Head and neck cancer patients

Head and neck cancer remains among the top ten most common malignancies in Taiwan, with the prevalence of oral cancer in men ranking among the highest worldwide. In recent years, the Taiwanese government has actively promoted nationwide oral cancer screening programs, leading to earlier detection and improved treatment rates. Nevertheless, more than half of patients are still diagnosed at an advanced stage, resulting in substantial treatment-related morbidity and poor survival outcomes.

Building on our team’s longstanding clinical experience and research in health-related quality of life, nutritional assessment, and muscle strength evaluation in patients with head and neck cancer, we have developed an integrated physical fitness assessment framework that complements standard oncologic treatment. This approach aims to support patients in completing treatment successfully, enhance treatment adherence, improve quality of life, and ultimately contribute to better cancer survival. Through comprehensive supportive care, we seek to facilitate patients’ recovery and enable an earlier return to normal daily life.

To integrate assessments of patients’ quality of life, nutritional status, and muscle mass as a comprehensive, whole-person evaluation prior to cancer treatment.

To establish objective evaluation criteria across multiple indicators in order to enable early identification of high-risk patients and timely intervention.

To improve quality of life and treatment adherence among patients with cancer.

From August 13, 2021, to June 26, 2025, 1,384 patients with head and neck cancer were enrolled, with a total of 3,848 questionnaire assessments completed.

Over the past four years, more than 90% of head and neck cancer patients have completed comprehensive multidisciplinary assessments each month.

A 100% completion rate was achieved for head and neck cancer assessments conducted within 30 minutes.

Both the annual treatment retention rate and treatment completion rate have consistently approached 90%.

This initiative does not pose direct risks related to medical interventions. Instead, by conducting early assessments of nutritional status, muscle strength, swallowing function, and quality of life, it serves as an early warning system for potential treatment-related risks. These findings can be promptly communicated to the clinical care team to facilitate timely multidisciplinary interventions (e.g., referral to dietitians, psychologists, speech-language pathologists), thereby reducing the incidence of adverse events. In addition, downstream outcomes—such as treatment interruption, emergency department visits, and unplanned hospitalizations—can be continuously collected as indirect safety indicators to monitor the overall effectiveness of the intervention and trends in treatment-related risk.

The treatment retention rate for head and neck cancer exceeded 90%.

Patient satisfaction with head and neck reconstructive surgery exceeded 80%.

Satisfaction with head and neck cancer nurse case management exceeded 90%.

• Aligning with ERAS core principles, this model extends multidisciplinary, preoperative optimization to head and neck oncology, holding strong potential for inclusion in future international care guidelines.

• Unlike single-parameter studies (e.g., sarcopenia), this framework integrates quality of life, nutrition, frailty, muscle strength, and muscle mass, offering a rare multidimensional approach ripe for high-impact publication.

• The study design enables benchmarking against sarcopenia research by Remco de Bree’s team in the Netherlands, facilitating international exchange on risk prediction and clinical decision-making.

• This reproducible, cost-effective workflow can serve as a global reference for cancer care and education, supporting future multinational collaborations and standardized care pathways.

Enhancing quality of care:

Establish a comprehensive and standardized pre-treatment, patient-centered assessment workflow to improve the quality of head and neck cancer care in Taiwan, with strong potential for international dissemination.

Developing standards of care:

Integrate nutritional status, muscle strength, frailty, and quality-of-life metrics into a reproducible clinical assessment and intervention framework.

Patient-centered benefits:

Enable early identification of high-risk patients and timely intervention to improve quality of life, enhance treatment adherence, and reduce treatment interruption and complication rates.

Sustainable healthcare development:

Implement a one-stop integrated assessment model to reduce redundant medical services and costs, optimize resource utilization, and promote long-term sustainability of cancer care.