Panoramic view of head-and-neck cancer at Western Maharashtra’s rural tertiary cancer care center: A prospective observational study

ABSTRACT Background: Despite advances in diagnostics and therapeutics, outcomes of head-and-neck cancer (HNC) remain dismal. Rural patients and their family caregivers (FCGs) face unique challenges that remain underexplored. Objectives: The primary objective was to study the clinicodemographic profile, treatment compliance, knowledge, perception (KP), attitude (AT), and health-related quality of life (HRQOL) of rural patients with HNC. The secondary objective was to study the psychosocial and financial impact of HNC on FCGs. Materials and Methods: In this prospective observational study (June 2019–January 2022), 210 newly diagnosed, nonmetastatic patients with HNC and their FCGs attending Dr. Vitthalrao Vikhe Patil Pravara Rural Hospital, Loni, were enrolled. Structured questionnaires captured demographics, substance abuse, KP, AT, and caregiver experiences. HRQOL was assessed using EORTC QLQ-C30 and QLQ-H and N43. Results: Most patients were rural residents ( n = 167; 79.5%) and presented with locally advanced disease ( n = 181, 86.2%), predominantly oral cavity cancers ( n = 138, 65.7%). Substance abuse was reported by 200 patients (95.2%). Only 137 patients (65.2%) completed planned treatment; follow-up was often symptom-driven. HRQOL showed major impairment in financial, social, and emotional domains. Although the majority of the patients ( n = 186/192, 96.9%) had government health insurance, out-of-pocket costs were substantial. More than half of FCGs reported adverse financial ( n = 107, 50.9%) and social impacts ( n = 165, 78.6%). Conclusion: Rural patients with HNC and their caregivers experience multifaceted clinical, psychosocial, and financial challenges that reduce compliance and HRQOL. Context-specific interventions are essential to improve awareness, support, and outcomes.