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Background: Neurocognition and speech, relevant domains in head and neck cancer (HNC), may be affected pretreatment. However, the prevalence of pretreatment deficits and their possible concurrent predictors are poorly understood. Methods: Using an HNC prospective cohort (Netherlands Quality of Life and Biomedical Cohort Study, N ≥ 444) with a cross‐sectional design, we investigated the estimated prevalence of pretreatment deficits and their relationship with selected demographic, behavioral, and disease‐related factors. Results: Using objective assessments, rates of moderate‐to‐severe neurocognitive deficit ranged between 4% and 8%. From patient‐reported outcomes, 6.5% of patients reported high levels of cognitive failures and 46.1% reported speech deficits. Patient‐reported speech functioning was worse in larynx compared to other subsites. Other nonspeech outcomes were unrelated to any variable. Patient‐reported neurocognitive and speech functioning were modestly correlated, especially in the larynx group. Conclusions: These findings indicate that a subgroup of patients with HNC shows pretreatment deficits, possibly accentuated in the case of larynx tumors. [ABSTRACT FROM AUTHOR]

Background: Patients with head and neck cancer (HNC) are vulnerable to fear of cancer recurrence (FCR) and psychiatric morbidity. We investigated the prevalence of high FCR and demographic, clinical, psychological, and psychiatric factors associated with high FCR prior to the start of the treatment. Methods: In a cross‐sectional substudy of the large ongoing prospective NET‐QUBIC study questionnaires and psychiatric interviews of 216 patients newly diagnosed with HNC were analyzed. Results: High FCR was observed in 52.8% of patients and among those 21.1% also had a lifetime history of selected anxiety or major depressive disorder. FCR was not related to any clinical characteristics; however, younger age, higher anxiety symptoms, introversion, greater needs for support regarding sexuality, and being an exsmoker were significantly associated with higher FCR. Conclusion: Factors associated with high FCR provide us with a better conceptual understanding of FCR in patients newly diagnosed with HNC. [ABSTRACT FROM AUTHOR]

Background A Speech Handicap Index (SHI) questionnaire with 30 items on speech problems was developed and validated in 92 patients with cancer of the oral cavity or pharynx and 110 healthy subjects. Methods All subjects completed the SHI and the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire–Head & Neck module (QLQ-H&N35). Twenty-nine patients completed the SHI twice to assess test–retest reliability. Results Factor analysis identified 2 well-defined subscales, assessing speech function and psychosocial functioning related to speech. Internal consistency and test–retest reliability were high. Construct validity was evidenced by its ability to distinguish between patient subgroups formed on the basis of tumor grade. A cut-off score of 6 points was defined to identify patients with speech problems. Conclusions Results of this initial psychometric study indicate that the SHI is a reliable and valid questionnaire for assessing speech problems. Additional research is needed to evaluate responsiveness of the questionnaire to changes in speech-related problems over time. © 2008 Wiley Periodicals, Inc. Head Neck, 2008 [ABSTRACT FROM AUTHOR]

Background. The clinical results of radiotherapy and endoscopic cordectomy for T1a glottic carcinoma are reported to be similar, but costs of both treatments may differ. Therefore, we retrospectively evaluated the costs, voice quality, quality of life, and clinical results of both treatments. Methods. Costs and effects from the first visit up to 2 years of follow-up were calculated, based on chart data of 35 and 54 patients who were treated with curative intent for T1a glottic carcinoma from 1995 to 1999 with radiotherapy and endoscopic cordectomy, respectively. Voice quality and quality of life were evaluated by means of patient questionnaires. Results. Total costs (in Euros) of radiotherapy and CO2-laser cordectomy were €8322 and €4434, respectively, including the costs of treating possible recurrences. The effects of both treatments were equal, including voice quality and quality of life. Conclusions. We conclude that endoscopic cordectomy is an efficient alternative for radiotherapy for these patients. © 2006 Wiley Periodicals, Inc. Head Neck, 2007 [ABSTRACT FROM AUTHOR]