"I would have told you about being forgetful, but I forgot": the experience of cognitive changes and communicative participation after head and neck cancer.
Susan Bolt, Carolyn Baylor, Michael Burns and 1 others
PMID 30453786WHAT IT FOUND
Five survivors of head and neck cancer outside the nasopharynx described memory lapses, attention problems, slowed processing and word finding as unexpected after treatment.
They said these changes strained work, social eating and conversation, and felt providers had not warned or helped them.
Key findings
01Participants described memory problems affecting conversation, including repeating conversations and speaking an idea before forgetting it.
02Two participants found that attention and focus difficulties made it hard to combine safe swallowing strategies with conversation during meals.
03Participants reported word finding difficulty and trouble reading prescription bottles.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Only five participants were interviewed, and the planned sample of 10 to 12 was not reached. The authors state saturation was not reached, so the themes are preliminary. The sample was small and homogeneous, with all participants holding advanced academic degrees and speaking American English. Participants were recruited from cancer support groups in the Seattle area, so they may not represent other head and neck cancer survivors. All participants had been treated with chemo-radiotherapy, and three had also had surgery, so the paper does not separate effects of different treatments. Participants were selected because they reported cognitive changes, so the study cannot estimate how common these changes are. Findings rely on self-report interviews and questionnaires, not neuropsychological testing or observation of communication. Member checking produced only one response, so the participants did not broadly confirm the interpretations.
Declared interests
No conflicts of interest declaration appears in the supplied article text. The supplied publication types include research support from NIH extramural and non-U.S. government sources.
The easy way to misread this
Do not read this as evidence that cognitive changes are common in all head and neck cancer survivors. The study interviewed five people who were selected because they reported cognitive changes, and the authors state that no conclusions can be drawn about incidence or prevalence in the broader population.