'I Can't Eat, Speak, or Kiss My Wife. It's Half a Life, but at Least I'm Still Alive.' Navigating the Sequelae of Head and Neck Cancer
Depending on age, stage and HPV status, patients with locally advanced head and neck cancer have a high chance of cure, something that can be elusive in other advanced cancers. To achieve cure, patients undergo intense treatment regimens, including a long course of radiation, cytotoxic chemotherapy and sometimes disfiguring surgery. Treatments are often accompanied by significant physical, emotional and spiritual pain and other forms of suffering. While the promise of cure is alluring, the physical and psychological impacts of treatment can devastate patients. Patients may be left with visible facial scars, a changed or absent voice, a tracheostomy, and a gastrostomy tube, pieces of hardware that are often initially introduced as temporary supports but often become life-long necessities.
During and after completion of treatment, a multidisciplinary team including otolaryngology, oncology, radiation-oncology, speech therapy, nutrition, psychology and palliative medicine can help support the individual needs of patients as they grapple with and navigate the process of regaining a sense of self, even if cured. Patients often describe how eating, talking, and kissing, usually regular activities and simple pleasures in a normal life, are vastly different and complicated in their post-treatment lives. While most patients express joy for cure and deep gratitude for their lives, the adjustment to the new normal may lead to dissonant emotions and possibly regrets regarding treatment choices. Patients often lament the burden of a challenging and complex recovery that persists long after cure.
In this concurrent session, our interdisciplinary panel will review sequelae of head and neck cancer treatment and discuss treatment options for the major complications and persistent distressing symptoms. We will explore the physical and emotional challenges faced by head and neck cancer patients. In addition, we will discuss the integration of an interdisciplinary team approach into the usual care and current model of survivorship.
Upon completion of this activity the learner should be better able to:
- Describe four major sequelae of head and neck cancer treatment, including dysphagia, dysphonia, disfiguration and pain
- Describe the palliative care needs of patients with treated head and neck cancer, including the psychological burdens of being cured of cancer, while continuing to have significant residual sequelae
- Develop and implement actionable strategies for head and neck cancer patients that integrate palliative care approaches into the oncology practice during treatment and in survivorship
AAHPM endorses the Accreditation Council for Continuing Medical Education (ACCME) Standards for disclosure and commercial support and endeavors to ensure balance, independence, objectivity, and scientific rigor for all accredited products or programs. All who are in a position to control or influence the content of an educational activity must disclose any relevant financial relationships with ineligible companies.*Disclosure documents were reviewed for potential conflicts of interest and, if identified, they were resolved prior to confirmation of participation. Only those who had no conflict of interest or who agreed to an identified resolution process prior to their participation were involved in this activity.
All editors, faculty and staff have disclosed no relevant financial relationships.
*An ineligible company is defined as any entity producing, marketing, reselling, or distributing healthcare goods or services consumed by, or used on, patients. (Exclusions at the time of this writing included 501-C not-for-profit organizations, government organizations, liability and health insurance providers, non-healthcare-related companies, group medical practices, for-profit healthcare providers, blood banks and diagnostic laboratories.)
Dana Guyer, MD
Sumathi Misra, MD MPH CMD FAAHPM
Ariel Birnbaum, MD
Joshua Jones, MD MA FAAHPM
Continuing Medical Education (CME)
The American Academy of Hospice and Palliative Medicine (AAHPM) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The American Academy of Hospice and Palliative Medicine (AAHPM) designates this Enduring material for a maximum of 0.50 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
CME credits expire October 13, 2024.
Maintenance of Certification (MOC)
“Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.50 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
ABIM MOC points expire on October 13, 2024.
Physicians certified with the American Board of Internal Medicine who wish to earn MOC points within the current calendar year must submit their MOC data no later than December 31 of the calendar year.
- 0.50 ABIM MOC
- 0.50 CME (physician only)
- 0.50 Participation