Chinese Tongue Cancer Survivors’ Perspectives One Year Post-Partial Glossectomy

  • Yanhui Zhou Senior Nurse Consultant, Hunan Provincial Tumor Hospital P.R. China. Tumor Hospital Xiangya School of Medicine of Central South University
  • Yanqun Li Nurse, Second Xiangya Hospital School of Medicine of Central South University, PR.China
  • Xiao Zhou Surgeon, Hunan Provincial Tumor Hospital P.R. China. Tumor Hospital Xiangya School of Medicine of Central South University
  • Jianjun Yu MD, Hunan Provincial Tumour Hospital, Xiangya School of Medicine of Central South University, PR.China
  • Li Li RN, Hunan Provincial Tumour Hospital, Xiangya School of Medicine of Central South University
  • Caiyun Ouyang RN, Hunan Provincial Tumour Hospital, Xiangya School of Medicine of Central South University, PR. China
  • Zan Li RN, Hunan Provincial Tumour Hospital, Xiangya School of Medicine of Central South University, PR. China
  • Mei Gu RN, Hunan Provincial Tumour Hospital, Xiangya School of Medicine of Central South University, PR. China
  • Elisabeth M. Hicks Research Project Manager, UCLA School of Nursing
  • Sally L. Maliski UCLA School of Nursing and David Geffen School of Medicine Department of Urology
Keywords: Tongue cancer, quality of life, glossectomy, reconstruction, China, survivor, Traditional Chinese Medicine

Abstract

Background: Tongue cancer is the most common form of oral cancer globally. Treatment for tongue cancer has become more effective, but there are heavy functional and aesthetic sequelae that affect quality of life.  Assisting patients to attain a satisfactory quality of life post-operatively requires health care providers have an understanding of how these sequelae are perceived by the patients. Little is known about how people in China perceive and manage the sequelae of tongue cancer surgery.

Objective: To understand how people in one province in China perceive and manage the sequelae of surgery for tongue cancer.

Population: Sixteen participants from a provincial hospital in China who had partial glossectomy and free thigh flap reconstruction at a major Chinese cancer center were enrolled in the study. All were men.

Methods: Semi-structured interviews were conducted with participants one year following their surgery.  Interviews were conducted and transcribed in Mandarin.  Analysis was conducted using modified content analysis techniques to identify and describe major categories.

Interpretation: We identified several categories related to functional alterations, appearance changes, social impacts, and management of the sequelae.  These include changes in eating, speech, decreased shoulder mobility, facial appearance; the impact of these changes on social activities; and accommodations made such as use of Traditional Chinese Medicine and changes in eating patterns.

Conclusions: The support of family and friends was important to the recovery process. Adaptations to the treatment sequelae allowed these participants to maintain adequate food intake, resume some daily activity, and manage discomfort. Physical therapy may alleviate shoulder weakness and numbness post-surgery.

Author Biographies

Yanhui Zhou, Senior Nurse Consultant, Hunan Provincial Tumor Hospital P.R. China. Tumor Hospital Xiangya School of Medicine of Central South University
Senior Nurse Consultant, Hunan Provincial Tumor Hospital P.R. China. Tumor Hospital Xiangya School of Medicine of Central South University
Yanqun Li, Nurse, Second Xiangya Hospital School of Medicine of Central South University, PR.China
RN, Second Xiangya Hospital School of Medicine of Central South University, PR.China
Xiao Zhou, Surgeon, Hunan Provincial Tumor Hospital P.R. China. Tumor Hospital Xiangya School of Medicine of Central South University
Surgeon, Hunan Provincial Tumor Hospital P.R. China. Tumor Hospital Xiangya School of Medicine of Central South University
Jianjun Yu, MD, Hunan Provincial Tumour Hospital, Xiangya School of Medicine of Central South University, PR.China
MD, Hunan Provincial Tumour Hospital, Xiangya School of Medicine of Central South University, PR.China
Li Li, RN, Hunan Provincial Tumour Hospital, Xiangya School of Medicine of Central South University
RN, Hunan Provincial Tumour Hospital, Xiangya School of Medicine of Central South University
Caiyun Ouyang, RN, Hunan Provincial Tumour Hospital, Xiangya School of Medicine of Central South University, PR. China
RN, Hunan Provincial Tumour Hospital, Xiangya School of Medicine of Central South University, PR. China
Zan Li, RN, Hunan Provincial Tumour Hospital, Xiangya School of Medicine of Central South University, PR. China
RN, Hunan Provincial Tumour Hospital, Xiangya School of Medicine of Central South University, PR. China
Mei Gu, RN, Hunan Provincial Tumour Hospital, Xiangya School of Medicine of Central South University, PR. China
RN, Hunan Provincial Tumour Hospital, Xiangya School of Medicine of Central South University, PR. China
Elisabeth M. Hicks, Research Project Manager, UCLA School of Nursing
MA, Research Project Manager, UCLA School of Nursing
Sally L. Maliski, UCLA School of Nursing and David Geffen School of Medicine Department of Urology

Associate Professor, UCLA School of Nursing and David Geffen School of Medicine Department of Urology

Associate Dean of Academic Affairs UCLA School of Nursing

References

Asher, Benjamin F., Seidman, Michael, & Snyderman, Carl. (2001). Complementary and Alternative Medicine in Otolaryngology. The Laryngoscope, 111(8), 1383-1389. doi: 10.1097/00005537-200108000-00013

Author. (2005).

Bell, Kirsten, Lee, Joyce, & Ristovski-Slijepcevic, Svetlana. (2009). Perceptions of Food and Eating Among Chinese Patients With Cancer: Findings of an Ethnographic Study. Cancer Nursing, 32(2), 118-126 doi: 10.1097/NCC.0b013e3181982d36

Cassileth, Barrie R., & Deng, Gary. (2004). Complementary and Alternative Therapies for Cancer. The Oncologist, 9(1), 80-89. doi: 10.1634/theoncologist.9-1-80

Operasi bedah dari masa ke masa Avalaible via:http://adisucipto.web.id/kesehatan/operasi-bedah-dari-masa-ke-masa-12859.html

Chen, Lih-Mih, Miaskowski, Christine, Dodd, Marylin, & Pantilat, Steven. (2008). Concepts Within the Chinese Culture That Influence the Cancer Pain Experience. Cancer Nursing, 31(2), 103-108. doi: 103-108 10.1097/01.NCC.0000305702.07035.4d

Chow, Wen Hann, Chang, Pearlly, Lee, Soo Chin, Wong, Alvin, Shen, Han-Ming, & Marieke Verkooijen, Helena. (2010). Complementary and alternative medicine among Singapore cancer patients. Annals Academy of Medicine Singapore, 39(2), 129.

de Camargo Cancela, Marianna , de Souza, Dyego Leandro Bezerra, & Curado, Maria Paula. (2012). International incidence of oropharyngeal cancer: a population-based study. Oral Oncology, 48(6), 484-490. doi: 10.1016/j.oraloncology.2011.12.013

Demez, Pierre H., & Moreau, Pierre R. (2009). Perception of head and neck cancer quality of life within the medical world: A multicultural study. Head & Neck, 31(8), 1056-1067. doi: 10.1002/hed.21069

Dziegielewski, Peter. T., Ho, Michael. L., Rieger, Jana, Singh, Prabhjyot, Langille, Morgan, Harris, Jeffrey R., & Seikaly, Hadi. (2013). Total glossectomy with laryngeal preservation and free flap reconstruction: objective functional outcomes and systematic review of the literature. Laryngoscope, 123(1), 140-145. doi: 10.1002/lary.23505

Eades, Margaret, Chasen, Martin, & Bhargava, Ravi. (2009). Rehabilitation: Long-Term Physical and Functional Changes Following Treatment. Seminars in Oncology Nursing, 25(3), 222-230. doi: 10.1016/j.soncn.2009.05.006

Efferth, Thomas, Li, Paul C. H., Konkimalla, Venkata S.

Badireenath, & Kaina, Bernd. (2007). From traditional Chinese medicine to rational cancer therapy. Trends in Molecular Medicine, 13(8), 353-361. doi: 10.1016/j.molmed.2007.07.001

Escoda-Francoli, Jaume, Rodriguez-Rodriguez, Araceli, Perez-

Garcia, Silvia, Gargallo-Albiol, Jordi, & Gay-Escoda, Cosme. (2011). [Dental implications in oral cancer patients]. Medicina oral, patología oral y cirugía bucal, 16(4), e508-513. doi: 10.4317/medoral.16.e508

Furness, Penny, Garrud, Paul, Faulder, Annabella, & Swift, Judy. (2006). Coming to Terms: A Grounded Theory of Adaptation to Facial Surgery in Adulthood. Journal of Health Psychology, 11(3), 453-466. doi: 10.1177/1359105306063318

Goldstein, David P., Ringash, Jolie, Bissada, Eric, Jaquet, Yves, Irish, Jonathan, Chepeha, Douglas, & Davis, Aileen M. (2014). Scoping review of the literature on shoulder impairments and disability after neck dissection. Head & Neck, 36(2), 299-308. doi: 10.1002/hed.23243

Graneheim, U. H., & Lundman, B. (2004). Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24(2), 105-112. doi: 10.1016/j.nedt.2003.10.001

Hahn, T. R., & Krüskemper, G. (2007). The impact of radiotherapy on quality of life--a survey of 1411 patients with oral cancer. Mund-, Kiefer-und Gesichtschirurgie: MKG, 11(2).

Hahn, T. R., Krüskemper, G., Enkling, N., & Kübler, N. R. (2007). [On quality of life after surgical therapy of oral cancer-a retrospective multi-center study: the connection between dedentition, denture, quality of life, and dysphagia, and the resulting rehabilitation schemes]. Mund-, Kiefer-und Gesichtschirurgie: MKG, 11(1), 27-32. doi: 10.1007/s10006-006-0038-0

Hartl, D. M., Dauchy, S., Escande, C., Bretagne, E., Janot, F., &

Kolb, F. (2009). Quality of life after free-flap tongue reconstruction. The Journal of Laryngology & Otology, 123(5), 550-554. doi: 10.1017/s0022215108003629

Hsieh, Hsiu-Fang, & Shannon, Sarah E. (2005). Three Approaches to Qualitative Content Analysis. Qualitative Health Research, 15(9), 1277-1288. doi: 10.1177/1049732305276687

Jin, Y. H., Ma, E. T., Gao, W. J., Hua, W., & Dou, H. Y. (2014). Reporting and methodological quality of systematic reviews or meta-analyses in nursing field in China. Int J Nurs Pract, 20(1), 70-78. doi: 10.1111/ijn.12123

Kammer, Rachael E., & Robbins, JoAnne. (2011). Rehabilitation of Heavily Treated Head and Neck Cancer Patients. In J. Bernier (Ed.), Head and Neck Cancer (pp. 629-639): Springer New York.

Karnell, Lucy Hynds, Christensen, Alan J., Rosenthal, Eben L.,

Magnuson, J. Scott, & Funk, Gerry F. (2007). Influence of social support on health-related quality of life outcomes in head and neck cancer. Head & Neck, 29(2), 143-146. doi: 10.1002/hed.20501

Krishna Rao, S. V., Mejia, G., Roberts-Thomson, K., & Logan, R. (2013). Epidemiology of oral cancer in Asia in the past decade--an update (2000-2012). Asian Pac J Cancer Prev, 14(10), 5567-5577.

Langer, S. L., Brown, J. D., & Syrjala, K. L. (2009). Intrapersonal and interpersonal consequences of protective buffering among cancer patients and caregivers. Cancer, 115(18 Suppl), 4311-4325. doi: 10.1002/cncr.24586

Lauchlan, D. T., Mc Caul, J. A., Mc Carron, T., Patil, S., Mc

Manners, J., & Mc Garva, J. (2011). An exploratory trial of preventative rehabilitation on shoulder disability and quality of life in patients following neck dissection surgery. European Journal of Cancer Care, 20(1), 113-122. doi: 10.1111/j.1365-2354.2009.01149.x

Lauchlan, D. T., McCaul, J. A., & McCarron, T. (2008). Neck dissection and the clinical appearance of post-operative shoulder disability: the post-operative role of physiotherapy. European Journal of Cancer Care, 17(6), 542-548. doi: 10.1111/j.1365-2354.2007.00862.x

Li, Xun, Yang, Guoyan, Li, Xinxue, Zhang, Yan, Yang, Jingli,

Chang, Jiu, . . . Bensoussan, Alan. (2013). Traditional Chinese Medicine in Cancer Care: A Review of Controlled Clinical Studies Published in Chinese. PLoS ONE, 8(4), e60338. doi: 10.1371/journal.pone.0060338

Liu, Chun Hao, Tang, Woung-Ru, Wang, Hung Ming, & Lee, Ko Chen. (2011). Cancer Patients' Experience of Combined Treatment With Conventional and Traditional Chinese Medicine: A Biopsychosocial Phenomenon. Cancer Nursing, 34(6), 495-502 410.1097/NCC.1090b1013e31820d31824da31829.

Lou, Yan, Yates, Patsy, McCarthy, Alexandra, & Wang, HeMei. (2013). Fatigue self-management: a survey of Chinese cancer patients undergoing chemotherapy. Journal of Clinical Nursing, 22(7-8), 1053-1065. doi: 10.1111/jocn.12174

Low, C., Fullarton, M., Parkinson, E., O'Brien, K., Jackson, S. R.,

Lowe, D., & Rogers, S. N. (2009). Issues of intimacy and sexual dysfunction following major head and neck cancer treatment. Oral Oncology, 45(10), 898-903. doi: 10.1016/j.oraloncology.2009.03.014

McGarvey, Aoife C., Chiarelli, Pauline E., Osmotherly, Peter G., & Hoffman, Gary R. (2011). Physiotherapy for accessory nerve shoulder dysfunction following neck dissection surgery: A literature review. Head & Neck, 33(2), 274-280. doi: 10.1002/hed.21366

McGarvey, Aoife C., Osmotherly, Peter Grant, Hoffman, Gary R., & Chiarelli, Pauline E. (2013). Scapular Muscle Exercises Following Neck Dissection Surgery for Head and Neck Cancer: A Comparative Electromyographic Study. Physical Therapy, 93(6), 786-797. doi: 10.2522/ptj.20120385

Moore, S. R., Johnson, N. W., Pierce, A. M., & Wilson, D. F. (2000). The epidemiology of tongue cancer: a review of global incidence. Oral Diseases, 6(2), 75-84. doi: 10.1111/j.1601-0825.2000.tb00105.x

O'Brien, K., Roe, B., Low, C., Deyn, L., & Rogers, S. N. (2012). An exploration of the perceived changes in intimacy of patients' relationships following head and neck cancer. Journal Clinical Nursing, 21(17-18), 2499-2508. doi: 10.1111/j.1365-2702.2012.04162.x

Schuster, M., & Stelzle, F. (2012). Outcome measurements after oral cancer treatment: speech and speech-related aspects--an overview. Oral Maxillofacial Surgery, 16(3), 291-298. doi: 10.1007/s10006-012-0340-y

Semple, Cherith, Dunwoody, Lynn, Kernohan, William George, McCaughan, Eilis, & Sullivan, Kate. (2008). Changes and challenges to patients’ lifestyle patterns following treatment for head and neck cancer. Journal of Advanced Nursing, 63(1), 85-93. doi: 10.1111/j.1365-2648.2008.04698.x

Semple, Cherith J., Sullivan, Kate, Dunwoody, Lynn., & Kernohan, W. George. (2004). Psychosocial interventions for patients with head and neck cancer: past, present, and future. Cancer Nursing, 27(6), 434-441.

Swore Fletcher, Barbara, Cohen, Marlene Z., Schumacher, Karen, & Lydiatt, William. (2012). A Blessing and a Curse: Head and Neck Cancer Survivors’ Experiences. Cancer Nursing, 35(2), 126-132 doi: 10.1097/NCC.0b013e31821bd054

Wang, Jing, Luo, Hong, Liu, Fei, Fu, Kun, & Zhang, Mingzhi. (2013). Quality of Life in Oral Cancer Patients-Effects of Tongue Resection and Sociocultural Aspects. Journal of Craniofacial Surgery, 24(5), e493-e496 doi: 10.1097/SCS.0b013e31829429aa

Wierzbicka, M., Kuśnierkiewicz, M., Wójtowicz, J. G., Maune, S., & Szyfter, W. (2001). [The quality of life in head and neck cancer patients: description of randomized examination formula based on standardized questionnaires EORTC QLQ C-30]. Otolaryngologia Polska. The Polish Otolaryngology, 55(3), 287-292.

Williams, Phoebe D., Lopez, Violeta, Ying, Chair Sek, Piamjariyakul, Ubolrat, Wenru, Wang, Hung, Gloria T.Y., . . .

Williams, Arthur R. (2010). Symptom Monitoring and Self-care Practices Among Oncology Adults in China. Cancer Nursing, 33(3), 184-193 110.1097/NCC.1090b1013e3181c29598.

Wong, R., Sagar, C. M., & Sagar, S. M. (2001). Integration of Chinese medicine into supportive cancer care: A modern role for an ancient tradition. Cancer Treatment Reviews, 27(4), 235-246. doi: 10.1053/ctrv.2001.0227

Yan, X. Zhou J. Milne George W. A. (1999). Traditional Chinese medicines : molecular structures, natural sources, and applications. Aldershot, England; Brookfield, Vt., USA: Ashgate.

Yang, Zhao-hui, Chen, Wei-liang, Huang, Hong-zhang, Pan,

Chao-bin, & Li, Jin-song. (2010). Quality of Life of Patients With Tongue Cancer 1 Year After Surgery. Journal of Oral and Maxillofacial Surgery, 68(9), 2164-2168. doi: 10.1016/j.joms.2009.09.048

Santi, Trias Nur. "Delicious Recipes." Delicious Recipes. N.p., 26 Mar. 2015. Web. 11 June 2017. <http://www.deliciousrecipe.net/>.

Zarek, A. (2006). [Psychological responses of patients after partial or total glossectomy due to carcinoma of the oral cavity]. Annales Academiae Medicae Stetinensis, 52 Suppl 3, 113-117.

Published
2015-06-23
Section
Medical Surgical Nursing