Oral Cancer Survivors Research Articles

Causes of death after oral cancer diagnosis: a population based study

BackgroundNowadays, the number of oral cancer survivors is increasing, emphasizing the importance of thoroughly understanding diverse causes of death in oral cancer survivors. Our study aimed to investigate the distribution of causes of death after oral cancer diagnosis.MethodsEligible patients were identified between 2004 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) database. We calculated the number of deaths in different demographic and clinicopathological variables during each follow-up period. Standardized mortality ratios(SMRs) were generated for each cause of death after oral cancer diagnosis.ResultsA total of 30538 patients diagnosed with oral cancer were included, and 17654 deaths were reported during follow-up period. 27.08% of deaths were caused by non-caner reasons. The proportion of non-cancer related deaths increased with the extension of survival time, and non-cancer death accounted for 57.93% of all deaths when followed up more than 10 years. The most common non-cancer cause of death was cardiovascular disease (SMR 4.68#; 95%CI 4.46-4.92).ConclusionsNon-cancer causes of death should not be ignored in oral cancer patients. For oral cancer survivors, multidisciplinary follow-up strategy should be recommended to achieve longer survival time.

Survey of long term survivors of oral cancer: Looking beyond cancer biology.

6087 Background: While surgery is the main stay of treatment for early stage oral cancers, advanced stages require adjuvant treatments in the form of radiotherapy or concurrent radiotherapy. Yet, the effectiveness of these interventions is not solely determined by clinical measures but also by personal factors such as individual motivation, support from loved ones, and financial security. These aspects might explain the survival rate variations among patients who, despite having similar prognostic categories and stages of disease, show differing outcomes. The role of social determinants in influencing patient survival, apart from the acknowledged impact of disease biology, is not well understood. Methods: All treatment-naive oral cavity cancer patients who underwent definitive treatment during 2014 to 2018 at our institute and are alive for more than five years were selected for this study. A custom investigator-administered questionnaire was developed and it had 32 questions under six domains- personal, habit history, financial, social, functional, and emotional. The study was approved by the institutional ethics committee. Of the 1787 potential participants, we found that 219 had expired, only 442 patients agreed to answer the questionnaire, while 45 refused to participate. The rest of the patients were not reachable telephonically. Results: This survey had 442 patients, of which 90% were males, with a mean age of 52.1 years. The most common site of the presentation was buccal mucosa (60%), and 59% presented in the locally advanced stage. Post-operatively, 71% received adjuvant therapy. All patients were motivated to undergo the radical treatments and had their family support. However, post-treatment, about 10% of individuals experienced a change in marital status. Financial constraints did affect 20% of patients during and after treatment, and more than 70% had their out-of-pocket expenditure above 50% of the total cost. While 80% did not have trouble attending social functions, 46% reported trouble eating socially. However, this was more common for patients who received adjuvant treatment (p < 0.001). About 21% reported shoulder dysfunction and body discomfort. However, no statistically significant associations could be drawn for any of the domains of the questionnaire when compared to patients between the early and late stages. Shoulder discomfort was experienced more by patients who were treated for tongue cancer (p-value 0.010). Conclusions: The results of this study shed light on the challenges faced by long-term survivors of oral cancer following radical treatment regimens. More than half of patients reported that out-of-pocket expenses constituted more than half of their total treatment costs. A notable minority of people suffer from shoulder dysfunction, suggesting there is a clear opportunity for advancements in reconstruction and rehabilitation.

Exploring the Link between Head and Neck Cancer and Elevated Risk of Rheumatoid Arthritis: A National Population-Based Cohort Study.

An increased risk of cancer among patients with rheumatoid arthritis (RA) has been reported. However, the risk of RA events among patients with head and neck cancer (HNC) is unknown. Therefore, we investigated the incidence and risk of RA among patients with HNC. This study was based on a cohort dataset. Overall, 2824 individuals without HNC and 706 patients with HNC were selected using propensity score matching. The overall RA event rate was 12.19 for patients with HNC and 7.60 for those without HNC. A significantly increased risk of developing RA was also observed among patients with HNC. The risk of developing RA over time was relatively high within the first year after HNC diagnosis; further, it increased significantly during the follow-up period. Moreover, middle-aged male patients with HNC exhibited an increased risk of developing RA compared with the controls; however, no significant difference was noted among female patients or other age groups. Notably, subgroup analysis according to cancer subtype revealed that only oral cancer survivors had an increased risk of developing RA. These results underscore the importance of vigilant monitoring by clinicians to promptly identify the onset of RA in patients with HNC.

Health-related quality of life and its predicting factors among male oral cancer survivors in Sri Lanka: A cross sectional study

Introduction: Health-related quality of life (QoL) and its predicting factors for oral cancer survivors are varied and little evidence is available in Sri Lanka. This descriptive cross-sectional study aimed to assess the QoL and its predicting factors of male oral cancer survivors.Methods: The study was conducted at Apeksha Hospital (National Cancer Institute, Sri Lanka) from June to December 2018 for a period of six months. QoL of 295 oral cancer survivors was assessed using the WHOQoL-BREF questionnaire. The range of QoL score is from 0 to 100 and higher the score, higher the level of QoL Socio-demographic and disease-specific characteristics were considered as predicting factors for QoL and Multiple linear regression was performed to determine the predicting factors. The significant level was kept as p<0.05.Results: The mean score of QoL was averaged among all domains of WHOQoL-BREF questionnaire, which was depicted as 51.9±15, 52.3±19, 49.5±22 and 59.2±16 in Physical, Psychological, Social Relationship and Environment domains respectively. The number of years from diagnosis, metastasis, cancer stage and cancer site were the predictors of the physical health domain while employment status, metastasis, cancer stage and duration of betel chewing for the psychological domain (p<0.05). Age, education status, monthly income, metastasis, and duration of alcohol consumption were identified as the significant predictors of social relationships while employment, monthly income, metastasis, and duration of betel chewing were predictors of the environment domain (p<0.05).Conclusions: The study revealed that QoL of all domains were around average, but each QoL domain has different predicting factors. Therefore, consideration of these predicting factors are immensely helpful to enhance the QoL of these survivors.

Association of first primary cancer with risk of subsequent primary cancer among survivors of adult-onset cancers in Kentucky and Appalachian Kentucky.

Appalachia is a region with significant cancer disparities in incidence and mortality compared to Kentucky and the United States. However, the contribution of these cancer health disparities to subsequent primary cancers (SPCs) among survivors of adult-onset cancers is limited. This study aimed to quantify the overall and cancer type-specific risks of SPCs among adult-onset cancer survivors by first primary cancer (FPC) types, residence and sex. This retrospective cohort study from the Kentucky Cancer Registry included 148,509 individuals aged 20-84 years diagnosed with FPCs from 2000-2014 (followed until December 31, 2019) and survived at least 5 years. Expected numbers of SPC were derived from incidence rates in the Kentucky population; standardized incidence ratio (SIR) compared with those expected in the general Kentucky population. Among 148,509 survivors (50.2% women, 27.9% Appalachian), 17,970 SPC cases occurred during 829,530 person-years of follow-up (mean, 5.6 years). Among men, the overall risk of developing any SPCs was statistically significantly higher for 20 of the 30 FPC types, as compared with risks in the general population. Among women, the overall risk of developing any SPCs was statistically significantly higher for 20 of the 31 FPC types, as compared to the general population. The highest overall SIR were estimated among oral cancer survivors (SIR, 2.14 [95% CI, 1.97-2.33] among men, and among laryngeal cancer survivors (SIR, 3.62 [95% CI, 2.93-4.42], among women. Appalachian survivors had significantly increased risk of overall SPC and different site specific SPC when compared to non-Appalachian survivors. The highest overall SIR were estimated among laryngeal cancer survivors for both Appalachian and non-Appalachian residents (SIR, 2.50: 95%CI, 2.10-2.95; SIR, 2.02: 95% CI, 1.77-2.03, respectively). Among adult-onset cancer survivors in Kentucky, several FPC types were significantly associated with greater risk of developing an SPC, compared with the general population. Risk for Appalachian survivors was even higher when compared to non-Appalachian residents, but was not explained by higher risk of smoking related cancers. Cancers associated with smoking comprised substantial proportions of overall SPC incidence among all survivors and highlight the importance of ongoing surveillance and efforts to prevent new cancers among survivors.

Prevalence and correlates of fear of recurrence among oral and oropharyngeal cancer survivors.

Fear of recurrence (FoR) is a prevalent and difficult experience among cancer patients. Most research has focused on FoR among breast cancer patients, with less attention paid to characterizing levels and correlates of FoR among oral and oropharyngeal cancer survivors. The purpose was to characterize FoR with a measure assessing both global fears and the nature of specific worries as well as evaluate the role of sociodemographic and clinical factors, survivorship care transition practices, lifestyle factors, and depressive symptoms in FoR. Three hundred eighty-nine oral and oropharyngeal survivors recruited from two cancer registries completed a survey assessing demographics, cancer treatment, symptoms, alcohol and tobacco use, survivorship care practices, depression, and FoR. Forty percent reported elevated global FoR, with similar percentages for death (46%) and health worries (40.3%). Younger, female survivors and survivors experiencing more physical and depressive symptoms reported more global fears and specific fears about the impact of recurrence on roles, health, and identity, and fears about death. Depression accounted for a large percent of the variance. Lower income was associated with more role and identity/sexuality worries, and financial hardship was associated with more role worries. FoR is a relatively common experience for oral and oropharyngeal cancer survivors. Many of its correlates are modifiable factors that could be addressed with multifocal, tailored survivorship care interventions. Assessing and addressing depressive symptoms, financial concerns, expected physical symptoms in the first several years of survivorship may impact FoR among oral and oropharyngeal cancer survivors.

The development of a Cancer Pain Belief Modification Program for patients with oral cancer in China: a feasibility study

BackgroundAcceptance-based pain management interventions have been receiving growing attention in cancer pain care. This study aimed to develop a cancer pain management program based on belief modification to improve the cancer pain experience of Chinese oral cancer survivors and to explore the acceptability and preliminary outcomes of the Cancer Pain Belief Modification Program (CPBMP).MethodsA mixed-methods approach was applied to develop and revise the program. The CPBMP was developed and revised using the Delphi technique, and its further improvement was explored with a one-group pre- and post-trial designed with a sample of 16 Chinese oral cancer survivors, and semi-structured interviews. Research instruments included Numeric Rating Scale (NRS), Chinese version of Illness Perception Questionnaire-Revised for Cancer Pain (IPQ-CaCP), and the University of Washington Quality of Life assessment scale (UW-QOL). Descriptive statistics, t-test, and Mann–Whitney U test were used to analyse the data. The semi-structured questions were analysed using content analysis.ResultsThe six-module CPBMP was endorsed by most experts and patients. The expert authority coefficient value was 0.75 in the first round of the Delphi survey and 0.78 in the second round. The “pain intense”, “negative pain beliefs” scores of pre- and post-testing decreased from 5.63 ± 0.48 to 0.81 ± 0.54 (t = -3.746, p < 0.001); from 140.63 ± 9.02 to 52.75 ± 7.27 (Z = 12.406, p < 0.001); and the “positive pain beliefs”, “quality of life” scores increased from 55.13 ± 4.54 to 66.00 ± 4.70 (Z = -6.983, p < 0.001); from 66.97 ± 15.01 to 86.69 ± 8.42 (Z = 7.283, p < 0.001). The qualitative data also indicated that CPBMP was well acceptable.ConclusionOur study showed the acceptability and preliminary outcomes of CPBMP patients. CPBMP improves the pain experience of Chinese oral cancer patients and provides a reference for cancer pain management in the future.Trial registrationThe feasibility study has already been registered on the Chinese Clinical Trial Registry (ChiCTR) (www.chictr.org.cn) in 11/09/2021. (ChiCTR2100051065).

Unmet Needs of Oral Cancer Survivors in India: A Perspective

AbstractOral cancer is one of the predominant forms of cancer that alters the livelihood of survivors. They can have many unmet needs. However, very little research has been done on this topic, especially in India. This commentary piece discusses what unmet needs could mean, how the disease culminates differently and creates different realities, how the research and policymaking have been done and how it could be improved.

Distinct Dysphagia Profiles in Patients With Oral Cancer After Surgery.

To determine distinct profiles based on symptom severity in patients undergoing surgery for oral cancer and examine whether these profiles differ by participant characteristics. 300 patients who underwent surgery for oral cancer at two outpatient clinics between June and December 2021. Symptoms were assessed using the MD Anderson Symptom Inventory-Head and Neck Cancer Module. Sociodemographic and clinical characteristics were collected. Latent profile analysis was performed. Five distinct dysphagia profiles were identified, which qualitatively differed regarding co-occurrence patterns of dysphagia, mucus-related symptoms, speech disturbances, and psychoneurologic symptoms. Significant differences were reported in interference to function, number of co-occurring symptoms, time since diagnosis and treatment completion, use of symptom management medications, oral cancer stage and site, and treatment completed. Identifying distinct dysphagia profiles can improve patient outcomes and help in planning specific nursing interventions to influence nutritional and functional status in oral cancer survivors. Dysphagia and dry mouth can persist beyond one year post-treatment, so follow-up dysphagia assessments are needed.

Enhancing Self-care Among Oral Cancer Survivors: Protocol for the Empowered Survivor Trial

Survivors of oral cavity and oropharyngeal cancer frequently experience difficulties in swallowing; tasting; speaking; chewing; and maintaining comfortable movements of the head, neck, and shoulder. Engagement in regular self-care can reduce further loss of function and mitigate late effects. Despite the substantial self-care requirements, there are no empirically based interventions to enhance the skills and confidence of these survivors in managing their ongoing care. The aim of this study is to describe the rationale and methodology for a randomized controlled trial evaluating Empowered Survivor (ES) versus Springboard Beyond Cancer, a general web-based program for cancer survivors, on self-efficacy in managing care, preparedness for managing survivorship, and health-related quality of life (QOL). This study will recruit a total of 600 individuals who were diagnosed with oral cavity or oropharyngeal cancer in the past 3 years and are currently cancer free primarily from state cancer registries; these individuals will be randomly assigned to either the ES or Springboard Beyond Cancer condition. The participants complete measures of self-efficacy in managing care, preparedness for survivorship, health-related QOL, and engagement in oral self-examination and head and neck strengthening and flexibility exercises at baseline and 2 and 6 months after baseline. The primary aim of this study is to evaluate the impact of ES versus Springboard Beyond Cancer on self-efficacy, preparedness, and health-related QOL. The secondary aim is to examine the mediators and moderators of ES's impact on self-efficacy in managing care, preparedness, and health-related QOL at 6 months. The exploratory aim is to conduct a process evaluation of ES to identify potential oncology or community settings for future implementation. Multilevel modeling will be used to examine whether there are significant differences between the ES and Springboard Beyond Cancer interventions over time. Mediational models will evaluate the indirect effects of ES on outcomes. Quantitative analyses will evaluate the predictors of ES use, and qualitative analyses will evaluate the preferred timing and settings for the implementation of ES. This randomized controlled trial evaluates a completely web-based intervention, ES, versus a general web-based program for cancer survivors, Springboard Beyond Cancer, on self-efficacy in managing care, preparedness for managing survivorship, and health-related QOL and identifies the putative mediators and moderators of the intervention's effects. If an effect on the primary outcomes is illustrated, the next step could be an implementation trial to evaluate the intervention's uptake in and impact on an oncology care setting or nonprofit organizations. ClincalTrials.gov NCT04713449; https://clinicaltrials.gov/ct2/show/NCT04713449. DERR1-10.2196/39996.

Effect of Multicomponent Exercise Program on Temporomandibular Joint Dysfunction in Oral Cancer Survivors

Introduction: Cancer is the second most cause of mortality among which oral cancer is the most prevalent form. In temporomandibular joint dysfunction (TMJD), patients present with pain, restricted mouth opening, poor posture, facial asymmetry, diminished strength, altered breathing patterns, decreased deglutition, and poor eating habits The objective of this research was to determine and compare the effect of a multicomponent exercise program with conventional physiotherapy program for TMJD in oral cancer survivors. Materials and Methods: This study included 100 participants with TMJD based on inclusion and exclusion criteria. Then, the subjects were randomly allocated into Group A and Group B by a simple random sampling method. Group A was given a conventional physiotherapy exercise program and for Group B multicomponent exercise program was given. Outcome measures used were a Visual Analog Scale, assessment of range of motion (ROM) and manual muscle testing (MMT) and the American Academy of Orofacial Pain questionnaire. Pre- and post-assessment of the above measures was taken to confirm the results. Results: The results showed a statistically significant effect of the multicomponent exercise program as compared to a conventional exercise program for TMJD in oral cancer survivors. There was a significant reduction in pain (&lt;0.0001) in individuals in Group B than in Group A. Restriction in the ROM and improvement in MMT were also significantly (P &lt; 0.0001) resolved and the facial symmetry, breathing patterns as well as swallowing difficulty were also improved. Conclusion: On the basis of the results, it can be concluded that the Group B who followed the multicomponent exercise program showed better improvement in pain intensity, ROM, facial symmetry, muscle strength, breathing pattern and in swallowing as compared to Group A. Similarly utilizing a multifaceted patient-centered approach has been proven to be effective and lead to successful recovery of the temporomandibular joint function in oral cancer survivors.

Oral infections in oral cancer survivors: A mini-review.

The oral cancer survivors are a group of special individuals whose disease affect anatomical structures with a key role in identity and communication and a fundamental role in basic human functions such as speaking, eating, swallowing and breathing. Thus, quality of life of these individuals can be impaired by the consequences of disease and treatments, in particular surgery and radiotherapy. Among others, infectious conditions of any nature, bacterial, viral, fungal, are a frequent finding among oral cancer survivors. In fact, the peculiar systemic and local conditions of these subjects are known to significantly modify the microbiota, which, besides facilitating opportunistic infections, can affect the cancer microenvironment, as well as alter the effects of the anti-cancer therapies. Similarly, mouth infections can also affect the prognosis of oral cancer survivors. Among the opportunistic infections, fungal are the most common infections affecting these subjects, since neutropenia resulting from cancer, as well as chemotherapy and/or radiotherapy treatments, promote the shift from the carrier state of Candida species, to pathogen state. Treatment of oral candidiasis can be difficult in oral cancer survivors, and good evidence supports clotrimazole as the most effective for prevention, and fluconazole as the one with the best risk-benefit profile. Probiotics, although promising, need better evidence to be considered an effective treatment or preventive measure.

Eating and speech problems in oral and pharyngeal cancer survivors - Associations with treatment-related side-effects and time since diagnosis.

The aim of this cross-sectional study was to find factors associated with problems with the ability to eat and speak in oral and pharyngeal cancer (OPC) survivors and to evaluate if the panorama of oral problems varied with time since diagnosis. A questionnaire assessing cancer diagnosis and treatment, oral health-related quality of life, and presence of treatment-related side-effects was sent to members of the Norwegian Head and Neck Cancer Association. Three-quarters (n=117) of the respondents experienced xerostomia, and 51% (n=79) had dysphagia. Prevalence of dysphagia, trismus, and dysphonia was lowest among respondents diagnosed within the last 5-10 years prior to the study. Eating problems were reported by 75% (n=121) of the OPC survivors and were associated with xerostomia, dysphagia, trismus, having removed part of the tongue, cancer diagnosis within 5 years prior to the study and having little problems with caries and tooth fracture. Speaking problems were experienced by 60% (n=93) of the OPC survivors, and were associated with dysphonia, dysphagia, and trismus. Our study shows a high prevalence of oral problems among OPC survivors and points to targets for interventions for eating and speech impairments that may improve oral health-related quality of life.

Self-efficacy in managing post-treatment care among oral and oropharyngeal cancer survivors.

Physical and psychosocial effects of oral cancer result in long-term self-management needs. Little attention has been paid to survivors' self-efficacy in managing their care. Study goals were to characterise self-care self-efficacy and evaluate socio-demographics, disease, attitudinal factors and psychological correlates of self-efficacy and engagement in head and neck self-exams. Two hundred thirty-two oral cancer survivors completed measures of socio-demographics, self-care self-efficacy, head and neck self-exams and attitudinal and psychological measures. Descriptive statistics characterised self-efficacy. Hierarchical regressions evaluated predictors of self-efficacy. Survivors felt moderately confident in the ability to manage self-care (M = 4.04, SD = 0.75). Survivors with more comorbidities (β = -0.125), less preparedness (β=0.241), greater information (β = -0.191), greater support needs (β = -0.224) and higher depression (β = -0.291) reported significantly lower self-efficacy. Head and neck self-exam engagement (44% past month) was relatively low. Higher preparedness (OR = 2.075) and self-exam self-efficacy (OR = 2.606) were associated with more engagement in self-exams. Many survivors report low confidence in their ability to engage in important self-care practices. Addressing unmet information and support needs, reducing depressive symptoms and providing skill training and support may boost confidence in managing self-care and optimise regular self-exams.

Survivorship profile and post-treatment quality of life of oral cancer survivors in comparison with caregivers: An analysis of a real-world cohort of a developing country.

e18036 Background: Oral cavity cancer is the second most common cancer in India; India bears the most burden of oral cancer in the world. The most effective way to study the effectiveness of treatments is in clinical trials, but the quality of life (QOL) and post-treatment effects of those treatments are seldom studied in real-world settings. Methods: All oral cancer survivors treated with curative intent at our institute from September 2019 to January 2021, who were disease-free for a minimum of six months following treatment, were included in this study. The QOL of these cancer survivors was compared with that of their caregivers using the WHOQOL BREF questionnaire. The complete survivorship profile was evaluated using a Constant shoulder score for shoulder dysfunction, clinical oral dryness score (CODS) for xerostomia, Sydney Swallow Questionnaire (SSQ) for swallowing dysfunction, Patterson scale for lymphedema, Comprehensive Score for financial Toxicity (COST)‐Functional Assessment of Chronic Illness Therapy (FACIT) questionnaire for financial toxicity, Depression, Anxiety and Stress Scale - 21 Items (DASS-21) for psychological wellbeing. Results: A total of seventy-nine survivors were included. The median age was 49 years. Though both survivors and caregivers had similar QOL scores in the physical and environmental domains, survivors had poor scores in the social (M = 58.7,SD = 21.9) and psychological domains (M = 60.4,SD = 15.6). The T stage (p = 0.06), surgery (p = 0.008), and trismus (p = 0.03) were significant factors affecting swallowing. Those patients who had undergone selective neck dissection had better shoulder scores compared to those who had modified radical neck dissection (p = 0.006). 75% of people had xerostomia and 10.9% had severe xerostomia. Internal lymphedema was seen in 30.4% of people. Depression and anxiety were recorded in 46 (58.2%) and 33 (41.8%) patients respectively. Employment status (p = 0.04) and treatment modality (p = 0.05) were significant factors affecting financial toxicity. Conclusions: Oral cancer survivors had a poor psychosocial QOL compared to their caregivers. Treatment-related functional sequelae had a significant negative impact on quality of life across all domains. Clinical trial information: CTRI/2020/07/026848.

Surgical factors associated with patient-reported quality of life outcomes after free flap reconstruction of the oral cavity

ObjectivesTo determine which surgical factors are associated with quality-of-life (QOL) outcomes in oral cavity cancer survivors after free flap reconstruction of the oral cavity. Patients and MethodsA cross-sectional study was conducted from a multidisciplinary head and neck cancer (HNC) survivorship clinic. Oral cavity cancer survivors with at least 6-months of postoperative follow-up from ablation and free flap reconstruction were included. Primary outcome measures were validated patient-reported outcome measures (PROMs) including the Eating Assessment Tool-10 (EAT-10) measure of swallowing-specific QOL, University of Washington Quality of Life (UW-QOL) physical and social-emotional subscale scores and feeding tube dependence. ResultsExtent of tongue resection was associated with EAT-10 and the UW-QOL Physical subscale scores. Patients with oral tongue defects reported worse scores than with composite defects in the EAT-10 and UW-QOL physical domain (p = 0.0004, 0.0025, respectively). This association no longer applies when controlling for differences in extent of tongue resection. Patients with anterior composite resections reported worse EAT-10 scores than lateral resections (p = 0.024). This association no longer applies when controlling for extent of tongue resection (p = 0.46). Gastric tube dependence demonstrates similar trends to PROMs. ConclusionExtent of tongue resection was strongly associated with poor QOL outcomes after free tissue reconstruction of the oral cavity and mediates the associations between other defect characteristics and QOL. These findings demonstrate the need for emphasis on expected oral tongue defects when counseling patients and highlight the need to address QOL in a multidisciplinary fashion post-operatively.

Perception and Knowledge Regarding Role of Physiotherapy in Oral/Mouth Cancer Survivors amongst Non Medical Professionals: An E-Survey

Background &amp; Objectives: About 5 million people are diagnosed with cancer worldwide. 50% are expected to live at least 5 years with most survivors living with cancer related disabilities. Physiotherapy rehabilitation becomes crucial for better quality of life after cancer treatment. The objective of the present study was to assess the perception and knowledge regarding role of physiotherapy in oral/mouth cancer survivors amongst non medical professionals in India. Methodology: This e-survey was conducted using a self -prepared questionnaire in English language carried out for a period of 3 months. Questionnaire was circulated among respondents across India via social media Results: Out of 265 respondents, a total of 92.8% respondents had fair knowledge regarding oral cancer and its causes. 57.7% respondents had knowledge about problems faced by oral cancer survivors. Physiotherapy as a treatment option was known to 87.9%. 75% respondents possessed knowledge of physiotherapy in treating functional limitations seen in oral cancer patients . Conclusion: There was sufficient knowledge among the respondents regarding oral cancer and physiotherapy treatment in oral cancer survivors. However, there is a dire need to take measures to assess the awareness of physiotherapy in cancer to improve quality of life amongst rural population. KEY WORDS: Perception, Oral cancer survivors, Human papilloma virus (HPV), Palliative care, Physiotherapy, Quality of life.

Sleep Disorders and Psychological Profile in Oral Cancer Survivors: A Case-Control Clinical Study.

Simple SummarySleep disorders have been increasingly investigated in several medical illnesses as their presence may affect patients’ quality of life. However, the research examining sleep disorders in oral cancer is relatively weak. Indeed, the majority of the available studies present a cross-sectional or retrospective designs. Moreover, very few of them have evaluated quality of sleep in oral cancer survivors (OC survivors). We aimed to carry out a case-control study with the purpose to investigate sleep disorders and mood impairment in 50 OC survivors. Our research has shown that quality of sleep is significantly affected in OC survivors compared to a healthy population and that OC survivors suffers from higher levels of anxiety and depression. Our results may suggest that an appropriate assessment of quality of sleep and psychological profile should be performed in OC survivors as a prompt treatment for both sleep and mood disorders is crucial for the overall improvement of patients’ quality of life.Quality of sleep (QoS) and mood may impair oral cancer survivors’ wellbeing, however few evidences are currently available. Therefore, we aimed to assess the prevalence of sleep disorders, anxiety and depression among five-year oral cancer survivors (OC survivors). 50 OC survivors were compared with 50 healthy subjects matched for age and sex. The Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), the Hamilton Rating Scales for Depression and Anxiety (HAM-D, HAM-A), the Numeric Rating Scale (NRS), the Total Pain Rating Index (T-PRI) were administered. The global score of the PSQI, ESS, HAM-A, HAM-D, NRS, T-PRI, was statistically higher in the OC survivors than the controls (p-value: <0.001). QoS of OC survivors was significantly impaired, especially with regard to some PSQI sub-items as the subjective sleep quality, sleep latency and daytime dysfunction (p-value: 0.001, 0.029, 0.004). Moreover, poor QoS was negatively correlated with years of education (p-value: 0.042 *) and positively correlated with alcohol consumption (p-value: 0.049 *) and with the use of systemic medications (p-value: 0.044 *). Sleep disorders and mood disorders are common comorbidities in OC survivors; therefore, early assessment and management before, during and after treatment should be performed in order to improve the quality of life of OC survivors.

Caracterização do perfil alimentar e nutricional dos sobreviventes de câncer de cavidade oral e grau de adesão às recomendações de prevenção ao câncer emitidas pelo Fundo Mundial de Pesquisa de câncer e Instituto Americano de Pesquisa de câncer

Introdução: Sobreviventes do câncer de cavidade oral (SCCO) em controle normalmente apresentam inúmeras sequelas derivadas do tratamento oncológico, o que pode comprometer sua alimentação e, por extensão, o atendimento às diretrizes de alimentação e peso adequado emitidas pelo Fundo Mundial para Pesquisa do Câncer/Instituto Americano de Pesquisa para o Câncer (WCRF/AICR). Objetivo: Avaliar o perfil alimentar e o estado nutricional de sobreviventes de câncer de cavidade oral e verificar o grau de sua adesão, as diretrizes de alimentação saudável e peso corporal emitidas pela WCRF / AICR. Método: Estudo transversal que avaliou o estado nutricional pela Avaliação Subjetiva Global produzida pelo paciente (ASG-PPP) e índice de massa corporal (IMC) de 20 pacientes. Dados como condição social e histórico clínico foram coletados em prontuário. O consumo alimentar foi avaliado por meio de um diário alimentar de 30 dias. Os dados alimentares e o peso corporal receberam um escore de pontos conforme maior ou menor grau de adesão às recomendações WCRF / AICR. Resultados: 80% dos pacientes encontravam-se com desnutrição moderada ou suspeita de desnutrição pela ASG-PPP. Pelo IMC, 10% dos participantes estavam desnutridos, 45% eutróficos e 35% apresentavam sobrepeso. Foi encontrado escore médio 2,64 ±0.55 de adesão às recomendações de peso adequado e alimentação saudável, demonstrando atendimento de menos de 50% das recomendações WCRF / AICR. Conclusão: Os pacientes SCCO do presente estudo apresentam risco de desnutrição ou estão com desnutrição moderada; e possuem alta sintomatologia, que impacta negativamente na ingestão alimentar e na adesão às recomendações da WCRF / AICR.

Outcomes of Telehealth-Delivered Physical Activity Programs in Adult Cancer Survivors: A Systematic Review

Background and Purpose: Reduced physical activity (PA) is associated with poor prognosis in cancer survivors. Clinicians and researchers have attempted to improve adherence to PA recommendations, essentially bridging the gap between the clinic and the home by incorporating telehealth technologies in patients with chronic diseases. However, various approaches to telehealth may be used and the effectiveness of these interventions in cancer survivors is unknown. The purpose of this systematic review was to describe the type of technology used and outcomes of telehealth-delivered PA programs in adult cancer survivors. Methods: A systematic review was performed to examine telehealth methods used to deliver PA exercise programs in adult cancer survivors. Databases searched for articles included PubMed/Ovid, MEDLINE/Web of Science, and CINAHL Complete via EBSCO. All articles that met the inclusion criteria were appraised by 2 reviewers independently and discussed against inclusion/exclusion criteria. The Cochrane Risk of Bias Assessment was used to assess study quality. Results: The search located 21 articles, and 5 met inclusion criteria. Articles included survivors from breast cancer (n = 3), prostate cancer (n = 1), and mixed sample (n = 1), including breast, cervical, endometrial, lung, leukemia, lymphoma, urinary, melanoma, rectal, oral, ovarian, and prostate cancer survivors. Sample size ranged from 41 to 339 and comprised 81.2% breast cancer survivors. PA interventions were delivered via telehealth by telephone calls (2 studies), smartphone apps (2 studies), and one used a combination of telephone calls and text messaging. Limitations: Selection bias is possible. Limited types of telehealth technologies were used. Conclusions: Limited evidence exists describing better outcomes of telehealth-delivered PA programs in cancer survivors than by traditional home exercise program instruction, and further study is indicated.