Laryngeal and Hypopharyngeal Cancer: Follow-Up Care

Approved by the Cancer.Net Editorial Board, 10/2015

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

Care for people diagnosed with cancer doesn’t end when active treatment has finished. Your health care team will continue to check to make sure the cancer has not returned, manage any side effects, and monitor your overall health. This is called follow-up care.

This plan may include regular physical examinations and/or medical tests to monitor your recovery for the coming months and years. 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 2 months for the first year, every 4 months for the second year, every 6 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.

Watching for recurrence

One goal of follow-up care is to check for a recurrence. Cancer recurs because small areas of cancer cells may remain undetected in the body. Over time, these cells may increase in number until they show up on test results or cause signs or symptoms. During follow-up care, a doctor familiar with your medical history can give you personalized information about your risk of recurrence. Your doctor will also ask specific questions about your health. Some people may have blood tests or imaging tests as part of regular follow-up care, but testing recommendations depend on several factors including the type and stage of cancer originally diagnosed and the types of treatment given.

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. Joining a clinical trial researching new ways to prevent these diseases may also be an option.

Managing long-term and late side effects

Most people expect to experience side effects when receiving treatment. However, it is often surprising to survivors that some side effects may linger beyond the treatment period. These are called long-term side effects. In addition, other side effects called late effects may develop months or even years afterwards. Long-term and late effects can include both physical and emotional changes.

Talk with your doctor about your risk of developing such side effects based on the type of cancer, your individual treatment plan, and your overall health. If you had a treatment known to cause specific late effects, you may also have certain physical examinations, scans, or blood tests to help find and manage them. For example, people who had radiation therapy should have their thyroid function checked regularly.

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. Options include:

  • Esophageal speech. After a total laryngectomy, some people can learn to use the esophagus to produce sound. This is called esophageal speech.

  • Electrolarynx. 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.

  • Tracheoesophageal (TE) voice restoration. TE voice restoration is used by many people after 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.

Keeping personal health records

You and your doctor should work together to develop a personalized follow-up care plan. Be sure to ask about any concerns you have about your future physical or emotional health. ASCO offers forms to help create a treatment summary to keep track of the cancer treatment you received and develop a survivorship care plan once treatment is completed.

This is also a good time to decide who will lead your follow-up care. Some survivors continue to see their oncologist, while others transition back to the general care of their family doctor or another health care professional. This decision depends on several factors, including the type and stage of cancer, side effects, health insurance rules, and your personal preferences.

If a doctor who was not directly involved in your cancer care will lead your follow-up care, be sure to share your cancer treatment summary and survivorship care plan forms with him or her, as well as all future health care providers. Details about your cancer treatment are very valuable to the health care professionals who will care for you throughout your lifetime.

The next section in this guide is Survivorship, and it describes how to cope with challenges in everyday life after a cancer diagnosis. Or, use the menu on the side of your screen to choose another section to continue reading this guide.