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Background: Head and neck cancers (HNCs) are often diagnosed at an advanced stage. We investigated the lengths and factors associated with patient, primary health care (PHC), and specialist care (SC) delays in T3–T4 oral, oropharyngeal, and laryngeal cancer. Methods: A nationwide prospective questionnaire‐based study (n = 203) with the 3‐year long data collection period. Results: The median patient, PHC and SC delays were 58, 13, and 43 days, respectively. Lower level of education, heavy alcohol use, hoarseness, difficulties breathing, and eventual palliative treatment associated with a longer patient delay. A lump on the neck or facial swelling associated with a shorter PHC delay. Conversely, if symptoms were treated as an infection, PHC delay was longer. The treatment modality and tumor site affected SC delay. Conclusions: Patient delay stands as the most notable factor contributing to delays before treatment. HNC symptom awareness thus remains especially important among HNC risk groups. [ABSTRACT FROM AUTHOR]

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Objectives: To analyze the long‐term quality of life (QOL) among oropharyngeal squamous cell carcinoma (OPSCC) survivors. Study Design: Retrospective chart analysis and patient response to European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, Core Module (EORTC QLQ‐C30), Head and Neck Module (EORTC QLQ‐H&N35), and M.D. Anderson Dysphagia Inventory (MDADI) survey questionnaires. Methods: All survivors of OPSCC diagnosed and treated between 2000 and 2009 in Finland were included. There were 263 survivors (44.2% of all curatively treated patients), of which a total of 164 participated in this study (62.4%). Median follow‐up was 11.79 years (range = 8.59–18.53 years, interquartile range [IQR] = 4.64 years). The mean age of the participants was 67.9 years (standard deviation = 8.0 years) at QOL follow‐up. Results: Most survivors reported a good QOL. The EORTC QLQ‐C30 global health status median was 75.00 (IQR = 31.25). The single modality treatment group had significantly better QOL outcomes than the combined treatment group. Nonsmokers and previous smokers had significantly better QOL outcomes than patients who smoked at the time of diagnosis. A history of heavy alcohol use resulted in significantly worse QOL outcomes. The p16‐positive cancer patients had significantly better QOL outcomes than p16‐negative patients. Percutaneous endoscopic gastrostomy (PEG) tube–dependent patients reported a significantly worse QOL than patients without a PEG tube. Conclusions: Long‐term QOL in OPSCC survivors is generally good. In line with previous literature, single modality treatment was superior to combined treatment in long‐term QOL outcomes, and it should be pursued whenever possible. Level of Evidence: 4 Laryngoscope, 131:E1172–E1178, 2021 [ABSTRACT FROM AUTHOR]

Background: Treatment for oropharyngeal squamous cell carcinoma (OPSCC) has changed, as the proportion of human papilloma virus (HPV)-related disease has increased. We evaluated nationwide information on its management and outcome during the treatment paradigm change period. Methods: We included all patients diagnosed and treated for OPSCC at the five Finnish university hospitals from 2000 to 2009. Patient records and pathology registries provided the clinicopathological data. p16 staining was performed on primary tumor samples of patients who had received treatment with curative intent. Results: A total of 674 patients were diagnosed and treated for OPSCC and the incidence increased along the study period. Of the evaluable tumors 58.5% were p16-positive and the number of p16-positive tumors increased along the years. The treatment was given with curative intent for 600 patients and it was completed in 564. Of them, 47.9% underwent primary surgery and 52.1% received definitive oncological treatment. Also, the treatment protocol changed towards a more oncological approach. Among patients treated with curative intent the five-year overall, disease-specific and disease-free survival rates were 60.1, 71.5 and 57.0%. In multivariate analysis, p16-positivity seemed to relate to reduced disease mortality in lateral and anterior-wall disease. Depending on primary tumor localization, also sex, classes T3-4, presence of regional metastasis and radiotherapy modality had an association with disease mortality. Conclusion: The incidence of p16-positive OPSCC and delivery of definitive oncological treatment increased in Finland during the study period. An improved survival outcome compared with the previous nationwide investigation was observed in this subset of patients. [ABSTRACT FROM AUTHOR]

RADS is an airways dysfunction syndrome caused by a sudden, massive exposure to an irritative chemical. RADS is considered a subtype of occupational asthma. RADS patient may cure within months, but RADS may also become a permanent disability. RUDS is a dysfunction syndrome in upper airways caused by exposure to an irritative chemical. It seems that in RUDS there are problems in olfactory function in addition to inflammation of upper airways. We present a patient, who was suddenly exposed to chemical vapours in her workplace. She had RADS-like symptoms and was diagnosed with RUDS.