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Table 3 Overview of signs and symptoms experienced by patients prior to treatment

From: Patients’ experience of recurrent/metastatic head and neck squamous cell carcinoma and their perspective on the EORTC QLQ-C30 and QLQ-H&N35 questionnaires: a qualitative study

Symptom

Reported

Example quote

S

P

Total

Lumps; head/neck

6

 

6

“Basically when I was first diagnosed I had a lump on my neck, on my right hand side of my neck. I noticed it for maybe two months, it did not bother me, did not hurt.” (01–06-M-57)

Difficulty/difference in swallowing

3

 

3

“I first had a… noticed a difference in my swallow... it was something that was different.” (01–04-M-59)

Pain

1

1

2

”.. my mouth it would hurt and I knew there was something wrong.” (01–07-F-66)

Swollen lymph nodes (neck)

2

 

2

• “…nothing else other than the visible swelling of the lymph nodes and no pain, nothing else.” (01–03-M-55)

Tongue ulcer

1

 

1

“Initially I had a sore on my tongue that didn’t heal so I was sent to an oral surgeon and then an ear, nose and throat doctor.” (01–14-F-61)

Weight loss

 

2

2

“I started losing weight but not a lot at that time... I’m watching my weight go down and going okay but it wasn’t going down that much.” (01–07-F-66)

Change in voice

 

1

1

“That would be going back to like a raspy throat like what I had prior to being diagnosed, I had this… It would seem like my mouth was raspy and noticeably kind of different pitched.” (01–09-M-66)

Cough

1

 

1

• “I started to get a little more noticeable that I kept clearing my throat and coughing a little bit and so I decided to go to the doctor’s thinking maybe there was an infection or something of that nature.” (01–09-M-66)

Dry/peeling skin on the neck

 

1

1

“It felt like when you go swimming and your skin dries out, that’s how my neck was feeling, every two or three days or something like that.” (01–10-M-35)

Eating less

 

1

1

“I told him I used to be somewhat hungry all three times of the day, but it’s shifted now to only two times of the day.” (01–10-M-35)

Hearing problems

1

 

1

“I was having hearing problems…so I went to an ENT. He ran some tests on me and then he said we have a problem, we’re going to drill up and do a biopsy, and that’s when they found I have a nasopharynx tumour.” (01–13-F-62)

Impact on range of movement

 

1

1

“So my hands were throwing to a certain direction, but my eyes or my face wouldn’t turn in that direction, just because of the neck drying out, slowing up, stiffen up.” (01–10-M-35)

Tiredness

 

1

1

“I said I felt like I was getting enough sleep, but I still feel a little tired.” (01–10-M-35)

  1. Abbreviations: P reported when prompted, S reported spontaneously