The authors examined the relationship between depressive symptoms, smoking, problem drinking, and quality of life among 973 head and neck cancer patients who were surveyed and had their charts audited. Forty-six percent screened positive for depressive symptoms, 30% smoked, and 16% screened positive for problem drinking. Controlling for clinical and demographic variables, linear-regression analyses showed that depressive symptoms had a strong negative association with all 12 quality-of-life scales; smoking had a negative association on all but one of the quality-of-life scales; and problem drinking was not associated with any of the quality-of-life scales. Interventions targeting depression, smoking, and problem drinking need to be integrated into oncology clinics.
More than 40% of head and neck cancer patients have been shown to exhibit depressive symptoms during the course of their treatment. For head and neck cancer patients, emotional status and mental health may affect their global quality-of-life scores and disability status. Depression is also a risk factor for overall mortality. It has been shown that adequate treatment of depression can increase social functioning, patient productivity, and quality of life. Also, depression has been found to be associated with both smoking and problem drinking.
Smoking and alcohol act synergistically to increase the likelihood of developing head and neck cancer. Yet, 35% to 46% of head and neck cancer patients continue to smoke after a diagnosis of cancer and 41% to 54% are estimated to drink alcohol. Unfortunately, continued smoking and alcohol intake after the first diagnosis of head and neck cancer significantly increase medical complications (especially those related to surgery and radiation) and increase the likelihood of developing a second malignancy that adversely affects survival. One study showed that patients with oral cancer are often unaware that smoking and alcohol can cause oral cancer.
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http://psy.psychiatryonline.org/cgi/reprint/48/2/142
