Best practices in the management of the psychooncologic aspects of head and neck cancer patients: Recommendations from the European head and neck cancer society make sense campaign

Abstract

Squamous cell carcinoma of the head and neck (SCCHN) is considered a worldwide health care problem. The majority of patients have a history of alcohol abuse and high-level tobacco consumption; however, SCCHN is also associated with exposure to viruses including human papillomavirus (HPV) and Epstein-Barr virus. A major problem facing SCCHN patients is that their disease is often diagnosed at an advanced stage where treatment options may not be curative, or can have severe post-treatment consequences. Confronted with their diagnosis and treatment options, the patient can express a range of emotional reactions which may lead to maladaptive coping. During the SCCHN patient journey, there are a number of stages where emotional support could be offered. A point of contact should be allocated to help patients navigate these stages and deliver practical emotive support (such as encouraging attendance at hospital appointments compliance with lifestyle modifications and treatment adherence), and to identify if or when more advanced emotive support, in the form of a mental health professional, might be needed. This role might be carried out by a representative within the multidisciplinary health care team (e.g. a nurse). While optimal care is provided by specialist health care professionals, each with specific roles and responsibilities during the patient journey, all are important in screening for emotional distress and providing referral to the mental health team. This article reviews the key points for delivering emotional support to SCCHN patients at each stage of their care. Emotional problems cannot be ignored in SCCHN patients if optimal outcomes are to be achieved, particularly as therapeutic options extend overall survival for many patients. Health care professionals must be able to implement efficient screening for psychological distress to support patient's compliance to their care and treatment. They must also be able to recognize when to refer patients at risk for pharmacological and/or psychotherapeutic interventions.