Laryngeal and Hypopharyngeal Cancer: After Treatment

Approved by the Cancer.Net Editorial Board, 04/2014

ON THIS PAGE: You will read about your medical care after cancer treatment is finished and why this follow-up care is important. To see other pages, use the menu on the side of your screen.

After treatment for laryngeal or hypopharyngeal cancer ends, talk with your doctor about developing a follow-up care plan. This plan may include regular physical examinations and/or medical tests to monitor your recovery for the coming months and years. ASCO offers cancer treatment summary forms to help keep track of the cancer treatment you received and develop a survivorship care plan once treatment is completed.

People recovering from laryngeal or hypopharyngeal cancer should receive regular follow-up medical and dental examinations to check for signs of recurring cancer or a second primary cancer (a new type of cancer somewhere else in the body), as well as to manage any late or long-term side effects from cancer treatment.

A common follow-up schedule for people after treatment for either of these types of cancer is every two months for the first year, every four months for the second year, every six months for the third year, and once a year after that. Diagnostic tests and examinations may be repeated to look for a recurrence or monitor the progress of current treatment. If radiation therapy was given, a person should have his or her thyroid function checked regularly. If a person uses tobacco, it is important to be monitored for possible second cancers in the lung, esophagus, and head and neck, even without recurrence of the initial cancer. Enrollment in clinical trials researching new ways to prevent these diseases may also be an option.

Rehabilitation is a major part of follow-up care after head and neck cancer treatment. However, people should meet with all rehabilitation specialists before their head and neck cancer treatment begins. Following treatment, people may receive physical therapy to maintain range of movement and speech therapy to regain skills, such as speech and swallowing. When the cancer treatment impairs swallowing, exercise plans can often be designed to strengthen and maintain the ability to eat and swallow. It is important that people receive early evaluation by a speech pathologist and other members of the health care team to start specific treatment programs and avoid later problems. Supportive care to manage symptoms and maintain nutrition during treatment may also be recommended. Some people may need to learn new ways to eat or prepare food.

Sometimes rehabilitation requires developing a new voice. After a total laryngectomy, some people can learn to use the esophagus to produce sound; this is called esophageal speech. Some people use an electronic battery-powered device called an electrolarynx that produces vibration that is transmitted through the tissues of the neck or delivered into the mouth via a plastic tube for speech production. A third method of voice rehabilitation, called tracheoesophageal (TE) voice restoration, is performed in many people who have had a laryngectomy. TE speech is similar to normal laryngeal speech because it uses air from the lungs to power speech production just as it did prior to laryngectomy. A small, removable prosthesis (artificial device) that sits inside the stoma allows air from the lungs to pass into the esophagus for sound production. The sound then travels into the mouth for speech.

People may look different, feel tired, and be unable to talk or eat the way they used to before treatment. People who have a tracheostomy need to learn how to take care of the stoma and keep it clean. Some people may experience depression. The health care team can help people adjust and connect them with both physical and emotional support services.

People recovering from laryngeal or hypopharyngeal cancer are also encouraged to follow established guidelines for good health, such as maintaining a healthy weight, not smoking, limiting alcohol, eating a balanced diet, and having recommended cancer screening tests. Talk with your doctor to develop a plan that is best for you needs. Moderate physical activity can help rebuild your strength and energy level. Your doctor can help you create an appropriate exercise plan based upon your needs, physical abilities, and fitness level. Learn more about the next steps to take in survivorship, including making positive lifestyle changes.

The next section offers a list of questions you may want to ask. Use the menu on the side of your screen to select Questions to Ask the Doctor, or you can select another section, to continue reading this guide.