Elderly cope better with oral cancer

Older individuals with oral squamous cell carcinoma (SCC) report better health-related quality of life (HRQoL) at one year after curative surgical treatment than do their younger counterparts, indicate UK study results.

The finding is true for both physical and socioemotional HRQoL domains, report the researchers in the British Journal of Oral and Maxillofacial Surgery.

While the team cannot definitively explain the trends with age, David Laraway (University of Liverpool) and colleagues suggest that elderly SCC patients may adapt better after treatment, being slightly less conscious of body image than younger patients.

Furthermore, older individuals may interact mainly with family and friends who are all aware of their condition and treatment, "which will aid their communication and appearance HRQoL," write the authors.

The results are "worthy of further research to explore coping mechanisms and expectations, which will help to identify how additional support for young and elderly patients most at risk can be administered cost-effectively," they say.

A total of 638 SCC patients treated curatively between 1992 and 2009 formed the study cohort, with 177 aged under 55 years, 217 aged 55-64 years, 165 aged 65-74 years, and 79 aged 75 years and above.

The researchers compared HRQoL at 1-year postsurgery (using the University of Washington Quality of Life scale [UWQoL]) between patients aged 74 years and younger (younger patients), and those aged 75 years and older (older patients).

Overall, older patients reported better function than their younger counterparts, remark Laraway and co-workers. In particular, median physical function scores were higher among participants aged 75 years and over than among their younger counterparts, at 86 versus 74 out of 100, while socioemotional scores followed the same trend, at 83 versus 79, respectively.

Furthermore, older patients gave significantly higher scores than their younger peers for specific physical symptoms, at 87 versus 72 for saliva appearance, 87 versus 77 for speech, and 82 versus 73 for overall appearance.

A similar, significant pattern emerged among the socioemotional symptoms of pain: 84 versus 78 for older versus younger patients; 83 versus 73 for mood; and 83 versus 70 for anxiety.

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