ObjectiveEmotions, are in part conveyed by varying levels of fundamental frequency of voice pitch (f0). This study tests the hypothesis that patients display heightened levels of emotional arousal (f0) during Verona Coding Definitions of Emotional Sequences (VR-CoDES) cues and concerns versus during neutral statements. MethodsThe audio recordings of sixteen head and neck cancer survivors’ follow-up consultations were coded for patients’ emotional distress. Pitch (f0) of coded cues and concerns, including neutral statements was extracted. These were compared using a hierarchical linear model, nested for patient and pitch range, controlling for statement speech length. Utterance content was also explored. ResultsClustering by patient explained 30% of the variance in utterances f0. Cues and concerns were on average 13.07Hz higher than neutral statements (p=0.02). Cues and concerns in these consultations contained content with a high proportion of recurrence fears. ConclusionThe present study highlights the benefits and challenges of adding f0 and potential other prosodic features to the toolkit of coding emotional distress in the health communication setting. Practice implicationsThe assessment of f0 during clinical conversations can provide additional information for research into emotional expression.