167 9 large tumor are at risk (disease stage III and IV). In addition, patients with a tumor in the oral cavity and oropharynx, and patients receiving chemoradiation or surgery followed by radiotherapy or chemoradiation experienced the most problems after treatment. This subscale is mainly influenced by masticatory processes in the mouth, that need to break down the food into small enough particles ready to be swallowed.21 The mixing ability test explored in chapter 4 and 6 is only one part of these processes, in which the food is transported and mixed between the teeth. Besides mixing, saliva is needed to break down the food and moisten it, and the swallowing process needs to start. It was remarkable that only the subscale eating duration did not return to baseline levels after treatment, while all other subscales did (general burden, food selection, eating desire, fear of eating, mental health, social functioning, and symptoms). One possible explanation could be that this subscale is the most notable for patients, especially when comparing their eating duration to other people. For example, it can be confronting when patients dine out and find their companions finish their plate much faster than they do. HNC survivors may require specially prepared food and/or use compensatory strategies to facilitate safe swallowing, which may limit their ability and wish to dine out.22 Other subscales might be less notable or are easier to adjust to, possibly because of coping strategies and/or response shift of patients after treatment.8,23 Swallowing exercises by a speech therapist can be provided during the course of (chemo) radiation treatment, where promising results were found.24 These exercises are designed to improve swallowing safety, for example by reducing penetration or aspiration, and by increasing the efficiency of swallowing.25 As found in chapter 7, especially older patients, and patients that received extensive surgery involving, e.g., the tongue, base of tongue or larynx may benefit from these swallowing exercises. These exercises can prevent dysphagia, or reduce its severity.26 Older patients are at a higher risk of aspiration due to a decrease in mastication and swallowing function, in which swallowing exercises may help maintain or improve oral function.27-29 These proactive exercises may also lead to superior swallowing related QoL, better tongue base and epiglottic movement, lower rates of percutaneous endoscopic gastrostomy (PEG) placement, and an improved diet after treatment.30 Besides rehabilitation focused on mastication and swallowing, patients may also benefit from physical therapy such as lymphatic drainage, massages, exercises, education, and compression therapy in order to improve tiredness, depression, anxiety, and overall wellbeing.19 As also seen in chapter 8, patients that smoke and patients that lose weight before and during treatment, are at a higher risk to develop problems. Smoking cessation is not only important for improved survival and lower disease recurrence, but also for