Symptom prevalence and functional status in patient with terminal phase of head and neck cancer: Multi institutional research

Abstract

There have been a limited number of studies about clinical symptoms in patients in the terminal phase of head and neck cancers. The aim of this prospective multi-institutional study (11 institutes) was to assess the prevalence of symptoms and functional status among patients with advanced head and neck cancer. Of the 100 patients who met the inclusion criteria, 72 patients were observed until their death. Neck dressing treatment was needed for skin-infiltration symptoms, such as bleeding, infection, and exudation in 30.6% of patients at study entry and in 36.1% just before death. Severe bleeding causing death was observed in 6.9% of patients and the lethal rupture of the carotid artery was seen in only one case (1.4%). At the time of study entry, 75% of patients maintained enteral nutrition, and 61.1% still received enteral nutrition just before death. Laryngeal phonation ability was not maintained in 44.4% of patients at the time of study entry and 50% just before death. Edema in the head and neck region was observed in 23.6% of patients at entry and 36.1% at the time of death. Since the above-mentioned symptoms in patients in the terminal phase were not mild, these symptoms sometimes cause uneasiness in head and neck patients, their families, and the medical staff. To relieve the anxiety of patients, families, and the medical staff, further large-scale prospective studies are needed to establish care management of head and neck cancer patients in the terminal phase and bring them a better quality of life in the terminal phase.