Neck and Shoulder Impairments and the Relationship to Quality of Life in Head and Neck Cancer Survivors

Background: Head and neck cancer (HNC) treatment has been shown to impact function of the upper quarter; however, no standardized measures have characterized the frequency and severity of these effects and their impact on quality of life. Methods: Forty HNC survivors, age 30-82 years old completed the Neck Disability Index (NDI), Shoulder Pain and Disability Index (SPADI), and University of Washington Quality of Life questionnaire (UW-QoL). Correlations were calculated between each questionnaire. Results: Impairments were noted by 29/40 (73%) on the NDI and 26/37 (70%) on the SPADI. The mean scores on the questionnaires were: NDI = 20.85%, SPADI total = 19.71%, SPADI pain = 23.89%, SPADI disability = 18.59%, and UW-QWOL = 68.08%. Strong and significant correlations were found between: NDI and SPADI (r = 0.86), NDI and UW-QoL (r = -0.84), and SPADI and UW-QoL (r = -0.84). Conclusions: Most respondents indicated impairment in neck and/or shoulder function associated with HNC treatment that strongly correlated to quality of life. These findings suggest that interventions to minimize neck and shoulder impairment may improve quality of life as well as function.