Technology May Decrease Symptom Burden in Head and Neck Cancer Survivors

Patients with head and neck cancer experienced a decrease in symptom severity after using mobile and sensor technology that allowed their health care providers to remotely monitor symptoms, according to research that will be presented at the 2018 American Society of Clinical Oncology (ASCO) Annual Meeting.

The federally funded, randomized clinical trial included 357 patients with head and neck cancer — all of whom were undergoing radiation therapy at the University of Texas MD Anderson Cancer Center.

Patients were randomly assigned to the CYCORE (Cyberinfrastructure for Comparative Effectiveness Research) group (169 patients) or usual care group (188 patients).

The CYORE group was given technology devices that sent information to their physician every day. Devices included a Bluetooth-enabled scale, Bluetooth-enabled blood pressure cuff and a tablet with symptom-tracking apps. Since health care providers were getting patients’ updates daily, they were able to intervene if necessary.

Both groups had weekly in-person doctor visits.

At the start of cancer treatment, all participants were asked to complete a 28-item MD Anderson Symptom Inventory survey that asked questions about their health and daily activities. The survey also asked about general cancer-related symptoms, such as pain, fatigue and nausea, as well as some head and neck cancer-specific symptoms, such as difficulty swallowing or chewing, skin pain/burning/rash and problems tasting food.

The researchers found no difference in self-reported health severity scores between the CYCORE participants and those who received usual care at the start of the trial.

Six to seven weeks later, when the radiation ended, patients took a similar survey, and then again six to eight weeks later.

Results showed that the patients who were given the CYCORE program experienced lower symptom burden compared with the usual care group. On a scale of 0 to 10 (with zero being no symptom or pain and 10 being the highest level of symptom severity), the CYCORE participants reported an average score of 2.9 compared to 4.8 for the control group when rating general cancer symptoms. For head and neck cancer-specific symptoms, the average scores were 4.2 versus 4.8 for the CYCORE group versus control group, respectively.

Six to eight weeks after completion of therapy, CYCORE participants had a mean score of 1.6 compared with 1.9 for usual care participants based on overall health; however, both groups experienced slightly higher severity scores for specific head and neck symptoms (1.7 vs. 2.1).

Lead author Susan K. Peterson, Ph.D., professor in the Department of Behavioral Science at MD Anderson, noted that most patients (80 percent or more) did adhere to the daily monitoring.

“Our study generated evidence on how newer technologies can be integrated into cancer care relatively easily and improve patient outcomes without interfering too much in a person’s daily life,” she said in a statement.

“This study was done during a rather intense period in the patients’ care for head and neck cancer,” Peterson added. “The system helped their physicians to provide valuable support that ultimately resulted in lower symptom severity.”

ASCO President Bruce E. Johnson, M.D., FASCO, agreed how important these results are for patients with head and neck cancer. “This study demonstrates the power of leveraging smart technology to improve the care of people with cancer,” he added. “These tools helped simplify care for both patients and their care providers by enabling emerging side effects to be identified and addressed quickly and efficiently to ease the burden of treatment. I hope that these or similar technologies will be broadly available to patients soon.”