Body image distress in head and neck cancer patients: what are we looking at?

H. C. Melissant, F. Jansen*, S. E. Eerenstein, P. Cuijpers, E. Laan, B. I. Lissenberg-Witte, A. S. Schuit, K. A. Sherman, C. R. Leemans, I. M. Verdonck-de Leeuw

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

20 Citations (Scopus)
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Purpose: The aim of the present study is to investigate the prevalence of body image distress among head and neck cancer (HNC) patients after treatment and to examine its association with sociodemographic and clinical factors, health-related quality of life (HRQOL), HNC symptoms, sexuality, self-compassion, and psychological distress. Second, we aim to explore daily life experiences of HNC patients regarding body image. Methods: A cross-sectional survey among HNC patients investigated the prevalence of body image distress based on the Body Image Scale. Multivariable logistic regression analysis was applied to study associations with sociodemographic and clinical factors, HRQOL (EORTC QLQ-C30), HNC symptoms (QLQ-HN43), sexuality (FSFI-6; IIEF-5), self-compassion (SCS-SF), and psychological distress (HADS). Qualitative data from a body image writing intervention was used to explore experiences in daily life related to body image. Results: Body image distress was prevalent in 13–20% (depending on cut-off scores) of 233 HNC patients. Symptoms of depression (p < 0.001), younger age (p < 0.001), problems with social contact (p = 0.001), problems with wound healing (p = 0.013), and larger extent of surgery (p = 0.014) were associated with having body image distress. This model explained 67% of variance. Writing interventions of 40 HNC patients showed that negative body image experiences were related to appearance and function, with social functioning problems described most often. Conclusion: Prevalence of body image distress in HNC patients, using different cut-off scores, is 13–20%. Younger patients, patients after extensive surgery, and patients who had wound healing problems are most at risk. There is a significant association between body image distress and depressive symptoms and social functioning.

Original languageEnglish
Pages (from-to)2161–2169
Number of pages9
JournalSupportive Care in Cancer
Issue number4
Early online date3 Sep 2020
Publication statusPublished - Apr 2021

Bibliographical note

Copyright the Author(s) 2020. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


  • body image
  • health-related quality of life
  • head and neck cancer
  • depression
  • psychological distress
  • prevalence


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