Long-term follow-up study on nutritional problems and health-related quality of life among head and neck cancer survivors more than 5 years after diagnosis.

PURPOSE: Few studies have evaluated the long-term effects of head and neck cancer (HNC) and its treatment. Therefore, the objective was to study nutritional rehabilitation needs by assessing nutritional problems, dietary adjustments, muscle mass, muscle strength, physical performance, prevalence of sarcopenia, and health-related quality of life (HRQoL) among long-term HNC survivors.

METHODS

This cross-sectional study included HNC survivors more than 5 years after diagnosis. Nutritional status, sarcopenia, and physical performance were assessed through questions about dietary adjustments, muscle mass (bioelectrical impedance analysis), grip strength, and maximum walking speed measurements. HRQoL and nutrition impact symptoms (NISs) were assessed using quality of life questionnaires from the European Organization for Research and Treatment of Cancer (EORTC), QLQ-C30 and QLQ-HN35, and were compared with reference values from a normal Swedish population.

RESULTS

Almost 80% of 114 participating survivors needed dietary adjustments, most commonly extra liquid with meals and/or moist food and increased time to consume meals. Relatively few patients had reduced muscle mass and low BMI, and none had sarcopenia. Compared with reference values, survivors reported severe HNC-specific symptoms on the EORTC QLQ-HN35. Survivors with the most problems swallowing solid food had a higher NIS burden and more problems with role and social functioning.

CONCLUSIONS

In this cross-sectional study, many long-term HNC survivors experienced chronic NISs and had worse HRQoL than a matched reference group from the normal population. The findings suggest that survivors with nutritional problems may have adapted and used dietary adjustments to facilitate food intake. For some survivors, nutritional rehabilitation may be needed long after treatment has ended.