title: Living an everyday life with head and neck cancer 2-2.5 years post-diagnosis - A qualitative prospective study of 56 patients.
abstract: BACKGROUND
  There are many studies available describing how patients are affected by head and neck cancer (HNC) and its treatment. Usually these studies are quantitative and focus on assessing patients' quality of life or distress post-treatment. These studies are important, but they are of limited value if we are interested in understanding more about HNC in an everyday life context.
  
  
  OBJECTIVE
  The purpose was to determine how life was lived and valued during and after treatment for HNC and to detect different transitions in returning to everyday life.
  
  
  METHODS
  During 2009-2012, 56 patients with HNC were consecutively included, and interviewed at 6, 12, and 24 months post-treatment about how they lived their lives. All patients received primary treatment at a tertiary referral university hospital in Sweden.
  
  
  RESULTS
  Four different trajectories and transitions emerged. The first group (n = 15) evaluated their illness experience as a past parenthesis in their life suggesting that they had psychologically left the illness behind. In the second group (n = 9), the impact of the disease seemed to be diluted by other strains in their life, and although these patients to some extent were still hampered by side effects, they regarded them as 'no big deal'. The cancer really made a difference in the third group (n = 12) in both positive and negative ways and seemed to reflect a balance between such effects. In the fourth group (n = 20), the physical and/or psychological problems predominated and the patients' lives had changed for the worse.
  
  
  CONCLUSIONS
  The narratives showed that being afflicted by HNC has different impacts depending on how the patients live their lives - it is a matter of individual transition in an everyday life context. This idiosyncrasy challenges the meaningfulness of screening efforts to identify vulnerable groups for psychosocial intervention.
authors.affiliation: Department of Social Work, Umeå University, 901 87, Umeå, Sweden. Electronic address: joakim.isaksson@umu.se.
authors.forename: Joakim
authors.initials: J
authors.lastname: Isaksson
authors.affiliation: Department of Social Work, Umeå University, 901 87, Umeå, Sweden. Electronic address: par.salander@umu.se.
authors.forename: Pär
authors.initials: P
authors.lastname: Salander
authors.affiliation: Department of Social Work, Umeå University, 901 87, Umeå, Sweden; Department of Radiation Sciences - Oncology, Umeå University, 901 87, Umeå, Sweden. Electronic address: sara.lilliehorn@umu.se.
authors.forename: Sara
authors.initials: S
authors.lastname: Lilliehorn
authors.affiliation: Department of Surgical Sciences, Otorhinolaryngology and Head & Neck Surgery, Uppsala University, 751 85, Uppsala, Sweden. Electronic address: goran.laurell@surgsci.uu.se.
authors.forename: Göran
authors.initials: G
authors.lastname: Laurell
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000368:Aged; D005260:Female; D006258:Head and Neck Neoplasms / Q000523:psychology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D036301:Qualitative Research; D013548:Sweden; D013997:Time Factors
keywords: Everyday life; Head and neck cancer; Prospective; Qualitative study; Trajectory