Prehab in HNC
Research type
Research Study
Full title
Experiences of the start of the treatment journey for head and neck cancer.
IRAS ID
339405
Contact name
Sarah Kirby
Contact email
Sponsor organisation
University of Southampton
Duration of Study in the UK
0 years, 4 months, days
Research summary
Summary of Research
Research has found that the psychological impact of head and neck cancer (HNC) treatment leads to negative effects in quality of life, coping and distress. It is important for professionals to be aware of the impacts HNC have on daily functioning and sense of self in order to provide better care. Research is beginning to see the value of exploring psychological distress across the whole of the cancer trajectory.
It is important that patients are mentally well for the demands of treatment (Levett & Grimmett, 2019) and that researchers explore which interventions will help those waiting for surgery (Putu et al., 2022) Growing research is appearing in this area of prehabilitation (time between diagnosis and treatment starting) within a variety of cancer diagnoses. For example, Parker et al. (2009) used a stress management intervention which showed improvements in areas of quality of life for men undergoing radical prostatectomy for prostate cancer. Prehabilitation research appears limited within HNC and currently focusses on areas of physical exercise and nutrition (Boright et al., 2020; Loewen et al., 2021; Daun et al., 2022). The researcher found no studies exploring psychological prehabilitation within HNC.
This empirical project aims to explore how psychological prehabilitation can be applied to the under-researched area of HNC. Using a qualitative approach, the researcher hopes to explore patients experiences retrospectively of their cancer journey and consider what patients want, if anything, in the stage between diagnosis and treatment that may have a positive impact on coping, adjustment and outcomes. The researcher hopes that by gaining the voices of patients and looking at current research in other diagnoses can help to make recommendations for a prehabilitation protocol that could be used with patients in healthcare settings.
Summary of Results
When someone is told they have cancer, it can be a deeply emotional and confusing time. The period between being diagnosed and starting treatment is known as prehabilitation. During this time, patients often try to find ways to cope with their feelings and prepare for what’s ahead.
Most research on prehabilitation for people with head and neck cancer (HNC) has focused on improving physical health and nutrition. These studies have shown that physically preparing for treatment (e.g., learning swallowing exercises) can help patients recover better. However, much less is known about people’s emotional experiences during this time, or what kind of psychological support might help patients through their treatment journey.
This study explored how people with HNC felt and coped after being diagnosed, and what psychological support they thought might have helped them. Ten people who had been treated for HNC were interviewed. Their stories were analysed to identify common themes in their experiences.
Four main themes were found:
1) Cancer changes how people see themselves and how they feel they are seen by others. This change can be challenging but it can also reshape their sense of identity and provide new meaning to life.
2) People will use a wide range of coping strategies to help them feel more in control, but what works best depends on each person’s situation.
3) Life before treatment feels like living in two worlds — trying to stay connected to their “normal life” while waiting in uncertainty and lots of change.
4) Support needs to be timely and tailored — the right help at the right moment matters most to both patients and their families.
Overall, the study showed that emotional support during the prehabilitation time should be personalised to the patients needs, as each person’s reactions and coping styles will be different. It highlights the importance of patients being aware of what support is available to them that is not only individual psychological therapy for example, increasing awareness of local supports or charities, making it clear who patients can discuss their experiences with and asking patient preference on how much information they wish to receive. More research is needed to understand how to best include psychological care in prehabilitation for people with head and neck cancer.
REC name
South East Scotland REC 01
REC reference
25/SS/0002
Date of REC Opinion
30 Jan 2025
REC opinion
Further Information Favourable Opinion