer (HNC). Described as ‘mask anxiety’, there is little known about the patterns of this distress through the course of the treatment or what strategies are being used by people to help alleviate mask anxiety. People diagnosed with head and neck cancer (HNC) are at a high risk of experiencing distress along the continuum of cancer treatment.[1] Distress is a term that has been adopted to describe an unpleasant experience of a psychological, social, spiritual and/or physical nature.[2] In the population with HNC, patient–reported distress before and after radiotherapy (RT) is prognostic for poorer survival,[3] with long–term challenges associated with physical functioning, fatigue and reduced social supports contributing to distress.[1,3,4,5,6] ,.

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