A study looking at the care of people with head and neck cancer (Head and Neck 5000)

Cancer type:

Head and neck cancers

Laryngeal cancer

Mouth (oral) cancer

Nasal and paranasal sinus cancer

Nasopharyngeal cancer

Pharyngeal cancer

Salivary gland cancer

Status:

Results

Phase:

Other

This study looked at risk factors for head and neck cancer, and services available for those diagnosed with this type of cancer.

More about this trial

When this study was done, head and neck cancer services in the UK were changing so that there were fewer, larger centres. It’s important that these centres give the best service possible and in the most efficient way.

Researchers in this study wanted to see how well these new services were working. They asked health care professionals about their facilities and about how their teams worked.

They also wanted to find out more about risk factors for head and neck cancers. They asked more than 5,000 people who had been recently diagnosed about things such as their:

lifestyle
general health
alcohol intake
smoking habits

They hoped that this would help them find out more about how to improve care for people with a head and neck cancer.

The aims of this study included:

looking at how well these larger ‘centralised’ services work for people with head and neck cancer
finding out more about factors that affect how well people do after diagnosis

Summary of results

The research team found that depression and smoking at diagnosis can affect the survival of people with head and neck cancer. But drinking alcohol at diagnosis is less likely to.

This trial was open for people to join between 2011 and 2014. The research team published results in 2018.

About this study
More than 5,000 people with head and neck cancer took part. They completed questionnaires and gave blood samples.

The research team found out more about the services available for people with head and neck cancer. They also looked at various factors that may affect people’s risk. There is more information below.

Services for patients
In 2009 and 2010, the research team sent questionnaires to health care professionals caring for people with head and neck cancer in the UK.

They asked 37 cancer networks about the number of people in their area, how many new cases of head and neck cancer there were and what services were available.

They asked 53 cancer hospitals about waiting times, availability of treatments, the number of specialists and how many people joined clinical trials.

They asked 63 multi disciplinary teams (MDTs) about facilities for meetings, the types of patients they discussed and communication about decisions. An MDT is a team of various health care professionals who discuss treatment options and care for specific patients.

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The results from the questionnaires showed that:

on average, 263 people were diagnosed with head and neck cancer in each cancer network per year
the average time before people started treatment was 25 days
facilities for team meeting are generally acceptable
most MDTs have weekly meetings and discuss an average of 18 patients per meeting
most cancer specialists are able to prescribe common treatments and radiotherapy
the number of patients who join a clinical trial is low in many hospitals
some centres didn’t record or communicate information about the MDT discussions very well

They concluded that some teams need to communicate better and encourage more patients to join a clinical trial.

Alcohol intake and smoking habits at diagnosis

We already knew from research that smoking and drinking alcohol can increase the risk of developing head and neck cancer. But the research team wanted to find out whether smoking habits and alcohol intake at the time of diagnosis affected how well people did after diagnosis.

The research team analysed information from 1,393 people about their alcohol intake and smoking habits when they were diagnosed. They then looked at how many people had died about 3.5 years later.

The team compared people who were drinking large amounts of alcohol when they were diagnosed with people who didn’t drink alcohol. They didn’t find any evidence that people who were drinking large amounts of alcohol at diagnosis were more likely to have died.

They also compared people who smoked at the time they were diagnosed with people who used to smoke and those who had never smoked.

They found that people who smoked when they were diagnosed were significantly more likely to have died than people who had never smoked. People who used to smoke were also slightly more likely to have died.

Changing alcohol intake or smoking habits after diagnosis

Next they looked at whether 973 people changed how much alcohol they drank or whether they smoked, after being diagnosed with head and neck cancer. They compared smoking and drinking habits at diagnosis with habits 4 months and 12 months later.

They found that:

some people who drank a large amount of alcohol decreased their intake after diagnosis, but most didn’t
most people who were smoking at diagnosis had stopped 12 months later
some people who used to smoke but had given up, started smoking again after their diagnosis
most people who were smoking 4 months after diagnosis were still smoking 12 months after diagnosis

25 hydroxyvitamin D levels

Vitamin D is converted into a substance called 25 hydroxyvitamin D (25OHD) in the body. A low level of 25OHD had been linked to the development of head and neck cancer in other research.

The study team compared genetic markers of 25OHD in 5,133 people with head and neck cancer, and 5,984 people who didn’t have cancer.

They didn’t find any evidence of a link between markers of 25OHD levels and the risk of head and neck cancer. They suggest that 25OHD supplements are not likely to help prevent these cancers.

Depression

The team looked at the depressive symptoms (DS) of 1,217 people at diagnosis, and again at 4 months and 12 months. They then looked at how many people had died.

They found that:

66 people died out of 772 people (9%) who had never had depressive symptoms
18 people died out of 198 people (9%) who had previously had depressive symptoms but had recovered
39 people died out of 247 people (16%) who continued to have depressive symptoms

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They concluded that people who continue to have depressive symptoms are more likely to die sooner. They suggest that work needs to be done to find out how depression affects survival.

Where this information comes from

We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item

) and published in medical journals. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.

Recruitment start:

01/04/2011

Recruitment end:

31/12/2014

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

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Questions to ask your doctor about clinical trials

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Professor Andy Ness

Supported by

NIHR Programme Grants for Applied Research Scheme
NIHR Clinical Research Network: Cancer
University Hospitals Bristol NHS Foundation Trust
University of Bristol

If you have questions about the trial please contact our cancer information nurses

Freephone 0808 800 4040

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