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Factors affecting quality of life in patients experiencing facial disfigurement due to surgery for head and neck cancer

14 February 2019
Volume 28 · Issue 3



to explore the factors affecting quality of life in patients who experience facial disfigurement resulting from surgical treatment for head and neck cancer.


the number of people diagnosed with head and neck cancers has been rising over the past 30 years. This, combined with the improved survivorship of cancer patients, has led to a need to understand how these patients adapt to the physical, social and emotional toll of cancer and facial disfigurement and how these affect quality of life.


a systematic search of four nursing and psychological-focused databases was undertaken using pertinent keywords.


following a thematic analysis, four main themes and one subtheme emerged; changes within the self, social support; social reintegration; and help from healthcare professionals, which had the subtheme of information.


facial disfigurement has a significant effect on patients' quality of life. Nurses are ideally placed to identify, inform and support patients and their family and friends.

Head and neck cancers (HNCs) are malignancies that affect structures including the tongue, the floor of the mouth and other areas of the oral cavity, as well as the larynx and nose, among other structures (Feber, 2000). Cancer Research UK (2015a) estimates that approximately 3% of all cancers diagnosed are HNCs, an increase of 30% since the early 1990s. As with all cancers, survivorship has improved; it is estimated that 62 500 people who had been diagnosed with HNC were alive in the UK at the end of 2010 (Cancer Research UK, 2015b).

HNC has a number of known risk factors including smoking and excessive alcohol consumption (Rettig and D'Souza, 2015). In recent years, human papilloma virus (HPV) type 16 has become a well-established risk factor for three types of HNC (Shaw and Beasley, 2011; Rettig and D'Souza, 2015). HPV-driven cancers are becoming increasingly common, rising from being found in fewer than 20% of HNCs in the 1980s to 70% over 2000-2004 (Palma and Nichols, 2014). Research suggests that cancers that originate from HPV infection have better long-term survival rates than those caused by tobacco or alcohol (Tahtali et al, 2013).

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