Journal of Cancer Survivorship

, Volume 13, Issue 5, pp 792–803 | Cite as

To eat is to practice—managing eating problems after head and neck cancer

  • Marianne Boll KristensenEmail author
  • Tina Broby Mikkelsen
  • Anne Marie Beck
  • Ann-Dorthe Zwisler
  • Irene Wessel
  • Karin B. Dieperink



The purpose of this qualitative study was twofold: (1) to explore head and neck cancer (HNC) survivors’ experiences of everyday life with eating problems after cancer treatment and (2) to explore their experiences of participating in a multidisciplinary residential rehabilitation program with a primary focus on physical, psychological, and social aspects of eating problems after treatment.


Semi-structured focus group interviews were conducted with 40 Danish HNC survivors who participated in a 5-day residential rehabilitation program with follow-up after 3 months. The transcribed interviews were analyzed through qualitative content analysis.


Physical nutrition impact symptoms and unmet needs for support were frequent. Participants experienced a feeling of loss due to impaired eating abilities. Eating had become an obligation or a training situation, and the eating problems challenged the relationship with their relatives when well-meaning encouragement was perceived as a pressure. Social eating was a challenge, and this often led to social withdrawal. The residential program was a safe and supportive environment to practice eating skills, and participants benefited from meeting peers. The program provided participants with knowledge and skills that many of them had been missing during and after treatment.


Eating problems after treatment have substantial effects on the everyday life of HNC survivors. A multidisciplinary residential rehabilitation program may be beneficial to meet their rehabilitation needs.

Implications for Cancer Survivors

The results are useful for future planning of rehabilitation services and clinical studies that may contribute to improving current clinical practice and benefit HNC survivors.


Head and neck cancer Survivorship Rehabilitation Nutrition impact symptoms Eating problems Quality of life 



Head and neck cancer


Nutrition impact symptoms


Quality of life



We wish to thank all study participants for their valuable contributions. Furthermore, we wish to thank the health care professionals and other staff at RcDallund and REHPA who delivered the targeted residential rehabilitation program. Finally, we thank Vicky L. Joshi, MSc, for proofreading the manuscript.

Funding information

This study received external funding from Innovation Fund Denmark (grant no. 6171-00009B) and from Rigshospitalet’s and Odense University Hospital’s research fund for research collaboration between the two hospitals (grant no. 38-A2016).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

11764_2019_798_MOESM1_ESM.docx (24 kb)
ESM 1 (DOCX 23 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Nursing and NutritionUniversity College CopenhagenCopenhagen NDenmark
  2. 2.REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative CareOdense University Hospital and Department of Clinical Research, University of Southern DenmarkNyborgDenmark
  3. 3.OPEN, Odense Patient data Explorative NetworkOdense University HospitalOdense CDenmark
  4. 4.Dietetics and Clinical Nutrition Research UnitHerlev and Gentofte HospitalHerlevDenmark
  5. 5.Department of Otorhinolaryngology, Head and Neck Surgery and AudiologyRigshospitaletCopenhagen ØDenmark
  6. 6.Research Unit of Oncology, Department of OncologyOdense University HospitalOdense CDenmark
  7. 7.Department of Clinical ResearchUniversity of Southern DenmarkOdense CDenmark

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