Maurene McQuestion

Prevalence and nature of survivorship needs in patients with head and neck cancer

The purpose of this study was to determine the number, type, and predictors of patients with head and neck cancer unmet survivorship needs.

Advice about Work-Related Issues to Peers and Employers from Head and Neck Cancer Survivors

Purpose The purpose of this exploratory and descriptive study is to contribute to the sparse return-to-work literature on head and neck cancer (HNC) survivors. Interview participants were asked to reflect upon their work-related experience with cancer by answering two specific questions: (1) What advice would you give someone who has been newly diagnosed with head and neck cancer? (2) What advice would you give to employers of these people? Methods Data were gathered through 10 individual semi-structured in-depth interviews with HNC clinic patients at a regional cancer center’s head and neck clinic in Ontario, Canada. A constant comparative method of theme development was used. Codes identified in and derived from the data were discussed by research team members until consensus was reached. Codes with similar characteristics were grouped together and used to develop overarching themes. Results Work-related advice for peers focused on personal self-care and interactions within workplaces. Work-related advice to employers focused on demonstrating basic human values as well as the importance of communication. Discussion The study results suggest HNC clinic patients should be proactive with employers and help to set reasonable expectations and provide a realistic plan for work to be successfully completed. HNC clinic patients should develop communication skills to effectively disclose their cancer and treatment to employers. Conclusions In this exploratory study, HNC clinic patients’ advice was solution-focused underscoring the importance of self-care and pro-active communication and planning with employers. Employers were advised to demonstrate core human values throughout all phases of the work disability episode beginning at diagnosis.

Work-related experiences of head and neck cancer survivors: an exploratory and descriptive qualitative study

Abstract Purpose: This exploratory and descriptive study contributes to the growing knowledge about the return-to-work (RTW) experience of head and neck cancer (HNC) survivors. Viewing RTW as a process, participants were asked to consider the work-related experience with HNC at different phases: (1) at diagnosis/pre-treatment, (2) working during treatment (if the respondent did not take a work disability leave), and (3) post-treatment/RTW (if the respondent took a work disability leave). Methods: Data were gathered in nine individual semi-structured in-depth interviews with patients receiving treatment at a quaternary cancer center’s HNC clinic in Ontario, Canada. Using a constant comparative method of theme development, codes were identified in and derived from the data. Codes with similar characteristics were grouped, used to develop overarching themes, and were organized according to the RTW factors identified in the literature. Results: Each phase has different barriers that are in turn addressed by different facilitators. As reflected in the literature, we found that RTW or the process of work continuation is complex. Many players and interactions contribute to the worker’s experience. Conclusions: By recognizing that work-related experiences differ by phases, clinicians and employers can better support HNC survivors depending on the phase of the RTW process. Implications for Rehabilitation Our findings suggest that when rehabilitation specialists are working with survivors to develop interventions, the return-to-work phase and work context rather than diagnosis should be considered as a starting point. At every phase, supportive and empathetic managers are a key to successful work experiences for people who have been diagnosed and are being treated for head and neck cancer. Rehabilitation specialists should help survivors to seek supportive interactions with the environment that are essential to enable the ability to work.

SU-F-T-379: Dosimetric Impacts of Topical Agents and Dressings On Skin in Radiotherapy

PURPOSE This study investigated the superficial dose enhancement in the application of topical agents, clinical materials (thermal mask and bolus) and dressings in megavoltage photon beam radiotherapy. Different topical skin agents, clinical materials and dressings were evaluated and compared for their skin dosimetric impacts on the patients during radiation treatment. METHODS Superficial dose enhancements, or percentage doses with and without the studying materials, were measured using the 6 MV (Field size = 10×10 cm2 ) photon beams produced by a Varian TrueBeam linear accelerator. Twelve topical agents, five dressings (dry and wet conditions) and three clinical materials were studied. A solid water phantom was used with a MOSFET dose detector (TN-1002RD, Thomson and Nielsen Electronic, Ottawa, Ontario, Canada) located under a 1-mm PMMA slab to measure the skin dose. The distance between the radiation source and phantom surface was set to 100 cm in all measurements. The topical agents were distributed evenly with 1.5 mm thickness using our specific sample holder on the phantom surface. Extrapolations were made of 0.5 mm thickness for the agents to provide meaningful clinical value. RESULTS By comparing surface doses without studying materials, it is found that no topical agents had superficial dose enhancement higher than the clinical materials namely, thermoplastic mask (128%), 5-mm Superflab™ bolus (158%) and 10-mm Superflab™ bolus (171%) regarding the same thickness. Superficial dose enhancement of dry dressing did not exceed 110.5%, while wet dressings produced higher dose enhancements (133% for wet Mepilex lite and 141% for wet Mepilex Ag transfer). CONCLUSION It is concluded that the evaluated topical agents and dry dressings did not increase the superficial dose to a concerning level, even using excessive thickness in every fraction of radiation treatment. Wet dressings were found producing the bolus effect, but was still substantially less than applying a thin 5-mm bolus.