Oftentimes cancer and its therapy may cause neuroinflammation and central sensitization, resulting in chronic systemic symptoms (CSS) such as fatigue, sleep disturbance, chronic widespread pain, mood disorders, neuropsychiatric symptoms, and temperature dysregulation. A study published in Supportive Care in Cancer reports on the occurrence of CSS in head and neck cancer survivors.1

A total of 155 head and neck cancer survivors who were at least 12 months posttreatment without cancer recurrence completed a one-time compilation of self-reported measures. The measures included the Vanderbilt Head and Neck Symptom survey plus the General Symptom Subscale, the Body Image Quality of Life Inventory, Neurotoxicity Rating Scale, the Profile of Mood States, and a 5-item quality of life measure. 

One or more moderate-to-severe systemic symptoms were experienced by 48.4% of patients. Individual symptoms varied in frequency from 20% to 56%, with approximately half of patients experiencing moderate-to-severe symptom intensity.

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“Of note, previously underrecognized neuropsychiatric symptoms were endorsed by a significant cohort of patients warranting further study,” wrote the authors. Reported neuropsychiatric symptoms were also frequent and severe. Although body image was not negatively impacted, survivors had low profile of mood state scores.

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Approximately 40% of head and neck cancer survivors reported a diminished quality of life, with up to 15% reporting poor quality of life. Altogether, this highlights a need to understand and mitigate the commonly experienced and severe chronic systemic symptoms experienced by head and neck cancer survivors.


Wulff-Burchfield E, page1image55831808Dietrich MS, Ridner S, and Murphy BA. Late systemic symptoms in head and neck cancer survivors [published online December 15, 2018]. Support Care Cancer. doi: 10.1007/s00520-018-4577-3