Head and Neck Cancer Linked to Loss of Driving Skills

CHARLESTON, S.C., Sept. 18 -- Head and neck cancer may sap patients' driving skills in addition to its toll on the body, investigators here concluded.

Patients with cancer of the head and neck exhibited significantly poorer braking and steering skills than a control group, Hon K. Yuen, Ph.D., of the Medical University of South Carolina, and colleagues, reported in the September issue of Archives of Otolaryngology -- Head & Neck Surgery.

The reasons for the subpar driving performance remain undetermined and require further investigation, they said.

"Since a driving simulator is sensitive enough to distinguish the cancer group from the community control group, these findings provide preliminary evidence to open a new line of research on driving performance," the authors concluded.

In a previous survey of the driving habits of patients with head and neck cancer, Dr. Yuen and colleagues found that most patients drove less or stopped driving during cancer therapy, and about a fourth of the patients continued self-imposed driving limitations after completing therapy (Head Neck 2007;29:675-681).

In the earlier study, patients expressed concern about driving under challenging conditions and perceived impairment in cognitive function. Additionally, they had more traffic violations and accidents after cancer therapy than they had before the cancer was diagnosed.

In the current study, Dr. Yuen and colleagues extended the line of investigation to examine actual driving performance. Ten cancer patients completed a 12-minute evaluation with a virtual reality driving simulator. Their performance was compared with that of 50 individuals who were cancer-free.

The patients with head and neck cancer had a significantly slower average braking time than the control group (3,134.92 msec compared with 2,299.80 msec, P=0.04).

The patients also exhibited significantly greater variability in steering (271.26 in. versus 46.45 in., P=0.02).

The two groups did not differ with respect to average speed, number of collisions, and overall simulator driving performance.

The authors acknowledged several limitations of the study, most notably substantial demographic and clinical differences between the patients and the control group and the heterogeneity of head and neck region affected by cancer and the types of treatments patients received.

Nevertheless, the researchers concluded that the results of this and the earlier study provide a rationale for continued investigation, particularly research to identify potential causes of the degradation in driving performance of patients with head and neck cancer.