Purpose: The purpose of this study is to identify the incidence of anxiety and distress among patients requiring immobilization during radiation therapy to the head and neck region; then to compare this with radiation therapists’ ability to identify anxiety in the same group of patients.

Materials and methods: Data from a sample of 70 patients requiring an immobilization mask participated in this study. Patient self-report assessments and radiation therapists’ ratings were recorded at two time points, CT-Simulation and fraction 1 of treatment. Self-reported patient anxiety was assessed with the Brief Symptom Inventory-18. To determine radiation therapists’ ratings of patient anxiety, two rating scales were developed.

Results: Patient self-report identified anxiety in 16% and 14% of patients at CT Simulation and fraction 1 of treatment, respectively. Radiation therapists identified anxiety in 24% patients at time point one and in 44% of patients at time point two.

Conclusion: There was slight agreement between patient self-reported levels of anxiety and radiation therapists’ ratings of patient anxiety. This study suggests that there is scope for further investigation into the identification and management of anxiety and distress in head and neck cancer patients requiring immobilization.