Mental adjustment to cancer and its relation to anxiety, depression, HRQL and survival in patients with laryngeal cancer - A longitudinal study

95 patients with Tis-T4 laryngeal cancer were assessed at one and 12 months after start of treatment, respectively, using the Mini-Mental Adjustment to Cancer Scale (Mini-MAC), the European Organisation for Research and Treatment of Cancer (EORTC) Study Group on Quality of Life core questionnaire (EORTC QLQ-C30) supplemented with the Head and Neck cancer module (QLQ-H&N35) and the Hospital Anxiety and Depression (HAD) Scale. For survival analyses patients were followed up for a median time of 4.22 years from inclusion.The most commonly used adjustment response at both occasions was Fighting Spirit. The use of adjustment responses was relatively stable over time. Correlation analyses showed that patients using Helpless-Hopeless and Anxious Preoccupation responses reported more anxiety and depression, as well as decreased HRQL. Tumour site and stage showed no effect on adjustment response. Survival analysis indicated that use of a Helpless-Hopeless response was related to poorer survival (HR 1.17, p 0.001).The relation between adjustment responses Helpless-Hopeless and Anxious Preoccupation and anxiety, depression, HRQL and possibly poorer survival indicate that assessment of mental adjustment should be considered when planning treatment and rehabilitation in laryngeal cancer patients.To be diagnosed with laryngeal cancer places considerable demand on the patient. Besides the impact of being diagnosed with a life-threatening disease, patients also face psychosocial problems due to impairment in voice and speech and other physical effects caused by treatment [1,2]. As a consequence, laryngeal cancer patients risk mood disorders such as anxiety and depression, as well as decreased health-related quality of life (HRQL) [1,3-5]. Laryngeal cancer patients' different ratings of HRQL and psychological well-being have been associated to both treatment and size of tumour [6]. However, differences in HRQL levels and mental well-being may also be explained by mental coping respo