Artikel
Ear, nose and throat cancers: impairments of the patients, modules of rehabilitation, social medicine outcome, and impact on national economics
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Veröffentlicht: | 20. März 2006 |
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Introduction: Some 10500 ear, nose,and throat cancers (ENTC) per annum are newly diagnosed in Germany, 3.4 % of all cancers. The comparedly small number ensues that only few reports are found on the medical sequelae and the outcome in social medicine, with statistical drawbacks because of small numbers. Our presentation is based on 212 in-patients in rehabilitation ( ICD-10: 00 to 14 and 32 )and focuses - persisting somatic and psychic sequelae, - the patients' need für defined rehabilitation modules, and - data on the pretherapeutic social medicine date and on the outcome.
Patient characteristics: 75 % were between 45 and 65 years old, the relevant age for early retirement because of disease. 23 % had laryngeal cancer, 71 % with the primary cancer in the mouth or the throat. Almost all had undergone classical or laser surgery, 58 % with neck dissection, and 60 % with irradiation.
Rehabilitation modules: The prescription of the therapeutic modules quantitatively reflects the impairments of the ENTC-patients after the primary treatment. In 92 %, physiotherapy was prescribed, in 63 % logopaedic care, in 49 % manual lymphdrainage, in 47 % dietetic counseling, and in 22 % psychooncological psychotherapy.
Cancer disease and occupational life: Before cancer treatment, 70 % of the patients participated in occupational life. After treatment and rehabilition, only 36 % were able to cope with the preexisting full employment. 42 % were unable to perform in any employment for more than 2h/d. Some 10 % could not continue in their former occupation but a suitable different one.
Conclusions: The costs of ENTC-in-patient rehabilitation per year are presumably 28 Mio. €/annum in Germany. In addition, the costs for early retirement can be calculated. The presentation gives indications for the optimization of the rehabilitation process in ENTC and on the rehabilitation research in this field.