A majority of adult head and neck cancer survivors place a higher priority on maintaining their overall quality of life than on extending survival time, according to research published in BMC Cancer. As improvements in clinical interventions and therapeutic approaches continue to bolster survival rates for individuals diagnosed with head and neck malignancies, healthcare providers are increasingly recognizing the necessity of incorporating patient-reported outcomes and personal values directly into clinical decision-making. By systematically investigating patient preferences regarding quality of life versus life prolongation, the investigators sought to generate robust empirical evidence that can better inform and support patient-centered oncology strategies.

The malignancy itself and its subsequent clinical treatments can severely compromise physical functioning, daily psychosocial well-being, and broader health-related quality of life.

The study cohort comprised 207 adult head and neck cancer survivors who were evaluated across multiple validated self-report instruments. Within this study population, male patients represented 70.5 percent of the participants, and the cohort had an overall mean age of 66.2 years.

To assess survivor well-being and health status, the study utilized three standardized questionnaires. Health-related quality of life was evaluated using the EORTC QLQ-C30 questionnaire. Concurrently, psychological distress was measured using the Distress Thermometer instrument, while specific individual preferences between quality of life and life prolongation were gauged using the dedicated QQ questionnaire. Analytical protocols incorporated multivariable regression models to isolate independent predictors of quality of life and distress, while group comparison analyses examined associations between patient characteristics and treatment preferences.

Across the surveyed cohort of 207 individuals, the baseline assessments revealed a median global health status score of 66.6 on the EORTC QLQ-C30 metric. In parallel, participants demonstrated a median psychological distress score of 3 on the Distress Thermometer. According to the investigators, these scores indicated a relatively good overall quality of life and a comparatively low level of psychological distress.

Multivariable regression analyses identified independent factors associated with patient-reported quality of life. The statistical models demonstrated that lower levels of psychological distress and active employment status were both independently associated with superior quality of life, with each factor reaching high statistical significance at p < 0.001. Furthermore, the receipt of surgical treatment and the presence of lower medical comorbidity were also independently associated with enhanced quality of life, with both variables achieving statistical significance at p < 0.05.

When investigating factors associated with psychological distress, multivariable regression identified a distinct set of independent predictors. The analysis determined that patient sex, baseline global health status, tumor stage, educational attainment level, and the specific treatment modality administered were all independently predictive of reported distress scores, with all identified variables attaining statistical significance at p < 0.05.

Analysis of treatment preferences among the 202 patients who completed the QQ questionnaire showed that 53.0 percent explicitly prioritized quality of life, whereas 21.8 percent favored life prolongation, and 25.2 percent expressed no clear preference between the two options. Statistical testing demonstrated that patient preferences were significantly associated with chronological age at p = 0.035, with older individuals demonstrating a stronger inclination toward prioritizing quality of life. In addition, tumor stage was significantly associated with treatment preference at p = 0.032, with the divergence between quality of life and life prolongation diminishing noticeably among patients presenting with advanced disease stages.

The study authors concluded that overall quality of life among head and neck cancer survivors is jointly determined by clinical treatments and psychosocial circumstances. With lower distress, employment, surgical treatment, and lower comorbidity associated with better quality of life, and most patients prioritizing quality of life over life prolongation, the authors emphasized the need to align treatment strategies with patient values, placing quality of life at the center of clinical decision-making.

Subject of Research: Treatment preferences and quality of life predictors among head and neck cancer survivors

Article Title: Living longer or living better – priorities among head and neck cancer survivors

Article References: Thomsen, A., Trigui, N., Rast, J., Newton-Tanzer, E., Donate, M. G., Hoffmann, M., & Wiegand, S. (2026). Living longer or living better – priorities among head and neck cancer survivors. BMC Cancer, 26(1), Article 1344. https://doi.org/10.1186/s12885-026-17298-z

Image Credits: AI Generated

DOI: 10.1186/s12885-026-17298-z

Keywords: head and neck cancer, quality of life, life prolongation, cancer survivorship, treatment preferences, EORTC QLQ-C30, Distress Thermometer, QQ questionnaire, multivariable regression, psychological distress, patient-reported outcomes, surgical treatment, comorbidity, tumor stage, patient-centered care, oncology decision-making, employment status