Body Image Distress and Depression in Head and Neck Cancer Patients- a Narrative Review

Abstract

Body image distress (BID) and depression are significant psychosocial concerns in individuals with head and neck cancer (HNC). The unique physical and functional challenges associated with HNC contribute to alterations in self-perception and quality of life. However, the interplay between BID and depression remains underexplored in this patient population. This narrative review aims to synthesize current evidence on the relationship between BID and depression in patients with HNC, identify key determinants influencing these conditions, and explore potential intervention strategies to improve psychosocial outcomes. A non-systematic literature search was conducted from December 2024 to January 2025 using PubMed and Google Scholar. Studies published in the last five years (2019-2024) focusing on BID and depression in HNC patients and survivors were included. Both qualitative and quantitative studies were reviewed. Key areas of analysis included prevalence, risk factors, quality of life impact, and psychosocial interventions. The literature suggests a bidirectional relationship between BID and depression in HNC, where the presence of one exacerbates the severity of the other. Depression is a key predictor of BID, while other contributing factors include younger age, female gender, advanced cancer stage, extensive surgical interventions, postoperative radiation, social isolation, and dissatisfaction with aesthetic outcomes. BID and depression collectively contribute to poorer quality of life, impairing social-emotional functioning and treatment adherence. Emerging research highlights shame, stigma, and unmet needs (e.g., sexual dysfunction, substance use) as additional factors influencing BID and depression. Interventions such as cognitive behavioral therapy (CBT), telemedicine-based counseling, and peer support programs show promise in mitigating these psychosocial burdens, but their accessibility remains inconsistent. BID and depression are interrelated and significantly impact the well-being of patients with HNC. A multidisciplinary approach integrating psychological support, functional rehabilitation, and aesthetic interventions is essential for improving patient outcomes. Future research should prioritize longitudinal studies, standardized assessment tools, and culturally sensitive interventions to enhance the understanding and management of BID and depression in HNC survivors.

Supplementary information: The online version contains supplementary material available at 10.1007/s12070-025-05461-0.

Keywords: Body image distress; Cognitive behavioral therapy; Depression; Head and neck cancer; Psychosocial impact; Quality of life; Rehabilitation.