Qualitative study of process in daily life of patients with larynx/pharyngeal cancer before total laryngectomy

Abstract Background: Many patients with larynx/pharyngeal cancer only become aware of the disease in an advanced stage due to hoarseness and a strange feeling upon swallowing. The aim of this study was to discuss what kinds of support are required for these patients by clarifying the process in their daily life prior to total laryngectomy.Methods: A qualitative study was performed using the Modified Grounded Theory Approach in patients with larynx/pharyngeal cancer before total laryngectomy. In a semi-structured interview, patients were asked to talk freely about their health conditions, problems, and anxieties. Information on age, sex, family members living with the patient, occupation, diagnosis, staging, and subjective symptoms was also obtained in the interview. Results: The analysis theme of “How do cancer patients live before surgery?” had a storyline centered on {surviving surgery}. The patients had a [strange feeling] caused by a sense of a lump in the throat and pain of hoarseness, as well as [unexperienced anxiety] for their first experience of hospitalization and surgery. The core category and the two categories interacted with each other and recurred. [Unexperienced anxiety] was related to [cannot imagine] daily life after hospital discharge, and transitioned to [not knowing what will happen after surgery] until the time comes. The core category of {surviving surgery} and the three categories interacted with each other and recurred. The patients also had a positive mindset of [having a purpose in life after hospital discharge] and were [looking for positives] at that time, while making a [request of support from physicians] to improve their [strange feeling]. Quality of life (QOL) prior to laryngectomy is influenced by negative mental and physical feelings caused by cancer and by anxieties about postoperative life, but with hope for social support.Conclusions: Patients experience a “transition” before total laryngectomy, and at this turning point they try to think positively about surviving the surgery, but also feel loneliness, fear, and anxiety. These findings suggest the need for a healthcare team approach for pre- and postoperative support by staying close to a patient, even after hospital discharge.