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Is There Enough Psychological Support Available for Head and Neck Patients After Treatment?

Introduction

Head and neck malignancy is set in areas like the mouth and larynx, which becomes a real burden for patients. Quality treatment brings about better outcomes, but the fact remains that it cannot be dismissed that it has an unmistakable psychological impact after treatment has been given. Psychological support is essential because of the intricacies surrounding the acceptance of physical changes, functional impairments, and fears of cancer return. This essay analyses the current provision of psychological support to head and neck cancer patients in the UK, challenges in the provision, and strategies for the betterment of provision.

Overview of treatment for head and neck cancer

The United Kingdom has provisions for tailored treatment modalities to tackle the head and neck cancer of a particular patient, the needs that one has, the characteristics of the tumour, and the general state of being. The majority of the time, most management is mainly done through surgery to make sure cancerous tissue is removed with as much preservation of function and form as possible (Elaldi et al., 2021). The development of surgical techniques in the UK has been happening gradually over the years, and it points to the importance of reducing organs saved and reconstruction to a minimum to avoid disfigurement and functional impairment, which can quite significantly negatively influence a patient psychologically.

Chemotherapy, especially in advanced or metastatic cases or in combination with surgery or radiation, is an adjuvant or neoadjuvant therapy (Henry et al., 2020). There is a study in the UK to improve the effectiveness of chemotherapy while reducing associated toxicity. On the other hand, chemotherapy is associated with a number of side effects that contribute to the psychological distress in the patient that already arises from the challenges associated with the diagnosis and management of cancer.

Another major category of treatment is radiation therapy, which is a treatment strategy using high-energy radiation to destroy cancer cells, preventing their further growth and damage to surrounding healthy tissue. Treatment precision and reduction of the magnitude of side effects on patients are achieved with such technologies as intensity-modulated radiation therapy (IMRT) and proton therapy in the UK (McDowell et al., 2022). Radiation treatment does result in acute and chronic complications, however, which can alter the quality of life and psychological well-being of patients.

III. The psychological challenges post-treatment for head and neck cancer patients

Moreover, the psychological challenge, which the host of challenges following head and neck cancer presents after treatment, plays a massive role in disturbing the well-being and quality of life of patients. Firstly, physical disfigurement and functional impairments due to surgery, radiotherapy, or both can alter self-perception and confidence at a deep level in patients (Calver et al., 2019). The clinician should recognize that despite progress in surgical techniques in minimizing cosmetic change and retaining function, many patients will continue to experience visible changes in appearance, such as facial asymmetry and the loss of structures, provoking feelings of self-consciousness and social withdrawal.

Speech and swallowing difficulties are common in head and neck cancer patients undergoing treatments like surgery or radiation. Speech therapists, including specialists in swallowing, play a crucial role in post-treatment rehabilitation in the UK, helping patients improve communication and swallowing abilities. These challenges can erode patient confidence and independence, leading to feelings of frustration and isolation (Rogers et al., 2020). It’s essential to address the impact of cancer on body image and self-esteem, as treatment-related changes may significantly alter patients’ perceptions of themselves. In the UK, patients are encouraged to seek counselling and support from peers and professionals to cope with these challenges.

Lastly, the fear of cancer recurrence looms large in the minds of many head and neck cancer survivors in the UK. Indeed, after successful treatment outcomes are reached, the continuing concern that is associated with the potential for cancer recurrence or cancer spread can cause significant anxiety and distress that may impair the patient’s ability to go about their life, usually without worry. (Senchak et al., 2019) A comprehensive provision for psychological support should, therefore, be made in order to cater to the single-dimension or multifaceted challenges in the survivorship of head and neck cancer patients in the UK.

The existing provision in psychological support

Psychological support among head and neck cancer patients in the United Kingdom may include counsellors, support groups as well as online support facilities. Counseling usually comes with special training that many oncology professionals, such as psychologists, have, where individual sessions are conducted with patients to meet emotional needs (Lorenc et al., 2022). Among the possible interventions are those that provide ways of coping with anxiety, depression, and adjustment difficulties after treatment, such as cognitive-behavioral therapy (CBT), psychoeducation, and supportive counseling.

Head and neck cancer patients receive peer support and empowerment in support groups held under the guidance of health professionals or patient advocates. They are conducted through geographical meetings or online avenues and give the affected a chance to share experiences and coping strategies and receive solace in living with other people (Rogers et al., 200). Information and psychological support can also be found online by searching for UK-based websites, forums, and social media that provide tips about coping and links with others having similar experiences through well-regarded cancer charities and organisations.

Assessment of adequacy of provision of psychological support

In the UK, the adequacy of psychological support to head and neck cancer patients focuses on determining essential factors. First, it is an access issue in terms of accessibility of services as reflected in the ease of access to counselling appointments, the location in which support groups meet, and the usability of online resources, including mobile app functionality. This includes how best to remove barriers for patients located in remote or underserved areas (Senchak et al., 2019).

Second, it is practical and operationalized by impacts like reduced anxiety and depression, enhanced coping, and quality of life. Evidence should be evaluated rigorously through validated assessments and patient-reported measures in understanding impact, including the entire cycle of evidence-based practice. Also essential is patient satisfaction and feedback. Combining patients’ experiences in receipt of counselling, participation in support groups, and the use of online resources is one of the ways of highlighting areas of improvement and moulding future services (Henry et al., 2020). Findings from this study show that psychological support to patients with head and neck cancer in the UK is a diverse but unitary need, as shown by patients’ testimonies.

Delineated problems in offering psychological support on need

One of the challenges faced by the United Kingdom, thus making it hard for psychological support to be availed for head and neck cancer patients, is inadequacies in resources: funding and staffing, in particular (Rocke et al., 2020). First, the most notable barriers are inadequacies in the resources available, both financially and humanly. First, the need for psychological support is high, whereas healthcare budgets are limited, meaning long waiting times for counselling appointments and few support groups on offer.

Second, much stigma is attached to mental health problems; therefore, some head and neck cancer patients do not take up psychological support when it is offered or even sought. The stigma still lingers in UK society, with people fearing recognition as weak. Hence, many do tend to hide their emotional concerns and seek help. Secondly, health professionals are sometimes unaware of mental health problems in that they usually focus more on the physical symptoms and the desired outcomes of treatment without consideration of the psychological well-being of the patients (Calver et al., 2019). Education and training programs are developed across the UK health system to increase awareness and sensitivity to psychosocial problems that will be equated to ensuring psychological support.

To enhance psychological support for head and neck cancer patients in the UK, a multifaceted approach is essential. First, integrated care will foster the coming together of different health practitioners from different disciplines in developing an approach focusing on joint responsibility to support physical and psychological needs (Richardson et al., 2019). This may include setting up multi-disciplinary teams involving oncologists, psychologists, speech therapists, and dieticians for the patient’s best care and support.

Meaningful interventions to the psychosocial aspects of cancer care require awareness among healthcare professionals and appropriate skills; this calls for proper investment in education and training programs. These cover areas relating to communication, understanding issues related to psychology, and even evidence-based interventions. Moreover, advocacy and public awareness could be carried out so that the stigma associated with mental health issues in cancer care is reduced and the importance of psycho-oncological support for head and neck cancer patients is realized (Henry et al., 2020). This includes shifting the health system towards focusing on patient well-being, engaging stakeholders, raising awareness, and making policy demands.

Conclusion

In conclusion, the essay has discussed the psychological difficulties patients face post-treatment of head and neck cancer, such as disfigurement of the face, poor speech, and fear of the cancer coming back. Some of the psychological support services are available in the UK, and there are problems like lack of resources and stigma. Dealing with the psychological needs of such patients remains of utmost importance to the quality of life and well-being of an individual. Therefore, an integrated care approach is necessary with enhanced support services, which range from better education on the part of the health care providers to more excellent advocacy. The likes of these projects need to be priority-focused for policymakers and all those concerned with healthcare to provide head and neck cancer patients with comprehensive care.

References

Calver, L., Tickle, A., Biswas, S., & Moghaddam, N. (2019). How patients adjust psychologically to the experience of head and neck cancer: A grounded theory. European Journal of Cancer Care28(4), e13068.

Dahill, A., Al-Nakishbandi, H., Cunningham, K. B., Humphris, G. M., Lowe, D., & Rogers, S. N. (2020). Loneliness and quality of life after head and neck cancer. British Journal of Oral and Maxillofacial Surgery58(8), 959-965.

Elaldi, R., Roussel, L. M., Gal, J., Scheller, B., Chamorey, E., Schiappa, R., … & Bozec, A. (2021). Correlations between long-term quality of life and patient needs and concerns following head and neck cancer treatment and the impact of psychological distress. A multicentric cross-sectional study. European Archives of Oto-Rhino-Laryngology278, 2437-2445.

Henry, M., Alias, A., Cherba, M., Woronko, C., Rosberger, Z., Hier, M., … & Frenkiel, S. (2020). Immediate post-treatment supportive care needs of patients newly diagnosed with head and neck cancer. Supportive Care in Cancer28, 5557-5567.

Lorenc, A., Wells, M., Fulton-Lieuw, T., Nankivell, P., Mehanna, H., Jepson, M., … & Wong, W. (2022). Clinicians’ views of patient-initiated follow-up in head and neck cancer: a qualitative study to inform the PETNECK2 trial. Clinical Oncology34(4), 230-240.

McDowell, L., Rischin, D., Gough, K., & Henson, C. (2022). Health-related quality of life, psychosocial distress and unmet needs in older patients with head and neck cancer. Frontiers in Oncology12, 834068.

Richardson, A. E., Broadbent, E., & Morton, R. P. (2019). A systematic review of psychological interventions for patients with head and neck cancer. Supportive Care in Cancer27, 2007-2021.

Rocke, J., Mclaren, O., Hardman, J., Garas, G., Smith, M. E., Ishii, H., … & Integrate (UK ENT Trainee Research Network). (2020). The role of allied healthcare professionals in head and neck cancer surveillance: A systematic review. Clinical Otolaryngology45(1), 83-98.

Rogers, S. N., Waylen, A. E., Thomas, S., Penfold, C., Pring, M., Waterboer, T., … & Ness, A. R. (2020). Quality of life, cognitive, physical and emotional function at diagnosis predicts head and neck cancer survival: Analysis of cases from the Head and Neck 5000 study. European Archives of Oto-Rhino-Laryngology277, 1515-1523.

Senchak, J. J., Fang, C. Y., & Bauman, J. R. (2019). Interventions to improve quality of life (QOL) and/or mood in patients with head and neck cancer (HNC): A review of the evidence. Cancers of the head & neck4(1), 1-11.

 

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