Toward comprehensive multidisciplinary care for head and neck cancer patients: quality of life versus survival.

This article discusses how quality-of-life assessment in patients with head and neck cancer might be weighed against survival and how such assessment might be applied in clinical practice. While survival is understandably considered to be the outcome of primary interest, there are several clinical scenarios in which quality of life can be considered as a primary outcome. Quality-adjusted survival is also an important consideration and needs to be incorporated into the results of treatment. However, quality-of-life assessment has hitherto been virtually only a research tool and not been incorporated into clinical practice. Nowadays, speech pathologists and dietitians are integral to the multidisciplinary team that treats patients with head and neck cancer. The main point of this article is to provide a rationale for the proposition that the health psychologist--who is best able to understand and manage the psychosocial issues--should also be included as one of the team.