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Mapping the radiotherapy journey of patients with head and neck cancer: A qualitative study
Shuang Yang1, Shupei Wang1, Mengyue Han1
1Department of Radiation Oncology, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.
Objective:
To explore the multidimensional challenges and unmet care needs across the radiotherapy trajectory of patients with head and neck cancer (HNC) using a patient journey map, and to identify key intervention nodes, providing a basis for improving clinical management and patients' well-being.
Methods:
A descriptive qualitative research design was employed, and semi-structured in-depth interviews were conducted with 18 patients with HNC receiving radiotherapy in the Department of Radiation Oncology at Tianjin Medical University Cancer Institute & Hospital in Tianjin, China, between September and December 2025. Data were analyzed using Colaizzi's seven-step method, and a patient journey map was constructed for visualization.
Results:
Four themes were identified: (1) Physiological Trajectory of Suffering Accompanying Cumulative Toxicity Challenges, transitioning from latent early discomforts to severe prolonged symptom burdens; (2) Psychological Trajectory Intertwined with Cognitive Biases and Emotional Fluctuations, characterized by early expectancy violations, mid-term treatment burnout, and late-stage fear of recurrence; (3) Self-Identity Disruption and Social Withdrawal Precipitated by Altered Facial Appearance and Oral Feeding Dysfunction, highlighting how disrupted "social commensality" and body image disturbances lead to social isolation; and (4) Dynamic Evolution of Multidimensional Needs and Transitional Care Discontinuity, shifting from early information overload to a critical need for continuity of care post-discharge.
Conclusions:
The needs of patients with HNC during radiotherapy exhibit a complex, non-linear evolution. Future efforts should establish a phased, precision nursing model centered on "cognitive correction-crisis intervention-continuity empowerment." Integrating digital intervention technologies with peer support strategies may help address symptom burdens and social reintegration barriers, supporting high-quality care across the radiotherapy trajectory and improving patients' quality of life.
