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ASSESSMENT OF HEALTH RELATED QUALITY OF LIFE IN ORAL CANCER PATIENTS

-A Prospective Study

Introduction
Although cancer can occur at any age, it is preponderantly a disease of the age and can be acute or chronic in its course. Many types of cancer are perceptible when they are extensive or involve organs affecting routine activities. The complex disease is the major cause for morbidity and disability. Despite modern advances in the treatment of head and neck cancer, the survival rate fails to improve. In clinical studies of head and neck cancer, the treatment outcome has invariably been assessed in terms of survival time and loco regional control of the disease. Patients with head and neck cancer are rendered vulnerable to psychological problem because social interaction and emotional expression depends upon a great extent on the structural and the functional integrity of the head and neck region. The individuals cannot hide the deformity constantly in view.

The monitoring system for head and neck cancer and reconstructive surgery requires tools that are not only valid and reliable but that address broad constructs of general health as well as those specific to head and neck region. Gotay and moore conducted a systematic review and grouped all the dimensions of quality of life that were assessed using a standardized categorization scheme like emotional well being, social functioning,

emotional functioning, pain, treatment satisfaction, speech, eating, swallowing. Quality of life can be thought as the gap existing between ones actual status and ones ideal standard. It plays an important role in the field of oncology as it aims to include the patient as well as disease outcomes in assessment of the treament. Results of the present study will provide preliminary information regarding some of the factors frequently assumed to be related to the treatment outcome. The changes have been recognized clinically, but it is important that we have the empirical evidence of the effect on patients quality of life; in particular to the physical impact of the treatment influences the social and the psychological experience.

Objectives
This prospective study aims to ascertain the extent of deprivation and how deprivation affects a group of randomly selected patients suffering from oral squamous cell carcinoma. 1. To evaluate the quality of life in patients suffering from oral squmous cell carcinoma on the basis of following parameters: a) Chewing b) Swallowing c) Drooling d) Eating 2. To collect the data of various etiological factors causing oral squmous cell carcinoma and summarise. 3. To compare and evaluate the site related deprivation in quality of life in oral cancer patients.

Methodology
This study is a part of the larger investigation of the psychological aspects of patients with heasd and neck cancer.health related quality of life is a dynamic entity that is intrinsically subjective and based on patients perception. Health related quality of life is multidimensional, being composed of social, psychological, functional and somatic domains. 100 patients with various cancerous lesions of the tongue, alveolus, palate, lip and floor of the mouth will be studied for this project. The patients for this study will be seen at guru teg bahadur hospital, department of dentistry over a period of 3 years.

The participants will be asked to answer the quality of life questionnaire on their visit, pre operatively and post operatively. Exclusion criteria for the study are: a) Patients not willing to co-operate b) Patients who do not understand languages. c) Patients who are suffering from any other disease of the oral cavity apart from oral carcinoma. Before the patient is asked to answer the questionnaire , the need for the study will be explained and the benefits of the study to other patients. These

questions are simple and comprehensive and required the patient to answer in yes or no. The questionnaire has been made keeping in mid the mental status of the patient at the time of the study and takes a mean time of 5 minutes. The order and the manner of the questions asked to the patients will remain the same for two sessions so that the patient is able to recall their problems and thoughts at the previous assessment.

Experimental schedule:

Questionnaire

FUNCTIONAL ASSESSMENT
1. CHEWING a.) Do you ever have difficulty in chewing YES/NO (if no go to no. 2) b.) Do you have difficulty in chewing hard things like chapatis, meat, raw vegetables. YES/NO c.) Do you hae difficulty in chewing rice. YES/NO d.) Do you usually eat food that does not require chewing. YES/NO e.) You take only liquids.

2. SWALLOWING a.) Do you have difficulty in swallowing (if no go to no. 3) YES/NO b.) Do you have difficulty in moving food back to your throat. YES/NO c.) Do you swallow solids only by taking liquids. YES/NO d.) Do you swallow only semisolid and pureed food. YES/NO e.) Are you unable to swallow any food or liquid. YES/NO f.) Do you choke or gag if not concentrating while swallowing. YES/NO

g.) Do you usually choke on liquids YES/NO h.) Can you swallow liquids. YES/NO

3. DROOLING a.) Do you have problem of drooling (if not go to no. 4) b.) When do tou get drooling: i) ii) iii) iv) v) When tired While sleeping While speaking Most of the time Constant drooling YES/NO YES/NO YES/NO YES/NO YES/NO

4. EATING Do you enjoy eating and have no problems YES/NO


a.) b.) Do you eat whenever possible, but only what you want to ea

YES/NO
c.) You only eat with selected people

YES/NO
d.) Do you eat at home with your family

YES/NO
e.) You eat at home alone

YES/NO

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