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Patient Symptoms are Good Indicators in Head and Neck Cancer

According to an article recently published in JAMA Otolaryngology – Head and Neck Surgery, new patient symptoms such as pain and difficulty in speaking are associated with cancer recurrences in head and neck cancer. These symptoms may be useful indicators for physicians to take immediate measures in identifying and treating the recurrences.

Head and neck cancer refers to cancer that occurs in several different structures and locations of the head and/or neck. Although patients undergo periodic screening to detect for cancer recurrences following initial therapy, researchers have been evaluating whether patient symptoms might be an accurate indicator of the presence of a recurrence.

Researchers recently conducted a clinical study to further explore the potential associations between patient symptoms and their accuracy in the presence of a recurrence in head and neck cancer. The study included data from a regional hospital in which clinical records were reviewed. Patients in the study had been treated for oral cavity, oropharyngeal, laryngeal, and hypopharyngeal cancers between 2008-2009. Patients were followed for at least 2 years.

Overall symptoms were not a good indicator of a cancer recurrence.
New onset symptoms, particularly pain, pain in swallowing and difficulty in speaking were associated with cancer recurrences. This association was greatest among patients initially treated with just one type of therapeutic approach.
Site and stage of cancer did not have an effect on the correlation between symptoms and recurrence.
The correlation between symptoms and the presence of a recurrence was greatest between 6-12 months and 18-21 months following therapy.
The researchers concluded that overall, symptoms were not a good indicator of a cancer recurrence in head and neck cancer. However, new onset symptoms, in particular, general pain, pain in swallowing and difficulty in speaking were strongly associated with a recurrence. These findings may help guide patients and physicians in early identification of a recurrence and ultimately begin treatment in an optimal manner.

Reference: Nisa L, La Macchia R, Boujelben N, et al. Correlation Between Subjective Evaluation of Symptoms and Objective Findings in Early Recurrent Head and Neck Squamous Cell Carcinoma. JAMA Otolaryngology – Head and Neck Surgery. Early on-line publication: doi:10.1001/jamaoto.2013.3289 .