Intersectionality and family support of Latin American transgender individuals: A scoping review.

Head and neck cancers (HNC) (e.g., cancers of the oral/nasal cavity, pharynx, larynx) account for 5% of all cancer cases globally, and 8,100 new cases, and 2,100 deaths in Canada each year. The incidence and mortality of HNC varies by geographic region, socioeconomic characteristics, and lifestyle factors. HNC is more common in men than women with an incidence ratio of approximately 3:1, adults over 50 years of age, people with lower socioeconomic status and people of East and South Asian descent. While tobacco and alcohol use remain significant risk factors, there is an increasing incidence of human papilloma virus (HPV)-related HNC, especially among younger populations. HNCs and the treatments currently required to control them result in significant practical and functional impairments. Common impairments include difficulties in mastication, swallowing, and speaking; loss of smell, taste, and hearing; sexual health and body image challenges; memory and attention difficulties; and physical disfigurement, pain, and fatigue. These challenges reduce participation in social and occupational activities, resulting in social isolation and psychosocial distress, and contribute to worse health-related quality of life in HNC survivors relative to other cancer populations. Many HNC patients lack adequate support and experience barriers to care (e.g. stigma, lower socioeconomic status and complex survivorship care involving multiple providers), leading 60-70% to report unmet supportive care needs after treatment. Peer support and patient navigation were identified as priorities at an institutional retreat attended by HNC patients, caregivers and healthcare professionals that may address existing gaps in supportive care. Peer support - social support (e.g. informational, emotional, practical) from a person with relevant lived experience - may be particularly important for patients with HNC who are at higher risk of isolation given the impact of the disease on social functioning. Despite this, there has been limited prior research on the peer support needs or experiences of patients with HNC. A 2020 systematic review identified ten studies of peer support in HNC, the most common form of which was in-person support groups. In-person and online support groups can help patients with HNC discuss their feelings and the challenges they face, leading to a reduced sense of isolation and distress and improved quality of life. However, group-based peer support may not meet everyone’s needs. Groups may not contain the right composition of diagnoses, treatments or lived experiences, and they may not offer the personalized support needed to overcome barriers to care, particularly for structurally marginalized patients.