Social determinants of health and treatment decisions in head and neck cancer

Head & Neck ◽  
2021 ◽  
Author(s):  
Jennifer N. Shehan ◽  
Tooba Alwani ◽  
Jessica LeClair ◽  
Taylor F. Mahoney ◽  
Pratima Agarwal ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Social Determinants Of Health ◽  
Neck Cancer ◽  
Social Determinants ◽  
Treatment Decisions ◽  
Determinants Of Health

scholarly journals JAK3 Variant, Immune Signatures, DNA Methylation, and Social Determinants Linked to Survival Racial Disparities in Head and Neck Cancer Patients

2019 ◽  
Vol 12 (4) ◽  
pp. 255-270 ◽  
Author(s):  
Rafael Guerrero-Preston ◽  
Fahcina Lawson ◽  
Sebastian Rodriguez-Torres ◽  
Maartje G. Noordhuis ◽  
Francesca Pirini ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Head And Neck Cancer ◽  
Racial Disparities ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Social Determinants ◽  
Immune Signatures

Effect of oral tumour size on quality of life judgements by health care professionals working with head and neck cancer patients: a pilot study

2009 ◽  
Vol 123 (12) ◽  
pp. 1352-1357 ◽  
Author(s):  
K Reid ◽  
C Hicks ◽  
S Herron-Marx ◽  
S Parmar
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Health Care Professionals ◽  
Tumour Size ◽  
Treatment Decisions

AbstractAim:To investigate whether information about the size of an oral tumour influences the multi-disciplinary team's judgement about the quality of life of head and neck cancer patients.Method:Using a between-group design, two groups of health care professionals rated a hypothetical patient on 20 outcome variables. The patient description was identical for both groups, except for the tumour size.Results:Comparison of variable ratings revealed only three significant differences between the groups' predictions and no consistency within conditions, suggesting that the participants held few common assumptions about the impact of tumour size on a range of patient experiences.Conclusion:The lack of agreement amongst the health care professionals suggests that, where humane judgements are used in treatment decisions for head and neck cancer patients, these may be random and inconsistent. Consequently, patients should have a direct input into treatment decisions, via formalised quality of life data.

Assessing social determinants of health in a safety-net oncology population: Use of an EHR-based screening and referral system.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19072-e19072
Author(s):  
Rebecca N. W. Tsai ◽  
Muhammad M. Qureshi ◽  
Stephanie Losi ◽  
Michael A. Dyer ◽  
Minh Tam Truong ◽  
...  
Keyword(s):  
Head And Neck ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Radiation Oncology ◽  
Medical Center ◽  
Safety Net ◽  
Social Needs ◽  
Determinants Of Health ◽  
Oncology Patients ◽  
Safety Net Hospital

e19072 Background: Routine electronic health record (EHR)-based screening and resource referral to address social determinants of health (SDOH) have been established in adult primary care clinics and the emergency department of New England’s largest safety-net hospital. The burden of SDOH in safety-net oncology patients is less well-studied. This study aimed to understand the social needs of this vulnerable patient population and evaluate the need for implementation of SDOH screening in the oncology clinic. Methods: Patients with lung or head and neck cancer seen in consultation in the Department of Radiation Oncology at Boston Medical Center between 3/2019-1/2020 were identified. EHRs were reviewed for receipt of THRIVE, an EHR-based screening and referral model addressing SDOH. Associations between patient demographics and SDOH screening were evaluated. Results: A total of 104 head and neck (n = 53; 51%) and lung (n = 51; 49%) patients were identified. Median age was 65 years (interquartile range 57.5-72). The majority of patients were male (71.2%), and English-speaking (82%). Whites, Blacks, and Asians comprised 43%, 38%, and 3% of patients, respectively. Fifteen patients were Hispanic (14%). Patients were most likely to have private health insurance (n = 41; 39%), followed by joint Medicare-Medicaid plans including senior and community health plans for elderly (n = 27; 26%), Medicaid (n = 17; 16%), and Medicare (n = 17; 16%). 83 of 104 patients (79.8%) were screened for at least one SDOH domain, with 55 patients (66%) screened before presentation in radiation oncology clinic. Transportation to medical appointments (16%), food insecurity (14%), and inability affording medications (10%) were the most prevalent concerns among these oncology patients. Housing insecurity, utilities, caregiving, unemployment, and education were identified social concerns for 4-5% of patients. The majority of patients who had at least one social need requested resources to assist them (71%). Age, gender, race, language, and insurance status were not associated with receipt of the SDOH screener (p≥0.1). Conclusions: Safety-net oncology patients report significant social needs. Routine SDOH screening and resource referral should be considered in these vulnerable patients.

Patient Reported Outcomes and Financial Toxicity in Head and Neck Cancer (PaRTNer): Baseline financial toxicity and attitudes toward costs from a pilot study.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 56-56
Author(s):  
Fumiko Chino ◽  
David M. Brizel ◽  
Yvonne Marie Mowery
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Cancer Care ◽  
Patient Reported Outcomes ◽  
Treatment Decisions ◽  
Financial Toxicity ◽  
Cost Information ◽  
Patient Reported ◽  
Part Time

56 Background: Cancer patients face considerable financial burden, but few studies have explored associations between radiation therapy (RT) and financial toxicity. This study assessed financial toxicity, patient-reported outcomes, and attitudes/perspectives on the role of cost in treatment decisions. Methods: In a prospective, survey-based, longitudinal study (NCT3506451), eligible patients were adults with newly diagnosed non-metastatic head and neck cancer (HNC) undergoing RT as part of their definitive cancer treatment. Surveys collected demographics, cancer details, the COmprehensive Score for financial Toxicity (COST) score to measure financial toxicity, and patient attitudes regarding cost conversations. Results: 60 patients were enrolled (2019-2021), and 58 completed the baseline survey prior to the start of RT. Most were white (75.9%) and non-Hispanic (98.1%). Median age was 61 (range 42-86). Most were married or in long term partnerships (67.0%), had completed at least some college (70.7%), and had employer sponsored private insurance (55.2%). Half were working at least part time, and most earned > $60,000/yr (55.4%). Oropharynx (48.3%) was the most common disease site; almost half (48.1%) received concurrent chemotherapy. Median baseline COST score was 25 (range 0-44), indicating borderline financial toxicity. 37.7% had reduced spending on leisure items, and 30.9% had reduced spending on basics like food or clothing to pay for cancer care. 10.5% had skipped doses of medications to make them last longer, and 21.1% had not filled a prescription because it was too expensive. 19.6% had borrowed money, and 36.4% had used either all or part of their savings (or had no savings at all) to pay for care. Of those employed at diagnosis, 38.9% took extended leave or reduced hours to part time. 25.9% felt their treatment costs/financial situation should be a factor in treatment decisions. 50.8% wanted the less costly treatment, assuming equal effectiveness. 46.6% felt they should receive cost information from their doctor, and 63.8% wanted a financial assistance counselor or social worker to provide cost information. 46.6% felt that discussing their costs would make them feel more involved in their care. While 43.1% felt that talking about cancer-related costs would reduce their anxiety, 36.2% felt it would increase their anxiety. The majority (63.8%) had little or no understanding about the costs of their cancer care, and 69.0% felt that educational materials about costs would be helpful. Conclusions: Despite borderline baseline financial toxicity scores, some HNC patients had already made significant sacrifices in order to afford care before RT had even started. There was little baseline knowledge of cancer costs and overall mixed attitudes toward cost conversation. Most patients felt that cost education would be helpful. Clinical trial information: NCT03506451.

Nutritional status as a prognostic factor in advanced head and neck cancer

1998 ◽  
Vol 23 (4) ◽  
pp. 376-376
Author(s):  
Quak ◽  
Van Bokhorst ◽  
Klop ◽  
Van Leeuwen ◽  
Snow
Keyword(s):  
Head And Neck Cancer ◽  
Prognostic Factor ◽  
Nutritional Status ◽  
Head And Neck ◽  
Neck Cancer ◽  
Advanced Head
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