A study of quality of life of head and neck cancer patients attending ear, nose, throat out-patient department of tertiary care centre in upper Assam region


  • M. K. Mili Department of ENT and Head and Neck Surgery, Assam Medical College and Hospital, Dibrugarh, Assam, India
  • Monikuntal Sarmah Department of ENT and Head and Neck Surgery, Assam Medical College and Hospital, Dibrugarh, Assam, India
  • Suhanee Goswami Department of ENT and Head and Neck Surgery, Assam Medical College and Hospital, Dibrugarh, Assam, India
  • Asha Saikia Department of ENT and Head and Neck Surgery, Assam Medical College and Hospital, Dibrugarh, Assam, India




Head and neck cancer, Quality of life, UW-QOL


Background: Head and neck cancer makes up 3-4% of cancers, however, in developing nations like India, it constitutes 30-40% of cancer cases, primarily attributed to use of tobacco, alcohol.

Methods: A hospital-based, descriptive, cross-sectional study was done in a tertiary care centre upon 54 patients during a period of 1 year. Patients were subjected to a questionnaire on quality of life, using University of Washington quality of life questionnaire (UW-QOL).

Results: Out of 54 patients, 43 were males, 11 were females. Maximum cases were observed in the 6th decade of life. When asked to state the most important aspect of lifestyle for the patient in the past week, the highest percentage answered pain followed by appearance and chewing, swallowing and speech.

Conclusions: Around two-fifths of patients experienced moderate pain needing regular non-narcotic medications and approximately one/fourths stated they felt significantly disfigured. Around 45% patients stated they can chew soft solids, while 30% stated that they can swallow certain soft solids, 28% stated that they can swallow only liquids and 15% were unable to swallow (choking). Around one-third of patients complained of difficulty in speech and around a third of all patients were depressed. Around 45% patients were dissatisfied with their sex lives. Around half of the patients complained of reduced salivation, attributed to radiation-induced xerostomia. One-third of the patients experienced shoulder stiffness and/or pain due to possible injury to spinal accessory nerve.


Vigneswaran N, Williams MD. Epidemiologic trends in head and neck cancer and aids in diagnosis. Oral Maxillofac Surg Clin North Am. 2014;26(2):123-41.

Cancer.net. Fact sheet: Head and neck cancer: statistics, 2022. Available at: https://www.cancer.net/cancer-types/head-and-neck-cancer/statistics. Accessed on 5 March 2022

Prabhash K, Babu G, Chaturvedi P, Kuriakose M, Birur P, Anand AK, et al. Indian clinical practice consensus guidelines for the management of squamous cell carcinoma of head and neck. Indian J Cancer. 2020;57:1-5.

Francis D. Trends in incidence of head and neck cancers in India. Eur J Cancer. 2018;92(1):23.

International Agency for Research on Cancer. Tobacco smoking. IARC monographs on the evaluation of the carcinogenic risk of chemicals to humans. Washington DC: IARC; 1986.

Blot WJ, McLaughlin JK, Winn DM, Austin DF, Greenberg RS, Preston-Martin S, et al. Smoking and drinking in relation to oral and pharyngeal cancer. Cancer Res. 1988;48(11):3282-7.

Schildt EB, Eriksson M, Hardell L, Magnuson A. Occupational exposures as risk factors for oral cancer evaluated in a Swedish case-control study. Oncol Rep. 1999;6(2):317-20.

LaVecchia C, Tavani A. Fruit and vegetables and human cancer. Eur J Cancer Prevent. 1998;7(1):3-8.

Li FP, Correa P, Fraumeni JF. Testing for germ line p53 mutations in cancer families. Cancer Epidemiol Biomarkers Prev. 1991;1(1):91-4.

Kutler DI, Auerbach AD, Satagopan J, Giampietro PF, Batish SD, Huvos AG, et al. High incidence of head and neck squamous cell carcinoma in patients with Fanconi anemia. Arch Otolaryngol Head Neck Surg. 2003;129(1):106-12.

Berkower AS, Biller HF. Head and neck cancer associated with Bloom syndrome. Laryngoscope. 1988;98(7):746-8.

Hecht F, Hecht BK. Cancer in ataxia-telangiectasia patients. Cancer Genet Cytogenet. 1990;46(1):9-19.

Nandakumar A. National cancer registry programme. Consolidated report of the population based cancer registries. incidence and distribution of cancer: 1990-96. Bangalore, India: National Cancer Registry Programme (ICMR); 2001.

Bhattacharjee A, Bahar I, Saikia A. Nutritional assessment of patients with head and neck cancer in north-East India and dietary intervention. Indian J Palliat Care. 2015;21(3):289-95.

Mudur G. India has some of the highest cancer rates of the world. BMJ. 2005;330:215.

Joshi P, Dutta S, Chaturvedi P, Nair S. Head and neck cancers in developing countries. Rambam Maimonides Med J. 2014;5(2):0009.

Nandakumar A, Gupta PC, Gangadharan P, Visweswara RN, Parkin DM. Geographic pathology revisited: Development of an atlas of cancer in India. Int J Cancer. 2005;116(5):740-54.

World Health Organization. What quality of life? The WHOQOL Group. World Health Forum. 1996;17(‎4)‎:354-6.

Calman KC. Definitions and dimensions of quality of life In: Aaronson NK, Beckmann J, eds. The quality of life of cancer patients. New York: Raven Press; 1987: 1-9.

Rogers SN. Quality of life of head and neck cancer patients. Has treatment planning altered? Oral Oncol. 2009;45(4-5):435-9.

Rogers SN, Ahad SA, Murphy AP. A structured review and theme analysis of papers published on ’quality of life’ in head and neck cancer: 2000 to 2005. Oral Oncol. 2007;43(9):843-68.

Gomes EPAA, Aranha AMF, Borges AH, Volpato LER. Head and neck cancer patients' quality of life: analysis of three instruments. J Dent (Shiraz). 2020;21(1):31-41.

Rogers SN, Laher SH, Overend L, Lowe D. Importance-rating using the University of Washington quality of life questionnaire in patients treated by primary surgery for oral and oro-pharyngeal cancer. J Cranio-Maxillofac Surg. 2002;30(2):125-32.

Oliveira KG, vonZeidler SV, Podestá JR, Sena A, Souza ED, Lenzi J, et al. Influence of pain severity on the quality of life in patients with head and neck cancer before antineoplastic therapy. BMC Cancer. 2014;14(1):1-8.

Braam PM, Roesink JM, Raaijmakers CP, Busschers WB, Terhaard CH. Quality of life and salivary output in patients with head-and-neck cancer five years after radiotherapy. Radiation Oncol. 2007;2(1):1-8.

Low C, Fullarton M, Parkinson E, O’Brien K, Jackson SR, Lowe D, et al. Issues of intimacy and sexual dysfunction following major head and neck cancer treatment. Oral Oncol. 2009;45(10):898-903.

Kanatas A, Ghazali N, Lowe D, Rogers SN. The identification of mood and anxiety concerns using the patients concerns inventory following head and neck cancer. Int J Oral Maxillofac Surg. 2012;41(4):429-36.






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