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Mullan LJ, Blackburn NE, Gracey J, Dunwoody L, Lorimer J, Semple CJ. Evaluating the effects of lymphoedema management strategies on functional status and health-related quality of life following treatment for head and neck cancer: a systematic review. J Cancer Surviv 2025; 19:121-139. [PMID: 37648875 PMCID: PMC11813819 DOI: 10.1007/s11764-023-01453-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 08/17/2023] [Indexed: 09/01/2023]
Abstract
PURPOSE Patients living with head and neck lymphoedema (HNL) after completion of head and neck cancer (HNC) often can experience long-term functional challenges and overall poorer health-related quality of life (HRQOL). This systematic review aims to explore components of effective HNL interventions through identification and synthesising literature on existing HNL management interventions. METHODS Five electronic databases (MEDLINE via Ovid and PubMed, CINAHL, CENTRAL, and Scopus) were systematically searched using Medical Subject Headings and free text, as well as citation tracking and Google Scholar for grey literature. RESULTS A total of 1910 studies were screened, with 12 studies meeting the inclusion criteria. Findings indicated vast heterogeneity within HNL interventions. Patients' adherence to intervention strategies was reported as low and partially adhered to, particularly at home. This impacted on function domains and overall HRQOL during the post-treatment HNC phase, as well as further increasing the demands placed on healthcare professionals. CONCLUSIONS Synthesis of the research findings highlighted a need to provide and educate patients with individualised HNL self-management intervention strategies. Promoting adherence was reported as being essential, with self-efficacy and behaviour change techniques being emphasised as a critical element to enhance motivation and therefore effective intervention delivery. Further work is important to address barriers to adherence and promote both motivation and behaviour change, to develop individualised self-management interventions for this cancer population. IMPLICATIONS FOR CANCER SURVIVORS The findings from this systematic review will provide guidance in the development and delivery of individualised self-management HNL interventions for patients who have completed HNC treatment.
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Affiliation(s)
- Lauren J Mullan
- School of Nursing, Institute of Nursing and Health Research, Ulster University, Belfast, UK.
| | - Nicole E Blackburn
- School of Health Sciences, Institute of Nursing and Health Research, Ulster University, Londonderry, UK
| | - Jackie Gracey
- School of Health Sciences, Institute of Nursing and Health Research, Ulster University, Londonderry, UK
| | - Lynn Dunwoody
- School of Psychology, Faculty of Life and Health Sciences, Ulster University, Londonderry, UK
| | - Jill Lorimer
- Physiotherapy Department, Cancer Centre, Belfast Health and Social Care Trust, Belfast, UK
| | - Cherith J Semple
- School of Nursing, Institute of Nursing and Health Research, Ulster University, Belfast, UK
- Cancer Services, South Eastern Health and Social Care Trust, Belfast, UK
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de Boer J, Barnett R, Cardin A, Cimoli M, Davies L, Delany C, Dixon BJ, Evans SM, Findlay MW, Fox C, Ftanou M, Hart CD, Howard M, Iseli TA, Jackson A, Kranz S, Le BH, Lekgabe E, Lennox R, McLean LS, Neeson PJ, Ng SP, O’Reilly LA, Ramakrishnan A, Rowe D, Service C, Singh A, Thai AA, Tiong A, Yap T, Wiesenfeld D. Optimising Patient Outcomes in Tongue Cancer: A Multidisciplinary Approach. Cancers (Basel) 2024; 16:1277. [PMID: 38610956 PMCID: PMC11010906 DOI: 10.3390/cancers16071277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 03/21/2024] [Accepted: 03/24/2024] [Indexed: 04/14/2024] Open
Abstract
A multidisciplinary approach to the management of tongue cancer is vital for achieving optimal patient outcomes. Nursing and allied health professionals play essential roles within the team. We developed symposia comprising a series of online lectures offering a detailed perspective on the role each discipline and consumer perspective has in the management of patients with tongue cancer. The topics, including epidemiology and prevention, diagnosis, treatment planning, surgery, adjuvant care, and the management of recurrent or metastatic disease, were thoroughly examined. The symposia highlighted the significance of fostering collaboration and continuous learning through a multidisciplinary approach. This initiative should be relevant to healthcare professionals, researchers, and policymakers striving to enhance patient outcomes in tongue cancer care through innovative collaboration.
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Affiliation(s)
| | - Rebecca Barnett
- St. Vincent’s Hospital Melbourne, Melbourne 3065, Australia; (R.B.); (C.D.H.); (A.J.)
| | - Anthony Cardin
- Peter MacCallum Cancer Centre, Melbourne 3000, Australia (C.D.); (M.W.F.); (M.F.); (M.H.); (B.H.L.); (A.A.T.); (A.T.)
| | - Michelle Cimoli
- Austin Health, Heidelberg 3084, Australia; (M.C.); (R.L.); (S.P.N.)
| | - Lauren Davies
- The Royal Melbourne Hospital, Melbourne 3052, Australia; (L.D.); (C.F.); (T.A.I.); (S.K.); (E.L.); (A.R.); (C.S.); (T.Y.)
| | - Clare Delany
- Peter MacCallum Cancer Centre, Melbourne 3000, Australia (C.D.); (M.W.F.); (M.F.); (M.H.); (B.H.L.); (A.A.T.); (A.T.)
| | - Benjamin J. Dixon
- St. Vincent’s Hospital Melbourne, Melbourne 3065, Australia; (R.B.); (C.D.H.); (A.J.)
- Department of Surgery, University of Melbourne, Melbourne 3010, Australia
| | - Sue M. Evans
- Victorian Cancer Registry, Cancer Council Victoria School of Public Health and Preventive Medicine, Monash University, Melbourne 3002, Australia;
| | - Michael W. Findlay
- Peter MacCallum Cancer Centre, Melbourne 3000, Australia (C.D.); (M.W.F.); (M.F.); (M.H.); (B.H.L.); (A.A.T.); (A.T.)
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne 3010, Australia;
| | - Carly Fox
- The Royal Melbourne Hospital, Melbourne 3052, Australia; (L.D.); (C.F.); (T.A.I.); (S.K.); (E.L.); (A.R.); (C.S.); (T.Y.)
| | - Maria Ftanou
- Peter MacCallum Cancer Centre, Melbourne 3000, Australia (C.D.); (M.W.F.); (M.F.); (M.H.); (B.H.L.); (A.A.T.); (A.T.)
| | - Christopher D. Hart
- St. Vincent’s Hospital Melbourne, Melbourne 3065, Australia; (R.B.); (C.D.H.); (A.J.)
| | - Megan Howard
- Peter MacCallum Cancer Centre, Melbourne 3000, Australia (C.D.); (M.W.F.); (M.F.); (M.H.); (B.H.L.); (A.A.T.); (A.T.)
| | - Tim A. Iseli
- The Royal Melbourne Hospital, Melbourne 3052, Australia; (L.D.); (C.F.); (T.A.I.); (S.K.); (E.L.); (A.R.); (C.S.); (T.Y.)
- Department of Surgery, University of Melbourne, Melbourne 3010, Australia
| | - Andrea Jackson
- St. Vincent’s Hospital Melbourne, Melbourne 3065, Australia; (R.B.); (C.D.H.); (A.J.)
| | - Sevastjan Kranz
- The Royal Melbourne Hospital, Melbourne 3052, Australia; (L.D.); (C.F.); (T.A.I.); (S.K.); (E.L.); (A.R.); (C.S.); (T.Y.)
| | - Brian H. Le
- Peter MacCallum Cancer Centre, Melbourne 3000, Australia (C.D.); (M.W.F.); (M.F.); (M.H.); (B.H.L.); (A.A.T.); (A.T.)
| | - Ernest Lekgabe
- The Royal Melbourne Hospital, Melbourne 3052, Australia; (L.D.); (C.F.); (T.A.I.); (S.K.); (E.L.); (A.R.); (C.S.); (T.Y.)
| | - Rachel Lennox
- Austin Health, Heidelberg 3084, Australia; (M.C.); (R.L.); (S.P.N.)
| | - Luke S. McLean
- Peter MacCallum Cancer Centre, Melbourne 3000, Australia (C.D.); (M.W.F.); (M.F.); (M.H.); (B.H.L.); (A.A.T.); (A.T.)
| | - Paul J. Neeson
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne 3010, Australia;
| | - Sweet Ping Ng
- Austin Health, Heidelberg 3084, Australia; (M.C.); (R.L.); (S.P.N.)
| | - Lorraine A. O’Reilly
- The Walter and Eliza Hall of Medical Research (WEHI), Melbourne 3052, Australia;
| | - Anand Ramakrishnan
- The Royal Melbourne Hospital, Melbourne 3052, Australia; (L.D.); (C.F.); (T.A.I.); (S.K.); (E.L.); (A.R.); (C.S.); (T.Y.)
| | - David Rowe
- The Royal Melbourne Hospital, Melbourne 3052, Australia; (L.D.); (C.F.); (T.A.I.); (S.K.); (E.L.); (A.R.); (C.S.); (T.Y.)
| | - Carrie Service
- The Royal Melbourne Hospital, Melbourne 3052, Australia; (L.D.); (C.F.); (T.A.I.); (S.K.); (E.L.); (A.R.); (C.S.); (T.Y.)
| | - Ankur Singh
- Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne 3010, Australia;
| | - Alesha A. Thai
- Peter MacCallum Cancer Centre, Melbourne 3000, Australia (C.D.); (M.W.F.); (M.F.); (M.H.); (B.H.L.); (A.A.T.); (A.T.)
- Austin Health, Heidelberg 3084, Australia; (M.C.); (R.L.); (S.P.N.)
| | - Albert Tiong
- Peter MacCallum Cancer Centre, Melbourne 3000, Australia (C.D.); (M.W.F.); (M.F.); (M.H.); (B.H.L.); (A.A.T.); (A.T.)
| | - Tami Yap
- The Royal Melbourne Hospital, Melbourne 3052, Australia; (L.D.); (C.F.); (T.A.I.); (S.K.); (E.L.); (A.R.); (C.S.); (T.Y.)
- Melbourne Dental School, University of Melbourne, Melbourne 3010, Australia
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Cheng JT, Ramos Emos M, Leite V, Capozzi L, Woodrow LE, Gutierrez C, Ngo-Huang A, Krause KJ, Parke SC, Langelier DM. Rehabilitation Interventions in Head and Neck Cancer: A Scoping Review. Am J Phys Med Rehabil 2024; 103:S62-S71. [PMID: 38364033 DOI: 10.1097/phm.0000000000002384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
OBJECTIVE The aim of the study is to identify and appraise current evidence for rehabilitation interventions in head and neck cancer. DESIGN A previously published scoping review spanning 1990 through April 2017 was updated through January 11, 2023 and narrowed to include only interventional studies (Arch Phys Med Rehabil. 2019;100(12):2381-2388). Included studies had a majority head and neck cancer population and rehabilitation-specific interventions. Pairs of authors extracted data and evaluated study quality using the PEDro tool. Results were organized by intervention type. RESULTS Of 1338 unique citations, 83 studies with 87 citations met inclusion criteria. The median study sample size was 49 (range = 9-399). The most common interventions focused on swallow (16 studies), jaw (11), or both (6), followed by whole-body exercise (14) and voice (10). Most interventions took place in the outpatient setting (77) and were restorative in intent (65 articles). The overall study quality was fair (median PEDro score 5, range 0-8); none were of excellent quality (PEDro >9). CONCLUSIONS Most head and neck cancer rehabilitation interventions have focused on restorative swallow and jaw exercises and whole-body exercise to address dysphagia, trismus, and deconditioning. More high-quality evidence for head and neck cancer rehabilitation interventions that address a wider range of impairments and activity and social participation limitations during various cancer care phases is urgently needed to reduce head and neck cancer-associated morbidity.
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Affiliation(s)
- Jessica T Cheng
- From the Department of Supportive Care Medicine, City of Hope Orange County Lennar Foundation Cancer Center, California (JTC); Department of Orthopedic Surgery and Rehabilitation, SUNY Downstate Health Sciences University, Brooklyn, New York (ME); Rehabilitation Department, Instituto do Cancer, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil (VL); Faculty of Kinesiology, University of Calgary, Calgary, Canada (LC); Division of Physical Medicine and Rehabilitation, Department of Clinical Neurosciences, Cumming School of Medicine, Calgary, Canada (LC); Department of Internal Medicine, Section of Physical Medicine and Rehabilitation, University of Manitoba, Winnipeg, Canada (LEW); Department of Physical Medicine and Rehabilitation, McGovern Medical School at UTHealth Houston, Houston, Texas (CG); Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas (AN-H); Research Medical Library, The University of Texas MD Anderson Cancer Center, Houston, Texas (KJK); Department of Physical Medicine and Rehabilitation, Mayo Clinic Arizona, Phoenix, Arizona (SCP); and Department of Medicine, Division of Physical Medicine and Rehabilitation, University Health Network and University of Toronto, Toronto, Canada (DML)
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Mullan LJ, Blackburn NE, Lorimer J, Semple CJ. Evaluating the effects of lymphoedema management strategies on functional status and health-related quality of life following treatment for head and neck cancer: Protocol for a systematic review. PLoS One 2024; 19:e0297757. [PMID: 38306345 PMCID: PMC10836692 DOI: 10.1371/journal.pone.0297757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 01/11/2024] [Indexed: 02/04/2024] Open
Abstract
INTRODUCTION/BACKGROUND Patients living with and after head and neck cancer often experience treatment-related consequences. Head and neck lymphoedema can be described as a common chronic side effect of head and neck cancer and recognised as a contributing factor to impairment of functional status, symptom burden and health-related quality of life. The effects of head and neck lymphoedema can limit patients' involvement in daily activities and alter their appearance, increasing symptom burden and negatively affecting health-related quality of life. OBJECTIVE The protocol outlines the rationale and aims for the systematic review. The main aim of the systematic review is to identify and systematically synthesise the literature on the effectiveness of head and neck lymphoedema management strategies, on both function status and health-related quality of life for head and neck cancer patients. METHODS AND ANALYSIS This protocol will be conducted according to the PRISMA-P guidelines. Electronic databases will be systematically searched using MEDLINE via Ovid and PubMed, CINAHL, Cochrane Central Register of Controlled Trials and Scopus. Inclusion criteria will involve intervention studies for head and neck lymphoedema management, English language, and adult human participants following head and neck cancer. The software Covidence will be used to export, manage, and screen results. Risk of bias and quality will be assessed in included studies using the Cochrane Handbook of Systematic Reviews of Intervention risk of bias and GRADE tools. A meta-analysis will be performed if there are sufficient homogenous studies. Alternatively, a narrative synthesis will be completed on study findings. ETHICS AND DISSEMINATION No ethical approval is required as the study does not involve patient and public involvement. The findings of the review will be disseminated in conferences and submitted for approval to be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42022378417. (S1 Appendix).
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Affiliation(s)
- Lauren J. Mullan
- School of Nursing, Institute of Nursing and Health Research, Ulster University, Belfast, United Kingdom
| | - Nicole E. Blackburn
- School of Health Sciences, Institute of Nursing and Health Research, Ulster University, Londonderry, United Kingdom
| | - Jill Lorimer
- Physiotherapy Department, Cancer Centre, Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - Cherith J. Semple
- School of Nursing, Institute of Nursing and Health Research, Ulster University, Belfast, United Kingdom
- Cancer Services, South Eastern Health and Social Care Trust, Belfast, United Kingdom
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