Physical symptoms and psychological distress in head and neck cancer patients.

Abstract

e16056 Background: Little is known about the relationship between psychological distress and physical symptoms in head and neck cancer (HNC) patients undergoing radiation therapy (RT), and how these relationships may change over the course of treatment. We conducted exploratory analyses, on a previously published descriptive study examining the occurrence and severity of physical symptoms during RT. The purpose of this secondary analysis was to determine the relationship over time between psychological distress and physical symptoms in HNC patients. Methods: Ninety HNC patients receiving RT completed a Symptom Inventory (SI) weekly for five weeks, beginning with the week prior to the start of treatment. The SI assesses the presence and severity of 12 symptoms, including, pain, fatigue, nausea, disturbed sleep, feeling distressed, shortness of breath, memory, lack of appetite, drowsiness, vomiting, skin problems, and urination difficulty. Change scores in symptom severity between baseline and weeks 2, 3 and 4 were calculated, and Pearson’s correlations were used to determine the associations between psychological distress and physical symptoms. Results: Changes in psychological distress between baseline and week 2 of treatment were significantly correlated with changes in fatigue (r = 0.35, n=52, p = 0.01) and skin problems (r = 0.40, n=36, p = 0.02). Changes in psychological distress between baseline and week 3 of treatment were significantly correlated with changes in fatigue (r = 0.42, n=42, p = 0.006), shortness of breath (r = 0.48, n=42, p = 0.001), memory (r=0.36, n=42, p = 0.02), and lack of appetite (r = 0.53, n=42, p = 0.001). Changes in psychological distress between baseline and week 4 of treatment were correlated with changes in fatigue (r = 0.57, n=40, p=0.001), memory (r=0.48, n=39, p=0.002), and lack of appetite (r=0.49, n=40, p=0.001). Conclusions: Fatigue, memory, shortness of breath, and lack of appetite are significantly related to psychological distress in HNC patients undergoing RT. Additional research is needed to determine how psychological distress affects physical symptoms and if improvements in psychological distress may attenuate physical symptoms in HNC patients receiving RT.