Title: "Women's Experiences of Head and Neck Cancer: An Interpretative Phenomenological
Analysis"
Version: 3 Date: 03 Feb 2025
Reviewer's report:
Dear Authors.
Firstly thank you for submitting this paper, this research is so important in gaining a better
understanding of women's experiences of head and neck cancer. Your research will add great
value to the specific issues that women face when diagnosed with this challenging disease. I
do however, have some issues with this paper that need consideration to help to follow the
methodology and the findings.
Background
Your background is very well written with some excellent authoritarian evidence used to support
your argument for the value of this research.
Methods
From a methodological perspective I found the section very hard to follow,  it seemed to discuss
data analysis, then data collection, then analysis, then participants then back to analysis. The
checklist sits under 'Researcher's Stance' but really should be upfront. 'Researcher's Stance' is
probably better termed 'Reflexivity' and should be with the discussion about the IPA and why
reflexivity is used with this type of analysis. I wonder if using clearer signage/subheadings would
help guide the flow.
While I agree that IPA is an appropriate analysis technique for this study more information could
be given as to why this method of meaning making is so important. I think also for the reader
to really see the deep understanding you have gained of your participants more information is
needed about each participant. The chart supplied tells us very little about them - I am unsure
of the relevance of study level. To me the characteristics should tell us who they are as a person
and  what type of HNC they have, the stage of disease, the treatment.
Findings
The findings were interesting and showed a progression through the participants cancer and
their response to diagnosis, treatment and beyond. Interestingly many of the discussions about
treatment and the effects were not related to surgery at all - making the title of this paper
somewhat misleading, this is where I think that having more information about participants is
essential. The meaning making was often about reconciling toxicities related to chemotherapy
and or radiation therapy (in many countries these modalities are done instead of surgery), others
are talking about the consequences and importance of reconstruction surgery. However there is
little in the finding about definitive surgery for head and neck cancer - which your title suggests
is the focus of this paper. It is important to consider if this is more an exploration of women
with H&N Cancer in general.
Discussion
Your discussion highlights important points, but needs revision as there are paragraphs that
don't seem finished and some sections that don't link such as discussion about advanced disease
diagnosis and its relevance to meaning making.
Editorial issues
Avoid dot points - these sections in the analysis steps and themes should be written in paragraphs
Table 2 could just be supplementary - not needed in qualitative paper.
The use of the term 'announcement of cancer' is not a term that would commonly be used.
Normally we would say when someone is given their diagnosis - this may be a translation issue,
but needs revision in both the findings and the discussion.
Best wishes