Alcohol (Fayetteville, N.Y.) · 2025
The impact of alcohol addiction on the quality of life, mental condition, clinical condition and nutritional status of patients with head and neck cancer.
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Dorobisz Karolina, Dorobisz Tadeusz, Pazdro-Zastawny Katarzyna, Janczak Marzena, Czyż Katarzyna
Аннотация
INTRODUCTION: Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide, with over 880,000 new cases reported worldwide each year. Tobacco smoking and alcohol drinking are the main risk factors for HNSCC, accounting for 30 % of HNSCC cases worldwide. Alcohol is a particularly important risk factor not only for HNSCC and was recognized in 1988 by the International Agency for Research on Cancer (IARC) as a very important risk factor for the incidence of oral cavity, oropharyngeal, hypopharyngeal and laryngeal cancers, and was classified as group 1 cancer risk factors. The aim of the study was to assess the impact of alcohol on the quality of life, mental state, clinical state and nutritional status in patients with HNSCC.
MATERIAL AND METHOD: The single-center, prospective study included a group of 123 patients aged 42 to 89, treated for laryngeal cancer, pharyngeal cancer and cancer of unknown primary site HNSCC. Socio-demographic data and the presence of risk factors were assessed in each patient. The performance status of the patients was assessed using the Eastern Cooperative Oncology Group (ECOG) scale. The nutritional status of patients was assessed via a Body Mass Index (BMI) assessment and Mini Nutritional Assessment Short FORM (MNA-SF). Each patient was also assessed using the Nutrition Risk Screening 2002 (NRS2002). The level of depression and anxiety was assessed using the Hospital Anxiety and Depression Scale (HADS). Patients were also assessed for sleep problems using the Insomnia Severity Index. Quality of life was assessed using the Polish version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire for Head and Neck Cancer 35 (EORTC QLQ-H&N35). In each patient, the results of laboratory tests were also analyzed - morphology, nutritional parameters - total protein, total cholesterol and CRP protein level.
RESULTS: Patients who regularly drank alcohol more often suffered from throat cancer (91.2 %) and larynx cancer (59.2 %), while CUP was more often diagnosed in patients without a history of regular alcohol consumption. Patients who drank alcohol were diagnosed at a significantly higher stage compared to the group of non-drinkers. In the study group of patients regularly drinking alcohol with diagnosed HSCC, a significantly worse clinical condition, risk of malnutrition or malnutrition was demonstrated compared to patients with diagnosed HNSCC who did not drink alcohol. In laboratory tests, patients drinking alcohol had a lower hemoglobin level before treatment (11.7 vs 12.8 g/dl, p < 0.001), a higher leukocyte level (10.3 vs 7.5 × 10 9/l, p < 0.001), a lower total protein level (6.3 vs 6.8 g/dl, p < 0.001), a higher mean CRP level (8.0 vs 5.0 mg/l) and a lower total cholesterol level (134 vs 187 mg/dl, p < 0.001). Those who drank alcohol more often had significantly worse mental state and sleep problems in HADS and ISI surveys compared to those who did not drink alcohol. In the results of the EORT QLQ-H&N35 survey, patients who drank alcohol had worse results in questions about pain sensation, swallowing, sticky saliva, felt ill, speech, social eating and social contact.
CONCLUSIONS: Alcohol is a significant risk factor for HNSCC, usually associated by patients with smoking. It significantly affects the deterioration of the clinical condition and nutritional status of patients. It is a significant factor reducing the quality of life and worsening the mental state of patients with HNSCC. It is necessary to implement comprehensive care for patients abusing alcohol, along with education and promotion of cessation of alcohol consumption together with smoking. It is necessary to raise social awareness from the youngest age, and implement environmental and educational preventive measures with political support. Strengthening the view of alcohol carcinogenicity can significantly reduce morbidity and improve treatment outcomes in patients with HNSCC.
MATERIAL AND METHOD: The single-center, prospective study included a group of 123 patients aged 42 to 89, treated for laryngeal cancer, pharyngeal cancer and cancer of unknown primary site HNSCC. Socio-demographic data and the presence of risk factors were assessed in each patient. The performance status of the patients was assessed using the Eastern Cooperative Oncology Group (ECOG) scale. The nutritional status of patients was assessed via a Body Mass Index (BMI) assessment and Mini Nutritional Assessment Short FORM (MNA-SF). Each patient was also assessed using the Nutrition Risk Screening 2002 (NRS2002). The level of depression and anxiety was assessed using the Hospital Anxiety and Depression Scale (HADS). Patients were also assessed for sleep problems using the Insomnia Severity Index. Quality of life was assessed using the Polish version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire for Head and Neck Cancer 35 (EORTC QLQ-H&N35). In each patient, the results of laboratory tests were also analyzed - morphology, nutritional parameters - total protein, total cholesterol and CRP protein level.
RESULTS: Patients who regularly drank alcohol more often suffered from throat cancer (91.2 %) and larynx cancer (59.2 %), while CUP was more often diagnosed in patients without a history of regular alcohol consumption. Patients who drank alcohol were diagnosed at a significantly higher stage compared to the group of non-drinkers. In the study group of patients regularly drinking alcohol with diagnosed HSCC, a significantly worse clinical condition, risk of malnutrition or malnutrition was demonstrated compared to patients with diagnosed HNSCC who did not drink alcohol. In laboratory tests, patients drinking alcohol had a lower hemoglobin level before treatment (11.7 vs 12.8 g/dl, p < 0.001), a higher leukocyte level (10.3 vs 7.5 × 10 9/l, p < 0.001), a lower total protein level (6.3 vs 6.8 g/dl, p < 0.001), a higher mean CRP level (8.0 vs 5.0 mg/l) and a lower total cholesterol level (134 vs 187 mg/dl, p < 0.001). Those who drank alcohol more often had significantly worse mental state and sleep problems in HADS and ISI surveys compared to those who did not drink alcohol. In the results of the EORT QLQ-H&N35 survey, patients who drank alcohol had worse results in questions about pain sensation, swallowing, sticky saliva, felt ill, speech, social eating and social contact.
CONCLUSIONS: Alcohol is a significant risk factor for HNSCC, usually associated by patients with smoking. It significantly affects the deterioration of the clinical condition and nutritional status of patients. It is a significant factor reducing the quality of life and worsening the mental state of patients with HNSCC. It is necessary to implement comprehensive care for patients abusing alcohol, along with education and promotion of cessation of alcohol consumption together with smoking. It is necessary to raise social awareness from the youngest age, and implement environmental and educational preventive measures with political support. Strengthening the view of alcohol carcinogenicity can significantly reduce morbidity and improve treatment outcomes in patients with HNSCC.