Uptake of vaccination in older Indian patients with cancer: A cross-sectional observational study

Background: Older patients with cancer are at a higher risk of invasive infections. Vaccination is an effective approach to decrease the mortality and morbidity associated with infections. Objective(s): Our primary objective was to evaluate the proportion of older patients with cancer who had received routine vaccinations against pneumococcal, influenza, and coronavirus disease 2019 (COVID-19). Our secondary objective was to identify the factors associated with vaccine uptake such as age, sex, education, marital status, comorbidities, and place of residence. Material(s) and Method(s): This cross-sectional observational study was conducted in the geriatric oncology outpatient clinic of the Department of Medical Oncology at the Tata Memorial Hospital, a tertiary care cancer hospital in Mumbai, India, from February 2020 to January 2023. We included all patients aged >=60 years who were evaluated in the geriatric oncology clinic during the study period and for whom the immunization details were available. The uptake of COVID-19 vaccine was calculated from March 2021 onwards, which was when the COVID-19 vaccine became available to patients aged >=60 years in India. Result(s): We enrolled 1762 patients;1342 (76.2%) were male. The mean age was 68.4 (SD, 5.8) years;795 (45%) patients were from the west zone of India. Only 12 (0.68%) patients had received the pneumococcal vaccine, and 13 (0.7%) had received the influenza vaccine. At least one dose of the COVID-19 vaccine had been taken by 1302 of 1562 patients (83.3%). On univariate logistic regression, education, marital status, geographic zone of residence, and primary tumor site were correlated with the uptake of COVID-19 vaccine. Factors associated with a greater COVID-19 vaccine uptake included education (up to Std 10 and higher vs. less than Std 10: Odds Ratio [OR], 1.46;95% confidence interval [CI], 1.07-1.99;P = 0.018, and illiterate vs. less than Std 10: OR, 0.70;95% CI, 0.50-0.99;P = 0.041), marital status (unmarried vs. married: OR, 0.27;95% CI, 0.08-1.08;P = 0.046, and widow/widower vs. married: OR, 0.67;95% CI, 0.48-0.94;P = 0.017), lung and gastrointestinal vs. head-and-neck primary tumors (lung cancer vs. head-and-neck cancer: OR, 1.60;95% CI, 1.02-2.47;P = 0.038, and gastrointestinal vs.head-and-neck cancer: OR, 2.18;95% CI, 1.37-3.42;P < 0.001), and place of residence (west zone vs. central India: OR, 0.34;95% CI, 0.13-0.75;P = 0.015). Conclusion(s): Fewer than 1 in 100 older Indian patients with cancer receive routine immunization with influenza and pneumococcal vaccines. Hearteningly, the uptake of COVID-19 vaccination in older Indian patients with cancer is over 80%, possibly due to the global recognition of its importance during the pandemic. Similar measures as those used to increase the uptake of COVID-19 vaccines during the pandemic may be beneficial to increase the uptake of routine vaccinations.Copyright © 2023 Cancer Research, Statistics, and Treatment.

COVID-19 vaccine uptake and vaccine hesitancy in Indian patients with cancer: A questionnaire-based survey

Background: Patients with cancer are at a higher risk of severe forms of coronavirus disease 2019 (COVID-19) and mortality. Therefore, widespread COVID-19 vaccination is required to attain herd immunity. Objective(s): We aimed to evaluate the uptake of the COVID-19 vaccine in Indian patients with cancer and to collect information regarding vaccine hesitancy and factors that contributed to vaccine hesitancy. Material(s) and Method(s): This was a questionnaire-based survey conducted between May 7, 2021 and June 10, 2021 in patients aged 45 years and over, with solid tumors. The primary end points of the study were the proportion of Indian patients with cancer aged 45 years and older who had not received the COVID-19 vaccine, and the reasons why these patients had not received the COVID-19 vaccine. Our secondary end points were the proportion of patients with a history of COVID-19 infection, and the proportion of the patients who had vaccine hesitancy. Additionally, we attempted to assess the factors that could impact vaccine hesitancy. Result(s): A total of 435 patients were included in the study. Of these, 348 (80%) patients had not received even a single dose of the COVID-19 vaccine;66 (15.2%) patients had received the first dose, and 21 (4.8%) had received both the doses. Approximately half (47.1%) of the patients reported that they took the COVID-19 vaccine based on the advice from a doctor. The reasons for not taking the COVID-19 vaccine could be considered as vaccine hesitancy in 259 (77%) patients. The two most common reasons were fear in 124 (38%) patients (fear of side-effects and of the impact of the vaccine on the cancer/therapy) and lack of information in 87 (26.7%) patients. On the multivariate analysis, the two factors found to be significantly associated with vaccine hesitancy were a lower educational level (OR, 1.78;95% CI, 1-3.17;P = 0.048) and a lack of prior advice regarding the COVID-19 vaccine (OR, 2.80;95% CI, 1.73-4.53;P < 0.001). Conclusion(s): Vaccine hesitancy is present in over half of our patients, and the most common reasons are a fear of the vaccine impacting the cancer therapy, fear of side-effects, and lack of information. Widespread vaccination can only be attained if systematic programs for education and dissemination of information regarding the safety and efficacy of the COVID-19 vaccine are given as much importance as fortification of the vaccination supply and distribution system.Copyright © 2021 Cancer Research, Statistics, and Treatment Published by Wolters Kluwer - Medknow.

Virtual multidisciplinary meetings in a new COVID-19 world: how well are we doing it?

Background: As of January 16, 2022, coronavirus disease 2019 (COVID-19) has caused over 323 million confirmed cases and over 5.5 million deaths worldwide. The pandemic necessitated a fast transition within healthcare services around the globe. The Head and Neck cancer multidisciplinary meeting (MDM) is a regular meeting involving diverse health professionals. In the heat of the pandemic, meetings were swiftly transitioned online to adhere to social distancing rules and ensure clinician compliance and safety. This qualitative paper explores the experience of an Australian Head and Neck MDM following the vital shift. In particular, the views on preparation, login, attendance, quality, patient outcomes, safety, and interpersonal relationships were considered. Methods: An online questionnaire, including Likert Scale and free text type questions, was created using Redcap. An anonymous survey link was emailed to 59 Head and Neck Unit members at the University Hospital Geelong. The questions evaluated thoughts on preparation, login, attendance, quality, clinician safety and interpersonal relationships on the current virtual MDM (vMDM) compared to face-to-face meetings. Responders included surgeons (19%), medical oncologists (4%), radiology oncologists (8%), junior medical staff (31%), allied health (8%), nursing staff (15%) and other (4%). Results: Many participants (62.3%) find it easier to attend the meeting. Concerning login, 95.9% of participants know where to find the login details for the meeting, and 100% of survey participants find the weekly invitation link adequate. Many participants felt that presentation preparation was not disrupted by moving to an online platform (72.7%). Almost half of the participants (45.9%) find it difficult to hear during meetings. Most respondents were satisfied with the quality of radiology imaging (75.0%) and pathology slides (91.2%). In addition, 65.2% of attendees feel less of an interpersonal relationship with colleagues since moving online. Regarding participant contribution, 47.8% feel it has not impacted their ability to contribute to the meeting, and 34.8% feel there has not been a change. Conclusions: The ongoing resurgence of COVID-19 will mean that virtual meetings will stay. This study demonstrates that our participants find the vMDM a positive move. We hope other units benefit from being cognisant of the identified issues and allow for the development of their own MDMs during this pandemic. © 2023 Universidad de Castilla la Mancha. All rights reserved.

Surgery of head, neck, and skull base tumours during the COVID-19 pandemic: single center experience

Purpose: The purpose of this study is to provide usable instructions on how to avoid delays in the diagnosis and treatment of head and neck tumors during COVID-19 pandemic. Material and methods: Major head and neck surgeries performed in our clinic between March 11, 2020 and March 11, 2022 were included in the study. All patients underwent polymerase chain reaction testing for COVID-19 24-48 hours before surgery. A total of 134 patients (110 men, 24 women) were operated. While malignant diagnosis was made in the pathological examination in 79 patients, the diagnosis of benign tumor was made in 55 of our patients. A total of 167 procedures were applied. Results: No COVID-19 related postoperative complications developed. Neck dissection was mostly performed in addition to the excision of the primary malignancy. Primary neck dissection was undertaken in six patients. Although most of the parotidectomy operations were performed for primary parotid masses, parotidectomy was required in addition to surgical excision in six patients due to primary skin tumors. Reconstruction was undertaken using free flaps in three patients. Local flaps were used for defect repair in other head and neck operations. Conclusions: With rigorous preoperative COVID-19 screening and isolation, head and neck surgical procedures can be continued to avoid delay in diagnosis and treatment without compromising the risk of transmission of COVID-19 to patients or healthcare workers. © 2023, Pamukkale University. All rights reserved.

Impact of the COVID-19 pandemic on the treatment of head and neck cancer in Brazil

Introduction: To restrict the spread of COVID-19 infection, billions of people around the world have been quarantined or in social isolation. As a result of these health public measures, only essential services were maintained. Outpatient consultations and non-urgent surgeries were suspended to reduce hospitalizations and the risk of contagion. This context resulted in a delay in the diagnosis of several diseases, including head and neck cancer (HNC). Objective(s): To assess the impact of the COVID-19 pandemic on the treatment of HNC, comparing the number of surgery and radiotherapy, and chemotherapy procedures carried out during the pre-pandemic and pandemic periods in Brazil. Material(s) and Method(s): We compared the mean number of HNC surgeries and the number of radiotherapy and chemotherapy procedures carried out during the pre-pandemic (from March to July 2015-2019) and pandemic period (from March to July 2020) in the five geographic regions of Brazil. Result(s): Between 2015 and 2019, the mean number of surgeries for HNC was 5410. In 2020, during the same period, there were 3522 surgeries, representing a 35% decrease during the pandemic period. The greatest decrease was observed in the Northern region (60.7%). The number of radiotherapy and chemotherapy procedures increased by 50,8% in the pandemic period, with a higher prevalence in the Northeast (75.1%). Conclusion(s): During the peak of the COVID-19 pandemic, the data demonstrate a likely change in the HNC treatment protocol in Brazil.

Evaluation of a remote monitoring app in head and neck cancer follow-up care.

BACKGROUND: A remote monitoring app was developed for head and neck cancer (HNC) follow-up during the SARS-CoV-2 pandemic. This mixed-methods study provides insight in the usability and patients' experiences with the app to develop recommendations for future use. METHODS: Patients were invited to participate if they were treated for HNC, used the app at least once and were in clinical follow-up. A subset was selected for semi-structured interviews through purposive sampling considering gender and age. This study was conducted between September 2021-May 2022 at a Dutch university medical center. RESULTS: 135 of the 216 invited patients completed the questionnaire, resulting in a total mHealth usability score of 4.72 (± 1.13) out of 7. Thirteen semi-structured interviews revealed 12 barriers and 11 facilitators. Most of them occurred at the level of the app itself. For example, patients received no feedback when all their answers were normal. The app made patients feel more responsible over their follow-up, but could not fulfill the need for personal contact with the attending physician. Patients felt that the app could replace some of the outpatient follow-up visits. CONCLUSIONS: Our app is user-friendly, makes patients feel more in control and remote monitoring can reduce the frequency of outpatient follow-up visits. The barriers that emerged must be resolved before the app can be used in regular HNC follow-up. Future studies should investigate the appropriate ratio of remote monitoring to outpatient follow-up visits and the cost-effectiveness of remote monitoring in oncology care on a larger scale.

The analysis of cathepsin L that mediates cellular SARS-CoV-2 infection leading to COVID-19 in head and neck squamous cell carcinoma.

The vulnerability of the oral cavity to SARS-CoV-2 infection is well-known, and cancer patients are at a higher risk of COVID-19, emphasizing the need to prioritize this patient population. Head and neck squamous cell carcinoma (HNSCC) is one of the most common malignant cancers associated with early metastasis and poor prognosis. It has been established that cancerous tissues express Cathepsin L (CTSL), a proteinase that regulates cancer progression and SARS-CoV-2 entry. Therefore, it is essential to evaluate the correlation between disease outcomes and CTSL expression in cancer tissues and predict the susceptibility of cancer patients to SARS-CoV-2. In this study, we used transcriptomic and genomic data to profile CTSL expression in HNSCC and developed a CTSL signature that could reflect the response of HNSCC patients to chemotherapy and immunotherapy. Additionally, we investigated the relationship between CTSL expression and immune cell infiltration and established CTSL as a potential carcinogenic factor for HNSCC patients. These findings could aid in understanding the mechanisms underlying the increased susceptibility of HNSCC patients to SARS-CoV-2 and contribute to the development of therapy for both HNSCC and COVID-19.

HPV+ Oropharyngeal Cancer in Waldenström Macroglobulinemia.

We present a case of squamous cell carcinoma (SCC) in the setting of Waldenström macroglobulinemia (WM). A 68-year-old male and daily marijuana smoker with recently diagnosed WM presented via telemedicine in 2020 for a progressively worsening sore throat and unintentional weight loss. Immunotherapy for WM was delayed due to the COVID-19 pandemic. In the clinic, examination revealed an indurated, tender midline mass at the base of the tongue, not limiting tongue mobility. The left level-II and right level-III lymph nodes were enlarged. The oropharyngeal lesion was biopsied, and pathology was consistent with human papillomavirus-positive (HPV+) SCC. Four cycles of concurrent chemotherapy and radiation for SCC were administered without delay, with an initial response. However, on surveillance, metastases to the brain and lungs were detected, and the patient was placed on palliative treatment as he did not meet eligibility for a clinical trial due to his WM. Concurrent WM and HPV+ SCC may have a worse prognosis, due to disease progression and reduced therapeutic options.

Returning to work: a qualitative study of the experiences of head and neck cancer survivors.

BACKGROUND: UK head and neck cancer incidence and prevalence in working-age people are increasing. Work is important for individuals and society. Head and neck cancer survivors return to work less than other cancer survivors. Treatment affects physical and psychological functioning long-term. Evidence is limited, with no UK qualitative studies. METHODS: A qualitative study was conducted, underpinned by a critical realism approach, involving semi-structured interviews with working head and neck cancer survivors. Interviews were conducted using the Microsoft Teams communication platform and interpreted using reflexive thematic analysis. RESULTS: Thirteen head and neck cancer survivors participated. Three themes were drawn from the data: changed meaning of work and identity, return-to-work experiences, and the impact of healthcare professionals on returning to work. Physical, speech and psychosocial changes affected workplace interactions, including stigmatising responses by work colleagues. CONCLUSION: Participants were challenged by returning to work. Work interactions and context influenced return-to-work success. Head and neck cancer survivors want return-to-work conversations within healthcare consultations, but perceived these as absent.

Fast-Tracking of Publication Times of Otolaryngology Papers During the COVID-19 Pandemic.

To study the impact of the COVID-19 pandemic on journal processing times before publication in the field of otolaryngology-head and neck surgery (ORL-HNS). Online search of original papers published in selected ORL-HNS journals in terms of times from submission to acceptance (S-A), acceptance to first online publication (A-P), and submission to online publication (S-P). Papers were divided into those published in the pre-COVID-19 era and those during the COVID-19 era. The latter were further divided into unrelated to COVID-19 and related to COVID-19. A total of 487 articles from 5 selected ORL-HNS journals were included, of which 236 (48.5%) were published during the pre-COVID-19 era and 251 (51.5%) were published during the COVID-19 era. Among them, 180 (37%) papers were not related to COVID-19, and 71 (14.5%) were related to COVID-19. The S-A duration of COVID-19-related articles was significantly shorter compared to papers submitted in the pre-COVID-19 era and to papers submitted in the COVID-19 era but unrelated to COVID-19 (median 6-34 days compared to 65-125 and 46-127, respectively) in all 5 journals. The most prominent reductions in S-A and S-P times were documented in the laryngology and otology/neurotology disciplines, respectively. Processing times of the included papers were significantly shorter in most of the selected ORL-HNS journals during the COVID-19 era compared to the pre-COVID-19 era. COVID-19-related papers were processed more rapidly than non-COVID-19-related papers. These findings testify to the possibility of markedly expediting S-P times and hopefully set a precedent for post-pandemic publishing schedules.

Surgical Lip Cancer Reconstruction in the COVID-19 Era: Are Free Flaps or Loco-Regional Flaps Better?

Lip carcinoma is one of the most frequent conditions affecting the general population. It is among the ten most common neoplasms, but despite advances in research and therapy, its prognosis has not improved in a significant way in the past few years, making it a challenge in the medical research field and in surgical treatment. This study was conducted with the aim of evaluating the available reconstructive surgical options for the treatment of lip carcinomas in order to define which could be the most appropriate technique to achieve satisfying aesthetic and functional outcomes considering hospital resources in the COVID-19 era. Seventeen patients were included in this retrospective study, which took place between January 2019 and April 2021. There were two groups: seven patients who underwent a radial forearm free flap and ten who underwent locoregional flaps. The statistical analysis was performed to evaluate four different endpoints. Surgical length, ICU stay, and hospitalization time were minor for locoregional flaps. There was no statistically significant difference between the two groups when considering post-operative complications. Locoregional flaps have a more aesthetically pleasing result, but from a functional point of view, the results can be superimposable. Both techniques are associated with adequate speech, mouth opening, sealing, and symmetry. Given the impact of the COVID-19 pandemic on the healthcare system, locoregional flaps have been proven to be a good surgical option in the reconstruction of lip defects both in terms of aesthetics and functional outcome. © 2023 by the authors.

Impact of Covid19 Infection in Patients with Cancer

Background: coronaviral pandemic (COVID-19) induced by severe acute coronaviral syndrome 2 has imminent consequences for COVID-19 patients. To determine the effect of this pandemic on oncological treatment, Netherlands cancer patients performed a national study . Method(s): From 11 April 2020 to 11 Jan 2021, the oncological care perspective was discussed by an online study. The survey included 20 questions on four topics: patient characteristics, hospital engagement, COVID-19 and COVID-19 problems. Result(s): A total of 2418 (64.53%) patients were female and the remainder (57.5%) were <50 years of age. The most prevalent cancer diagnosis were haematological malignancies (26.1%), breast cancer (22.8%) and other cancers (19.2%). Depending on their illness environment, 34.7% of patients had incurable conditions while 21.6% and 31.8% had curable or healed diseases. The (expected) result of their illness was 'unknown' for 11.9% of patients. According to outpatient environment, 1691 (45.1%) patients have been oncologically examined and have taken follow-up, contrasted with 529 (14.1%) and 1527 (40.8%) patients presently or pending for therapy. Conclusion(s): This is the first research exploring cancer patients' experiences after the COVID-19 pandemic in Iraq. The research indicates the major effect of COVID-19 on oncological treatment, showing the need for psycho-oncological assistance during this pandemic.Copyright © 2020 Ubiquity Press. All rights reserved.

Feasibility and safety of Heavy Lifting Strength Training in Head and Neck Cancer survivors post-surgical neck dissection (the LIFTING trial).

BACKGROUND: Light-to-moderate intensity strength training (LMST) improves muscular strength, physical functioning, and some side effects in head and neck cancer survivors (HNCS). Heavy lifting strength training (HLST) may further improve these outcomes; however, it has not been studied in HNCS. The primary aim of the LIFTING trial was to examine the feasibility and safety of a HLST program in HNCS ≥1-year post-surgical neck dissection. METHODS: In this single-arm feasibility study, HNCS were asked to complete a twice weekly, 12-week, supervised HLST program, gradually progressing to lifting heavy loads of 80-90% of 1 repetition maximum (1RM) for barbell squat, bench press, and deadlift. The feasibility outcomes included recruitment rate, 1RM completion rate, program adherence, barriers, and motivation. The preliminary efficacy outcomes included changes in upper and lower body strength. RESULTS: Nine HNCS were recruited over an 8-month period during the COVID-19 pandemic. All 9 (100%) completed the 1RM tests and successfully progressed to heavy loads at approximately 5 weeks. The median attendance was 95.8% (range 71-100%), and few barriers were reported. Weight lifted increased for squat/leg press (median change: +34kg; 95% CI +25 to +47), bench press (median change: +6kg; 95% CI +2 to +10), and deadlift (median change: +12kg; 95% CI +7 to +24). No adverse events were reported and participants were motivated to continue HLST after the study. CONCLUSIONS: HLST appears feasible and safe for HNCS and may result in meaningful improvements in muscular strength. Future research should consider additional recruitment strategies and compare HLST to LMST in this understudied survivor population. TRIAL REGISTRATION: NCT04554667.

The Great Contrast Shortage of 2022-Lessons learnt in Australia.

INTRODUCTION: Computed tomography (CT) imaging is one of the most commonly used diagnostic tools. Iodine-based contrast media (IBCM) are frequently administered intravenously to improve soft tissue contrast in a wide range of CT scans. Supply chain disruptions triggered by the SARS-CoV-19 pandemic led to a global shortage of IBCM in mid-2022. The purpose of this study was to explore the impact of this shortage on the delivery of healthcare in Western Australia. METHODS: We performed a single-centre retrospective analysis of the provision of CT studies, comparing historical patterns to the shortage period. We focussed our attention on the total number of CT scans (noncontrast CT [NCCT] and contrast-enhanced CT [CECT]) and also specifically CT pulmonary angiogram (CTPA) and CT neck angiogram with or without inclusion of circle of Willis (CTNA) examinations. We also examined whether a decrease was compensated by increasing frequency of alternate examinations such as ventilation/perfusion (V/Q) scans, carotid Doppler ultrasound studies and Magnetic Resonance Angiograms (MRAs). RESULTS: Since 2012, there has been an approximate linear increase in the frequency of CT examinations. During the period of contrast shortage, there was an abrupt drop-off by approximately 50% in the CECT, CTPA and CTNA groups compared with the preceding 6 weeks (49%, 55% and 44%, respectively, with P < 0.001 in all cases). During the contrast shortage, the frequency of V/Q scans increased fivefold (from 13 to 65; P < 0.001). However, the provision of carotid Doppler ultrasound studies and MRAs remained approximately stable in frequency across recent time intervals. CONCLUSION: Our findings demonstrate that the IBCM shortage crisis had a very significant impact on the delivery of healthcare. While V/Q scans could (partially) substitute for CTPA studies in suspected pulmonary emboli, there appeared to be no valid alternative for CTNA studies in stroke calls. The unexpected and critical shortage of IBCM forced healthcare professionals to conserve resources, prioritise indications, triage patients based on risk, explore alternate imaging strategies and prepare for similar events recurring in the future.

[Guiding opinion for infection protection in Ear & Nose & Throat Department during the outbreak of coronavirus disease].

It has been more than 2 months since the outbreak of coronavirus disease（COVID-19）. The Chinese Ear & Nose & Throat Department（ENT） health care workers are brave in defending against the disease. The COVID-19 patients without predominant symptoms may consult ENT doctors, even though the ENT department isn't thought first front of the battle. The ENT health care workers have high risks of exposing to the SARS-CoV-2 virus. This article gives some recommendations of infection prevention and control to ENT health care workers of the outpatient and inpatient department.

An Experience of Scalp Island Flap Based on the Posterior Branch of the Superficial Temporal Artery for Patients with Mucormycosis and Cancer.

To find out the utility of the scalp flap based on the posterior branch of the superficial temporal artery in patients with head and neck mucormycosis and malignancy. This was a multi-institutional observational study conducted at a tertiary cancer centre in North East India and a super-speciality hospital in Maharashtra from January 2021 to June 2021. Patients with malignancy and mucormycosis were only considered. In our study, we have seven patients (n = 7), two of them had mucormycosis and 5 had squamous cell carcinoma of the head and neck region. Out of the 5 cases of the head and neck malignancy, two cases were recurrent ones, another two cases where primary flap failed and in the last case, the patient was unfit for free tissue transfer due to cardiac issues. The mean age in the series was 50.42 years and the average duration of raising the flap was 22.86 min. Average hospital stays for head and neck cancer patients are 4.6 days and for mucormycosis patients, it is 22.5 days. No flap related complications were noted during the series. Scalp flap based on the posterior branch of the superficial temporal artery is a useful option in recurrent malignancy cases, in primary cases as a salvage option and in patients where long duration surgery is not possible due to poor general condition like in critical mucormycosis. Post-operative hair growth at the flap site and alopecia at the donor scalp are concerns and therefore, careful patient selection is a must.

Women Facing Head and Neck Cancer: Psychosocial Implications and Protective Factors

Background/Purpose: In the United States, 26% of newly diagnosed head and neck cancer (HNC) patients are women (Siegel et al., 2022). New cases have remained steady for 20 years, but the mortality rate has increased 1.9% per year. Currently, oral cavity and pharyngeal cancers have the second highest mortality rate of all cancers in women (www.seer.cancer.gov/report-to-nation/). This is alarming considering overall cancer mortality in women has dropped 1.4% (www.seer.cancer.gov/report-to-nation/). HNC disrupts the social, emotional, and physical lives of patients. The literature highlights such concerns as depression, problems with speech, eating, and body image, and social support needs (Bond et al., 2014;Hodges & Humphris, 2009;Locher et al., 2010;Maguire et al., 2017;Nund et al., 2015). The purpose of this study was to investigate the unique experience of being a woman with HNC. Problem: The psychosocial impact of HNC is documented in the literature;however, studies include few women and do not report results by sex. Method(s): Women were recruited from two academic medical centers in the Midwest. Participants were interviewed twice for 30-60 min each session. Most were interviewed using a virtual platform, with some in person or by phone. Each semi-structured interview was recorded and transcribed. Transcripts were analyzed using grounded theory techniques to identify themes. Result(s): This study included 10 women, with a mean age of 62.9 years. Several themes emerged, including physical and emotional impact of HNC, adjustment to life with cancer, coping and control, and support needs. Most surprisingly, this study found having HNC helped women feel prepared to navigate the Covid-19 pandemic. Topics included mask wearing, social interactions, family implications, societal views about illness, and feeling prepared. Conclusions and Implications: This study offers insights about the non-medical needs of women with head and neck cancer and provides some guidance on care provision.