Head and neck cancers are considered to be one of the most "traumatic" forms of cancer because of the impact of treatment on quality of life. Treatment complications can include post-surgical disfigurement, high levels of pain, and significant alterations to appearance such as facial disfigurement and significant weight loss. Physical dysfunction is common and may include difficulty eating and swallowing, communication problems, altered sensations, mobility problems, and difficulty breathing. Head and neck cancer (HNC) patients may also experience generalized treatment side-effects such as fatigue, nausea, and skin reactions. Additionally, many HNC patients suffer from high levels of distress and social isolation. The transactional model predicts that those who are able to handle and adapt to illness-related stressors will show lower levels of distress, improved symptom management and higher quality of life. The overall goal of this R21 proposal is to conduct a feasibility study of a new and innovative telephone counseling program to improve symptom management and psychosocial care among a largely understudied population of cancer patients, those with head and neck cancer. The lack of previous intervention research among HNC patients; argues strongly for a program of research that would begin with an R21 feasibility study. The overall goal of this pilot project, hereafter referred to as the Program for Easing and Alleviating Symptoms Everyday - Telephone Counseling (EASE-TC), is to provide essential process evaluation data pursuant to a future randomized trial. The program will utilize counselor-initiated telephone calls that occur at strategic points prior to, during and following cancer treatment. This study will target patients with newly diagnosed squamous cell carcinomas of the head and neck who are receiving treatment at the University of Colorado Comprehensive Cancer Center, a major regional treatment center for HNC patients in the Rocky Mountain area. Three specific aims will guide this exploratory study: (1) conduct a feasibility study of the EASE-TC program; (2) provide a preliminary assessment of intervention benefit among HNC patients undergoing cancer treatment in which intervention participants will serve as their own controls; and (3) utilize these essential process evaluation data to prepare and submit a research proposal for a large Phase III multi-institutional randomized clinical trial to test the efficacy, cost-effectiveness, and exportability of the EASE TC program.

R21CA115354

2005-09-29

2009-08-31