Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Pay It Forward: Carers' perspectives of a novel peer to peer support initiative for individuals receiving treatment for head and neck cancer. (146018)

Matthew Mason 1 2 3 , Justin Roe 4 5 , Rosemary Brezmen 1 , Cassandra White 3 6 , Claire Jeans 1 , Christine Paul 2 3
  1. Genesiscare Newcastle, Gateshead, NSW, Australia
  2. School of Medicine and Public Health College of Health, Medicine and Wellbeing, University of Newcastle, NEWCASTLE, NSW, Australia
  3. Hunter Medical Research Institute, Newcastle, NSW, Australia
  4. Department of Surgery and Cancer, Imperial College, London, United Kingdom
  5. Department of Speech, Voice and Swallowing , The Royal Marsden NHS Foundation Trust, London, United Kingdom
  6. Department of Medical Oncology, Maitland Public Hospital, Metford, NSW, Australia

Aims: Pay It Forward is an anonymous peer-to-peer support initiative in which individuals undergoing chemoradiotherapy for Head and Neck Cancer receive a handwritten card from someone who has completed the same treatment. On recovery they write a card for a future patient. A pilot study has reported the initiative's benefits to individuals during and after treatment1. This study describes the carer's perspective.

Methods: Single centre prospective study using convenience sampling within the Pay It Forward study. Individual semi-structured interviews were conducted and analysed using inductive thematic analysis with open ended coding.

Results: Of the thirteen patients recruited to the study, eight carers agreed to participate. Interviews lasted a mean of 15 minutes. Preliminary analysis identified two main themes. 1) Emotional and psychological impact: The card consistently elicited strong, positive emotional responses. One carer described its effect vividly: "I just loved it. It was just like wings on my heels. I was so encouraged." Carers reported feelings of hope, reassurance, and reduced isolation for both patient and carer. The initiative was seen as validating the experience of both parties, as one carer explained: "It validated my emotional journey… It's a hard journey." The credibility of peer-to-peer support was particularly valued, offering a sense of "virtual kinship" that friends and family could not replicate. 2) Communication and reflection: The card prompted patients to open up to their carers, which was felt to strengthen the couple or family unit. Carers reported the act of writing by the patient as therapeutic, encouraging reflection and helping articulate feelings they might not otherwise have expressed.

Conclusion: Carers’ perspective about Pay It Forward suggest this initiative may have psychological benefits which extend beyond the individual receiving treatment, offering hope, validation and connection. Unmet carer support needs were highlighted, and development of a carer-specific card is under consideration.

  1. Mason, M., Roe, J., Paul, C. et al. Pay It Forward: Analysis of a novel peer-to-peer support initiative for individuals receiving treatment for head and neck cancer. Support Care Cancer 34, 556 (2026). https://doi.org/10.1007/s00520-026-10776-x