Effects of Head and Neck Cancer Diagnosis and Treatment on Patient-Partner Intimacy

Abstract

<h3>Purpose/Objective(s)</h3> Head and Neck cancer (HNC) diagnosis and treatment have the potential to significantly affect patient relationships. We aimed to understand the effects of a HNC diagnosis on patient and partner perceived intimacy at diagnosis and after treatment. Additionally, we sought to understand if the diagnosis of HPV related HNC influenced patients' and partners' levels of perceived intimacy. <h3>Materials/Methods</h3> A prospective, survey-based study was conducted using two cohorts of HNC patients and partners: HPV-positive and HPV-negative. Respondents completed a survey of questions adapted from the HPV Impact Profile, the Dyadic Adjustment Scale, and the Miller Social Intimacy Scale at two time points. Within 2 months of diagnosis prior to treatment and again after 3-6 months post treatment. Responses were then scored as: loss of intimacy (0-48), stable relationship (49-71), improvement in intimacy (72-120). Respondents were also asked whether changes in perceived intimacy were due to HPV or effects of cancer treatment. Survey responses were considered discordant if patient and partner scores equated to different levels of perceived intimacy. <h3>Results</h3> 25 patient-partner pairs completed the first survey. 68% of couples demonstrated concordant responses with 16 couples reporting increased intimacy, one couple reporting stable intimacy and none reporting decreased intimacy. 32% of patient-partner pairs showed some discordance in responses with 7 couples in which one partner reported stability and the other reported increase in intimacy and one couple in which one partner reported an increase and the other reported a decrease in intimacy. 15 patient-partner pairs completed the second survey 3-6 months post HNC treatment. 73% of patient-partner pairs demonstrated concordant responses with 8 couples reporting increased intimacy, two couples reporting stable intimacy and one couple reporting decreased intimacy. 27% of patient-partner pairs showed some discordance in responses, with four couples in which one partner reported an increase and the other reported stable intimacy. Overall scores were not significantly different between patients and partners at either timepoint (p=0.31, p=0.63). Mean scores were similar between HPV+ and HPV- groups at both timepoints (p=0.35, p=0.22); however, the patient and partner who reported loss of intimacy cited presence of HPV in diagnosis as a reason for the decline. <h3>Conclusion</h3> The majority of patients and partners surveyed reported either stable or increased intimacy both at diagnosis and after treatment. Further, most patients and partners agreed about their perceived level of intimacy. The simultaneous diagnosis of HPV related malignancy did not significantly affect intimacy scores; however, individuals who experienced a loss of intimacy reported that HPV was at the core of the decline.