Holistic Wellness Intervention for Head and Neck Cancer (HNC) Patients and Caregivers: Mayo Clinic Rochester (MCR) Pilot

Abstract

Patients treated for HNC experience a high burden of long-term treatment-related toxicity and medical comorbidities, yet few programs have included interventions for healthy living, which have the potential to improve overall survival and reduce treatment-related side effects. This is a report of a pilot wellness program for patients with HNC and their caregivers. The program was developed and implemented through collaboration with physicians specializing in HNC and the staff of the Dan Abraham Healthy Living Program (DAHLP), a state-of-the-art wellness center at MCR. The multidisciplinary team consisted of medical oncologists, HNC surgeons, internists, dietitians, physical therapists, health psychologists, and certified wellness coaches. The 1-day program took place in the wellness facilities of the DAHLP at no cost to participants. Pre- and postintervention surveys were conducted to assess the needs of the population and the overall satisfaction with the program. The pilot program took place on May 18, 2015. Target enrollment was 30 patients and caregivers; 30 people registered and 28 attended (15 men, 13 women; 20 survivors, 8 caregivers). Most of the HNC survivors were >2 years from diagnosis and >1 year from their last cancer treatment. The key components of the program included (1) motivational welcome by physician staff; (2) physical activity programs including gentle yoga, NEAT (non-exercise activity thermogenesis), and a physical therapy session entitled “Open & Release Your Neck & Shoulders”; (3) resiliency participatory group sessions for both survivors and caregivers; and (4) a hands-on nutrition/cooking session demonstrating strategies to increase consumption of vegetables and fruits by making whole food smoothies and soup. Twenty-one participants responded to the preintervention survey. The top 2 reasons for participation were to improve overall health and increase energy. Other common reasons included to increase strength, increase flexibility, improve quality of life or longevity, and reduce weight or improve body composition. Twenty-six of the 28 participants responded to the postintervention survey. Sixty-one percent and 33% of patients were very satisfied and satisfied, respectively, and 1 person (6%) was neutral. Eighty-eight percent and 12% of caregivers were very satisfied and satisfied, respectively. No participants were dissatisfied. On the postintervention survey, the following components were rated most valuable: gentle yoga, NEAT, and the nutrition session. Physician referral was cited as an important motivator to participation. A comprehensive HNC-specific wellness intervention is feasible in this underserved patient population, and further programs for HNC patients should be developed.