Palliative care for Head and Neck Cancer Patients: A 10 year review

Abstrakt

Background: Head and neck cancers (HNC) constitute a diverse group of diseases including malignancies of the oral cavity, oropharynx, larynx, si nuses, and skull base. They constitute 5-
50% of all cancers globally and 6.2% of all cancers in Nigeria. Majority of these patients usually present with advanced staged disease and they are mostly for palliative care.

Methodology: Data for this study was retrieved from case files of patients seen at Hospice and Palliative care unit, UCH, Ibadan from February 2008 - January 2018. Their bio data, diagnosis and services offered were extracted and analyzed.

Results: There was a total of 77 patients with Head and Neck Cancers seen; 38 males and 39 females (M/F=1:1) out of a total of 1,765 patients enrolled by the Unit during the study period. Of these 77 patients, 20(26%) lived within the department’s catchment area for Home based care services. Services rendered included pain control, home based care, patient counseling, financial support,
phone calls, psychosocial support, day care forum and bereavement support. Patient counseling was offered to all patients and pain control was managed with analgesics using the World
Health Organization analgesic ladder. Other symptoms managed were sore throat, weight loss, headache, drowsiness, odynophagia. At the end of the period under review 50 (65%) were dead and 26 (34%) of the patients were lost to follow up and 1 (1%) of the patients is alive.

Conclusion: Patients with Head and Neck Cancers had supportive services rendered for their pain, other symptoms control and their psychosocial issues. Palliative care should be made available and accessible to all patients who require it.

Keywords: Head, neck, cancer, malignancies, oropharynx, sinuses

Résumé
Contexte: Les cancers de la tête et du cou (HNC) constituent un groupe diversifié de maladies, y compris les tumeurs malignes de la cavité buccale, de l’oropharynx, du larynx, des sinus et de la base du crâne. Ils constituent 5 à 50% de tous les cancers dans le monde et 6,2% de tous les cancers au Nigéria. La majorité de ces patients présentent généralement une maladie à un stade avancé et ils sont principalement destinés aux soins palliatifs.

Méthodologie: Les données de cette étude ont été extraites des dossiers de cas de patients vus à l’unité de soins palliatifs et palliatifs, UCH, Ibadan de février 2008 à janvier 2018. Leurs données biologiques, le diagnostic et les services offerts ont été extraits et analysés.

Résultats: Au total, 77 patients atteints de cancers de la tête et du cou ont été vus; 38 hommes et 39 femmes (H / F = 1: 1.) Sur un total de 1 765 patients recrutés par l’Unité au cours de la période d’étude. Sur ces 77 patients, 20 (26%) vivaient dans la zone de desserte du département pour les services de soins à domicile. Les services rendus comprenaient le contrôle de la douleur, les soins à domicile, les conseils aux patients, le soutien financier, les appels téléphoniques, le soutien psychosocial, le forum de garde de jour et le soutien au deuil. Des conseils aux patients ont été proposés à tous les patients et le contrôle de la douleur a été géré avec des analgésiques en utilisant l’échelle analgésique de l’Organisation mondiale de la santé. Les autres symptômes pris en charge étaient les maux de gorge, la perte de poids, les maux de tête, la somnolence, l’odynophagie. À la fin de la période sous revue, le nombre (65%) étaient décédés et le nombre (34%) des patients ont été perdus de vue et le nombre (1%) des patients est en vie.

Conclusion: Les patients atteints de cancers de la tête et du cou ont bénéficié de services de soutien concernant leur douleur, le contrôle des autres symptômes et leurs problèmes psychosociaux. Les soins palliatifs doivent être disponibles et accessibles à tous les patients qui en ont besoin.

Mots clés: Tete et cou, oropharynx, larynx, sinus

Correspondence: Mrs. O.A Maboreje, Hospice and Palliative Care Department, University College Hospital, Ibadan, Nigeria

pdf (angličtina)

Reference

Johnson NW. Orofacial neoplasms: global epidemiology risk factors and recommendations for research.Int Dent J 1991; 41:365-375.

Sisson GA, Torium DM and Atiyah RA. Paranasal sinus Malignancy- A comprehensive update Laryngoscope 1989; 143-152.

Yu MC. Nasopharyngeal carcinoma: epidemiology and dietary factors. In: Relevance to human cancer of N-nitroso compounds, tobacco smoke and mycotoxins.O’Neil IK,Chen J. Bartsch H(eds). IARC SciPubl, No105:1991; p39-47.

Key Tj, Allen NE, Spencer EA and Travis RC. The effect of diet on risk of cancer. Lancet 2002; 360:861-68.

Evaluation of carcinogenic Risks to Humans. IARC Monogrcarcinog Risks Hum, Internal Report 1998; No.98/004.Vol 77.

Bhatia PL: Head and neck cancer in Plateau State of Nigeria. West Afr J Med 1990, 9:304-310. Pub Med abstract.

Lilly-Teriah da OB, Ukoli CO and Nwana EJC: Cancer of the larynx in black Africans in Jos,Nigeria.Cent Afr J Med. 1999, 45(2):40-42.

Okafor BC: Otolaryngology in South-Eastern Nigeria III. Pattern of disease of the throat.Nig Med J 1983, 13:30-41

Somefun AO, Nwanwolo CC, Okeowo PA et al, :Prognostic factors in the management outcome of carcinoma of the larynx in Lagos.Niger Postgrad Med J 2003, 10:103-106.

AmusaYB, Olabanji JK and Ogundipe OV: Pattern of head & neck malignant tumour in a Nigerian teaching hospital: a ten year review. West Afr J med 2004, 23:280-285.

Nwaorgu O, Kokong D, Onakoya P et al: Prevalence of human immunodefiency virus sero-positivity in head and neck malignancies in sub-Saharan Africa. Acta Oto-Laryngol 2007, 127:1218-1221.

Garfinkel L. Perpective on cancer prevention.Cancer J clin. 1995;45:5-9.13.Tobias JS.cancer of the head and neck. BMJ 1994; 308:961-966.

Zagar GK, Smith JL, Norante JD and McDonald S; Tumours of the head and neck. In clinical Oncology: A multidisciplinary approach for physicians and students. 7th edition. Edited by Rubin P. Baltimore W.B Saunders; 1993:319-362.

Sanghvi LD, Rao DN and Joshi S: Epidemiology of head and neck cancers. Seminsurgoncol 1989, 5:305-309.

Bhatia PL: Head and neck cancer in Plateau State of Nigeria. West Afr J Med 1990, 9:304-310.

Otoh EC, Johnson NW, Danfillo Is: Primary head and neck cancers in North Eastern Nigeria West Afr. J Med 2004; 23: 305-313

Lilly-Tariah da OB, Nwana EJ and Okeowo PA: cancers of the ear nose and throat.Nig. J surg science 2000. 10:52-56

AmusaYB, Olabanji JK and Ogundipe OV: Pattern of head & neck malignant tumour in a Nigerian teaching hospital: a ten year review. West Afr J med 2004, 23:280-285.

Nwawolo CC, Ajekibge AT, et al : Pattern of head and neck cancers among Nigeria in Lagos. WAJM 2001, 20: 111-116.

Nigeria year book Times press Ltd.Apapa; 1981:451-467.

Scott SE, Grunfeld EA et al. Patient delay in oral cancer. A qualitative study of patients’ experience.Psychooncology. 2006;15:474-85[PubMed]

who.int/cancer/palliative/painladder/en

http://uch-ibadan.org.ng/hospice_and_palliative_care