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Patients' ability to participate in activity and recreation is an important facet of health-related quality of life (HRQOL) outcomes following head and neck cancer (HNC). These two domains are included in the University of Washington Quality of Life questionnaire (UW-QOL). The aim of this study was to analyse patients' responses to the activity and recreation domains of the UW-QOL questionnaire, relating this to clinical characteristics and intensity of leisure time exercise per week, perceived exercise interference barriers, and feeling able to participate in an exercise programme. The questionnaires comprised the Godin Leisure Time Exercise Questionnaire, the Perceived Exercise Barriers Questionnaire and the Exercise Preferences Questionnaire. The survey sample comprised 1021 HNC patients with a response rate of 43% (437). 9% reported a significant problem with activity and 8% with recreation. The main influencing factors were site (oropharynx), advanced stage, radiotherapy and chemotherapy, composite flap, gastrostomy tube, and comorbidity. There was an association between patients reporting less time and intensity on exercise, more barriers, and less preference to exercise with lower (worse) scores in UW-QOL activity and recreation. The use of UW-QOL in follow-up assessments can help to identify those patients who are having notable difficulties with activity and recreation and this also reflects their perception of being able to participate in an exercise programme. Further research is required to optimise interventions aimed at promoting these aspects in order to improve post treatment recovery and well-being. Kind regards Simon The importance of activity and recreation in quality of life following head and neck cancer

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Acute orofacial pain in the head and neck region is a common complaint; however it can be a diagnostic challenge due to the anatomical complexities in this region, sometimes making the origin of pain difficult to source. Accurate diagnosis relies on a systematic evaluation of the patient's pain history, medical factors and clinical signs and symptoms. An assessment of the patient's cervical musculoskeletal system is often overlooked but can provide important diagnostic information.