Patients perceive tonsil cancer as a strike at psycho-socially "vital organs"

Tonsil cancer (TC) is a type of head and neck cancer (HNC) that is predominantly associated with infection with human papilloma virus (HPV). In Denmark, the incidence of HPV-related HNC has increased fivefold over the past three decades. HNC more often affects men than women, and HPV-related HNC tends to affect younger age groups than other HNCs. The present study examined the long-term health-related quality of life (QoL) in patients with TC.

A medical anthropological approach was applied using individual qualitative interviews with seven former TC patients. The participants included men and women who had undergone various treatments, i.e. radiation therapy, chemotherapy and operation. Data were analyzed using a narrative methodology.

Treatment sequelae peaked within the first three months and included severe pain in the radiated area, nausea and fatigue. Within this period, patients were unable to eat solid food and often had difficulty speaking. Half of the participants lost some of their hearing due to radiation. Even two years after treatment, most participants had persisting sequelae, mainly xerostomia, porous teeth and reduced mobility of the tongue and jaw. Fatigue and difficulties eating and communicating, in particular, had a very negative effect on the participants' psycho-social QoL.

This study allowed for a deeper understanding of the negative effects of HNC on patients' QoL. These QoL effects ought to be included in future considerations of HPV vaccination of boys as well as girls.

The study was funded by an unrestricted research grant from Sanofi Pasteur MSD.

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