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To examine the patterns of care for octogenarian head and neck cancer patients.
Methods
All newly diagnosed patients aged 80 years or older, who presented at our centre between June 2018 and October 2020, were included.
Results
The total number of patients was 42. The median Charlson Comorbidity Index was 5 (range, 4–9). The larynx was the most common subsite (n = 12). Twenty-nine patients (66 per cent) were diagnosed at disease stage IV. Squamous cell carcinoma was the most common histology (86 per cent). Twenty-six patients (62 per cent) had radical treatment and 16 (38 per cent) had palliative treatment. The estimated six-month and one-year overall survival rates for the radical and palliative treatment cohorts were 92.3 per cent and 42.9 per cent (p = 0.001) and 65.4 per cent and 15.4 per cent (p = 0.003), respectively.
Conclusion
This study provides useful information on octogenarian patients with head and neck cancer. This information may help in conducting prospective studies, especially those focusing on older patients with head and neck cancer, in order to define the ideal care of this patient population.
To examine the patterns of care for octogenarian head and neck cancer patients.
Methods
All newly diagnosed patients aged 80 years or older, who presented at our centre between June 2018 and October 2020, were included.
Results
The total number of patients was 42. The median Charlson Comorbidity Index was 5 (range, 4–9). The larynx was the most common subsite (n = 12). Twenty-nine patients (66 per cent) were diagnosed at disease stage IV. Squamous cell carcinoma was the most common histology (86 per cent). Twenty-six patients (62 per cent) had radical treatment and 16 (38 per cent) had palliative treatment. The estimated six-month and one-year overall survival rates for the radical and palliative treatment cohorts were 92.3 per cent and 42.9 per cent (p = 0.001) and 65.4 per cent and 15.4 per cent (p = 0.003), respectively.
Conclusion
This study provides useful information on octogenarian patients with head and neck cancer. This information may help in conducting prospective studies, especially those focusing on older patients with head and neck cancer, in order to define the ideal care of this patient population.
Contextualization: health professionals’ anguish towards the patient with head and neck cancer (HNC) permeates clinical issues: the location of the tumour, if advanced diagnosis, the psychosocial features of the patient. The perception, coming from patients as undesirable, refers to the conflict of how to deal with one’s own anguishes.
Objectives
AIM: To explore and interpret how anguish experienced by physicians and nurses are mobilized regarding to the clinical and psychosocial peculiarities of patients with HNC.
Methods
Strategies: Clinical-qualitative design; semi-directed interview with open-ended questions in depth. Trigger question: “Tell me about the management of the patient with …”. Ten interviewees (06 nurses and 04 resident doctors) from a university oncology outpatient. Intentional sample. Clinical-Qualitative Content Analysis with psychodynamic concepts. Findings validated by peers at the Laboratory of Clinical-Qualitative Research at the University of Campinas, Brazil.
Results
Topics: the treatment of the speeches resulted in three emerging categories: (1) Cancer is literally on the face: self-perception of peculiarities; (2) An appalling illness: dealing with the ‘deteriorated’; (3) To naturalize without trivializing: handling with their own anguish.
Conclusions
Final considerations: The anguish of health professionals who deals with the HNC patient consists of the feelings, which are not exposed, because they are not organized and neither understood as natural feelings. It is up to them to seek neutrality to minimize the anguish present in the conflict of not manifesting thoughts considered inadequate by the patient, avoiding moral judgments and conflicts. Balint groups are recommended to attend emotional demands of health professionals.
The clinical situation of coexisting significant cardiac arrhythmias complicating head and neck cancer (HNC) is uncommon, accounting for <11% of comorbid illnesses present in this particular cohort of individuals. Little is documented about the outcomes of these people with cardiac pacemakers (CP) when surgery combined with postoperative radiotherapy is rendered. The authors report two cases wherein full-course postoperative irradiation was administered without any patient mishap. Appropriately indicated adjuvant radiotherapy for locally advanced HNC can be conducted safely and effectively in patients with CPs. Implementation of essential precautionary measures is encouraged to avoid any serious, unwanted cardiac events.
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