Cancer clinical nurse specialists develop a unique relationship with patients. The use of expert decision-making and clinical judgement skills ensures that patients are supported and well informed before starting treatment. However, providing this support requires specialised empirical knowledge as well as experience and intuition. Practising in the field of head and neck cancer is challenging and rewarding, despite the high mortality and recurrence rate. This article illustrates the processes that are required to provide psychological, physiological and sociological care of patients with head and neck cancer.