Qualityof Life Issues in Head and Neck Cancer Management

"Quality of life and quality of death are opposite sides of the same coin and both are presumably optimized when the likelihood of locoregional cancer recurrence is minimized."

Sharon L. Collins

"It is however vital for oncologists to appreciate the only way that meaningful therapeutic decisions regarding our patient's well-being can be made is to incorporate these QOL instruments into our decision-making algorithm."

Jack L. Gluckman

"The great physicians never stop learning, and recognize the roles our patients play as teachers. It is our responsibility to occasionally pause and reflect on what we know works, what doesn't, and what new avenues might be explored."

Nancy L. Snyderman

Quality-of-Life Issues in Head and Neck Cancer Management

Sharon L. Collins

CHAPTER 19

As we go beyond the year 2000, health care professionals, regardless of their area of practice, will be required (like it or not) to participate in evolving areas of medical practice that have not been part of the traditional medicine of earlier decades: outcomes assessment, patient quality-of-life (QOL) issues, statistical methods such as decision analysis and meta-analysis, and new areas of patient interest such as alternative medicine, to name a few.1 A voluminous literature already exists concerning QOL assessment in head and neck cancer (HNC) patients, but it is too embryonic to have fostered distinct controversies at this point. This chapter presents a brief overview of where we have been, where we are, and where we are going on issues related to QOL in HNC patients. The goals of this presentation are to make health care professionals aware of (1) new issues that must be dealt with; (2) how espousing, rather than resisting, these new trends can optimize relationships with patients and foster compliance with any desired treatment regimen; (3) current deficiencies in the existing literature toward the goal of correcting them expeditiously; and (4) what can be done now in daily practice to enhance the QOL of HNC patients.

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