Survival of head and neck cancer patients is greatly affected by coexistin...( Current estimates for head and neck ...),Health

Current estimates for head and neck cancer survival are largely inaccurate because they widely disregard many of the most common diseases such patients have in addition to their primary cancer, says Jay Piccirillo, M.D., a head and neck specialist at Washington University School of Medicine in St. Louis, the Siteman Cancer Center and Barnes-Jewish Hospital.

This highlights a broader problem with cancer survival statistics, which generally don't take into account the effect of co-existing conditions, or comorbidities, according to Piccirillo.

In a recent study, Piccirillo, director of the Clinical Outcomes Research Office at Washington University School of Medicine and professor of otolaryngology, showed that the risk of death increased up to seven-fold when patients with head and neck cancer developed new or more severe co-existing ailments such as heart problems, diabetes or lung disorders after cancer diagnosis.

The study, published in the October issue of the Archives of Otolaryngology, Head and Neck Surgery, is the first to look at comorbidities in head and neck cancer patients in the period following diagnosis.

"For decades, we have used a cancer staging system based on tumor size, lymph node involvement and whether cancer has spread to other parts of the body when estimating a patient's survival while mostly ignoring how sick patients are from other diseases," Piccirillo says. "In fact, national databases used to estimate cancer survival don't account for comorbidities, and as a result, we don't have very accurate estimates of how long patients are likely to survive their cancers."

Some past studies of head and neck cancer have investigated the effect of comorbidities present at diagnosis, but this study shows that comorbidities grow in severity and frequency in about a third of head and neck cancer patients after their primary cancer treatment is complete.

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