Body image distress in head and neck cancer patients: what are we looking at?

H C Melissant,I M Verdonck-De Leeuw,E Laan,C R Leemans,S E Eerenstein,F Jansen,K A Sherman,P Cuijpers,A S Schuit,B I Lissenberg-Witte

doi:10.1007/s00520-020-05725-1

Abstract

PurposeThe aim of the present study is to investigate the prevalence of body image distress among head and neck cancer (HNC) patients after treatment and to examine its association with sociodemographic and clinical factors, health-related quality of life (HRQOL), HNC symptoms, sexuality, self-compassion, and psychological distress. Second, we aim to explore daily life experiences of HNC patients regarding body image.MethodsA cross-sectional survey among HNC patients investigated the prevalence of body image distress based on the Body Image Scale. Multivariable logistic regression analysis was applied to study associations with sociodemographic and clinical factors, HRQOL (EORTC QLQ-C30), HNC symptoms (QLQ-HN43), sexuality (FSFI-6; IIEF-5), self-compassion (SCS-SF), and psychological distress (HADS). Qualitative data from a body image writing intervention was used to explore experiences in daily life related to body image.ResultsBody image distress was prevalent in 13–20% (depending on cut-off scores) of 233 HNC patients. Symptoms of depression (p < 0.001), younger age (p < 0.001), problems with social contact (p = 0.001), problems with wound healing (p = 0.013), and larger extent of surgery (p = 0.014) were associated with having body image distress. This model explained 67% of variance. Writing interventions of 40 HNC patients showed that negative body image experiences were related to appearance and function, with social functioning problems described most often.ConclusionPrevalence of body image distress in HNC patients, using different cut-off scores, is 13–20%. Younger patients, patients after extensive surgery, and patients who had wound healing problems are most at risk. There is a significant association between body image distress and depressive symptoms and social functioning.

Highlights

Head and neck cancer (HNC) patients have to deal with a wide range of symptoms related to HNC cancer and its treatment [1]
The first aim of the present study is to investigate the prevalence of body image distress in HNC patients, and whether sociodemographic and clinical factors, health-related quality of life (HRQOL), HNC symptoms, sexuality, self-compassion, and psychological distress are associated with body image distress
521 HNC patients were invited to participate in the study of which 233 patients (45%) participated

Summary

Introduction

Head and neck cancer (HNC) patients have to deal with a wide range of symptoms related to HNC cancer and its treatment [1]. Vital functions can be affected, such as breathing, speaking, and swallowing. These functional impairments may negatively influence a patient’s body image [2]. Appearance changes in the visible head and neck area may influence body image [3]. Surgical treatment may cause scarring, an amputated facial area, an affected facial contour and expression, or result in a tracheostomy [4,5,6]. Radiotherapy may induce swelling, fibrosis, and alterations in skin pigmentation [5]

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