Influence of Pretreatment Social Support on Posttreatment Depression and Health-related Quality of Life in Patients with Head and Neck Cancer.

Howren MB, Christensen AJ, Karnell LH, Funk GH. Influence of Pretreatment Social Support on Posttreatment Depression and Health-related Quality of Life in Patients with Head and Neck Cancer. Paper presented at: Society of Behavioral Medicine Annual Meeting and Scientific Sessions; 2011 Apr 28; Washington, DC.

: Background: Head and neck cancer (HNC) and its treatment may have significant physical and psychosocial impact on patients. Evidence suggests that lack of social support in individuals with cancer may be related to poor health-related quality of life (HRQOL) outcomes. We sought to determine the effect of social support present at the time of diagnosis (i.e., prior to the initiation of treatment) on HRQOL outcomes in patients with HNC at two specific posttreatment time points. Methods: As part of a large, longitudinal study of HNC outcomes, 366 patients were assessed on several clinical and psychosocial characteristics at diagnosis and then at three and twelve months posttreatment. Depressive symptomatology was assessed using the Beck Depression Inventory and HRQOL was assessed using the SF-36. Physical and Mental Component Summary (PCS, MCS) scores from the SF-36 were calculated. Results: Controlling for age, physical comorbidities, sex, cancer site and stage of disease, and baseline depressive symptomatology or HRQOL, multiple regression analyses indicated that patients with a greater degree of social support at diagnosis--prior to the initiation of oncologic treatment--reported significantly lower depressive symptomatology at 3- and 12-month follow-up assessments (p's .01) as well as significantly better PCS (12-month follow-up; p < .05) and MCS HRQOL scores (3- and 12-month follow-up; p's = .01). Conclusion: These results suggest that, after controlling for several important clinical characteristics, the level of social support present before the initiation of treatment can have a significant impact on depression and HRQOL over time in patients with head and neck cancer. Thus, it may be useful to assess available social support networks in HNC patients at diagnosis and provide structured support options for individuals at greater risk of poor HRQOL outcomes.