Symptom Experiences and Management of Patients with Head and Neck Cancer Receiving Radiation Therapy: Integrated Review

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Sirikorn Rojthamarat, RN
Chomchuen Somprasert, RN, PhD
Puangpaka Kongvattananon, RN, PhD


There is a limited number of literature reviews of the symptom experience and self-management of head and neck cancer (HNC) patients who have undergone radiation therapy, in the period before, during, and after treatment. Moreover, a qualitative approach exploring these specific experiences and their management will benefit both health care providers and researchers to understand the factual experience. Knowledge of this kind is needed to help eliminate distress from treatment-related symptom toxicities and to develop novel and adequate interventions to support these patients’ needs. A literature search was carried out in April 2017 using Cochrane, CINAHL, Ovid, Pubmed, PsycINFO, and ScienceDirect databases to review the literature on HNC patients, symptom experience and management during radiation or concurrent chemoradiotherapy. Symptoms experienced by HNC patients mainly relate to eating difficulties and uncertainty from the moment of being diagnosed with cancer until treatment completion. Symptom management is focused on self-management for out-patients by providing guidance, and disease education is delivered by knowledgeable healthcare providers with good interpersonal skills. Communication strategies with tailored information also provide vital data found in this synthesis. Early assessment and intervention with patients, and an effective family involvement, is important to facilitate access to quality oncology services. This is vital in helping overcome the uniquely complex treatment-related symptoms and to help patients and families to cope with the difficult time of getting through the treatment trajectory.


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Rojthamarat S, Somprasert C, Kongvattananon P. Symptom Experiences and Management of Patients with Head and Neck Cancer Receiving Radiation Therapy: Integrated Review. BKK Med J [Internet]. 2018 Sep. 20 [cited 2023 Dec. 6];14(2):108. Available from:
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1. Chaturvedi AK, Anderson WF, Lortet-Tieulent J, et al. Worldwide trends in incidence rates for oral cavity and oropharyngeal cancers. J Clin Oncol 2013;31(36):4550-9.
2. Mallick I, Waldron JN. Radiation therapy for head and neck cancers. Semin Oncol Nurs 2009;25(3):193-202.
3.  Langendijk JA, Doornaert P, Verdonck-de Leeuw IM, et al. Impact of late treatment-related toxicity on quality of life among patients with head and neck cancer treated with radiotherapy. J Clin Oncol 2008;26(22):3770-6.
4. Wells M, Swartzman S, Lang H, et al. Predictors of quality of life in head and neck cancer survivors up to 5 years after end of treatment: a cross-sectional survey. Support Care Cancer 2016;24(6):2463-72.
5. Jensen SB, Pedersen AM, Vissink A, et al. A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: management strategies and economic impact. Support Care Cancer 2010;18(8):1061-79.
6. Glenny AM, Furness S, Worthington HV, et al. Interventions for the treatment of oral cavity and oropharyngeal cancer: r a d i o t h e r a p y. C o c h r a n e D a t a b a s e S y s t R e v 2010(12):CD006387.
7. Furness S, Glenny AM, Worthington HV, et al. Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy. Cochrane Database Syst Rev 2011(4):CD006386.
8. Rosenthal DI, Mendoza TR, Fuller CD, et al. Patterns of symptom burden during radiotherapy or concurrent chemoradiotherapy for head and neck cancer: a prospective analysis using the University of Texas MD Anderson Cancer Center Symptom Inventory-Head and Neck Module. Cancer 2014;120(13):1975-84.
9. CASP. Critical Appraisal Skills Programme (CASP) Qualitative Research Checklist 2017 [Accessed August 8, 2017, at].
10. Eades M, Chasen M, Bhargava R. Rehabilitation: long-term physical and functional changes following treatment. Semin Oncol Nurs 2009;25(3):222-30.
11. Lang H, France E, Williams B, et al. The psychological experience of living with head and neck cancer: a systematic review and meta-synthesis. Psychooncology 2013;22(12):2648- 63.
12. Donovan M, Glackin M. The lived experience of patients receiving radiotherapy for head and neck cancer: a literature review. Int J Palliat Nurs 2012;18(9):448-55.
13. Brockbank S, Miller N, Owen S, et al. Pretreatment information on dysphagia: exploring the views of head and neck cancer patients. J Pain Symptom Manage 2015;49(1):89-97.
14. Semple CJ, Dunwoody L, George Kernohan W, et al. Changes and challenges to patients’ lifestyle patterns following treatment for head and neck cancer. J Adv Nurs 2008;63(1): 85-93.
15. Schaller A, Larsson B, Lindblad M, et al. Experiences of pain: a longitudinal, qualitative study of patients with head and neck cancer recently treated with radiotherapy. Pain Manag Nurs 2015;16(3):336-45.
16. Charalambous A. Hermeneutic phenomenological interpretations of patients with head and neck neoplasm experiences living with radiation-induced xerostomia: the price to pay? Eur J Oncol Nurs 2014;18(5):512-20.
17. McQuestion M, Fitch M. Patients’ experience of receiving radiation treatment for head and neck cancer: Before, during and after treatment. Canadian Oncology Nursing J 2016;26(4):325-35.
18. Pattison N, Brown MR, Gubbay A, et al. Towards a pain free hospital: an in-depth qualitative analysis of the pain experiences of head and neck cancer patients undergoing radiotherapy. Br J Pain 2016;10(1):29-37.
19.  Taylor A, Wells M, Hubbard G, et al. From an illusion of certainty into a reality of uncertainty: A longitudinal qualitative study of how people affected by laryngeal cancer use information over time. Eur J Oncol Nurs 2016;23:15-23.
20. McQuestion M, Fitch M, Howell D. The changed meaning of food: Physical, social and emotional loss for patients having received radiation treatment for head and neck cancer. Eur J Oncol Nurs 2011;15(2):145-51.
21. Moore KA, Ford PJ, Farah CS. “I have quality of life...but...”: Exploring support needs important to quality of life in head and neck cancer. Eur J Oncol Nurs 2014;18(2):192-200.
22. Rosen HI, Bergh IH, Schwartz-Barcott D, et al. The recovery process after day surgery within the symptom management theory. Nurs Forum 2014;49(2):100-9.
23. Dodd M, Janson S, Facione N, Faucett J, Froelicher ES, Humphreys J, et al. Advancing the science of symptom management. J Adv Nurs 2001;33(5):668-76.
24. Kwekkeboom KL. Cancer Symptom Cluster Management. Semin Oncol Nurs. 2016;32(4):373-82.
25. Xiao C, Hanlon A, Zhang Q, et al. Symptom clusters in patients with head and neck cancer receiving concurrent chemoradiotherapy. Oral Oncol 2013;49(4):360-6.
26. Rosenthal DI, Trotti A. Strategies for managing radiationinduced mucositis in head and neck cancer. Semin Radiat Oncol 2009;19(1):29-34.
27. Pignon JP, le Maitre A, Maillard E, et al. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiother Oncol 2009;92(1):4-14.
28. Head BA, Studts JL, Bumpous JM, et al. Development of a telehealth intervention for head and neck cancer patients. Telemed J E Health 2009;15(1):44-52.
29. Larsson M, Hedelin B, Athlin E. Needing a hand to hold: lived experiences during the trajectory of care for patients with head and neck cancer treated with radiotherapy. Cancer Nurs 2007;30(4):324-34.
30. Mason H, DeRubeis MB, Foster JC, et al. Outcomes evaluation of a weekly nurse practitioner-managed symptom management clinic for patients with head and neck cancer treated with chemoradiotherapy. Oncol Nurs Forum 2013;40(6):581-6.
31. Kilbourn KM, Anderson D, Costenaro A, et al. Feasibility of EASE: a psychosocial program to improve symptom management in head and neck cancer patients. Support Care Cancer 2013;21(1):191-200.
32. Bensinger W, Schubert M, Ang KK, et al. NCCN Task Force Report. prevention and management of mucositis in cancer care. J Natl Compr Canc Netw 2008;6(Suppl1):S1-21.
33. Lord AS, Brown M, Noor S, et al. The utilisation of virtual images in patient information giving sessions for prostate cancer patients prior to radiotherapy. Radiography 2016;22:269e73.