|7R21CA167554-03 Interpret this number
|University Of Central Florida
|Swallow Function and Oral Morbidities in Rt Treated Head/Neck Cancer Survivors
Cancer is a leading cause of long-term disability in the USA. Head and neck cancer rates are increasing and
their associated morbidity is among the highest. Treatment related morbidities have a negative impact on
quality of life, pose increased threats to health status, and demand a greater utilization of health care
resources. Given this scenario, patients with head/neck cancer represent a high impact, high morbidity sub
group requiring special consideration. One of the most common negative outcomes is difficulty swallowing
(dysphagia). Nearly all head/neck cancer patients treated with radiotherapy (with or without chemotherapy)
experience some degree of dysphagia during or following their cancer treatment. Other frequent morbidities
include oral pain, oral dryness, and taste deviations. Unfortunately, relationships between these common
clinical complaints (dysphagia and oral morbidities) are unclear and it is not known if they have a causative
and/or maintenance effect on impaired oropharyngeal function. Currently, information addressing oral pain,
oral dryness, and taste functions are not routinely integrated into dysphagia management or intervention
programs. [In the proposed study we evaluate the role of pain and pain avoidance strategies in the
development and maintenance of dysphagia, xerostomia, and taste deficits in a cohort of 60 patients with
head/neck cancer treated with radiotherapy. We propose to develop a ‘fear of swallowing’ scale and use this
scale to develop graded exposure hierarchies as a fear-avoidance intervention for persistent dysphagia in this
population. Subjects will undergo baseline assessments for oral pain, fear of pain avoidance strategies, oral
dryness, taste, and swallowing ability to provide objective data detailing the incidence and characteristics of
oropharyngeal functions subsequent to radiotherapy. Subjects will be monitored during radiotherapy and be re-
examined at the end of treatment and at 3, and 6 months post treatment. We hypothesize that oropharyngeal
pain will facilitate reduced frequency of swallowing which will associate with the severity of dysphagia, taste
deficit, and xerostomia. Furthermore, patients with high fear-avoidance profiles will demonstrate more
persistent deficits in these oral functions. The goals are: 1) To evaluate relationships between oropharyngeal
pain and dysphagia in this population both at the conclusion of medical treatment and up to 6 months post-
treatment. 2) To evaluate relationships between severity of swallowing deficit and xerostomia and taste loss up
to 6 months following medical treatment. 3) To evaluate a novel intervention approach to dysphagia in this
population based on resolution of fear-avoidance strategies that contribute to reduced movement. Successful
completion of this study will challenge traditional approaches to dysphagia management in head/neck cancer
survivors. Results will be invaluable in earlier identification of persistent dysphagic deficits, prevention of
dysphagic morbidity, and the integration of oral morbidity assessment to effective dysphagia management
strategies for this population.]
Change in Spontaneous Swallowing Frequency in HNC Patients Undergoing C/RT.
, Madhavan A.
, Barikroo A.
, Crary M.
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2022 Apr; 166(4), p. 727-733.
Feasibility and value of salivary cortisol sampling to reflect distress in head and neck cancer patients undergoing chemoradiation: A proof-of-concept study.
, Bonnen M.
, Asper J.
, Carnaby G.D.
International journal of oncology research, 2022; 5(2), .
Adoption into clinical practice of two therapies to manage swallowing disorders: exercise-based swallowing rehabilitation and electrical stimulation.
, Carnaby G.D.
Current opinion in otolaryngology & head and neck surgery, 2014 Jun; 22(3), p. 172-80.