Laryngeal and Hypopharyngeal Cancer: Follow-Up Care

Approved by the Cancer.Net Editorial Board, 09/2022

ON THIS PAGE: You will read about your medical care after cancer treatment is completed and why this follow-up care is important. Use the menu to see other pages.

Care for people diagnosed with laryngeal or hypopharyngeal cancer does not end when active treatment has finished. Your health care team will continue to check that the cancer has not come back, manage any side effects, and monitor your overall health. This is called follow-up care.

Your follow-up care may include regular physical examinations, medical tests, or both. Health care providers want to keep track of your recovery in the months and years ahead. 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, which is a new type of cancer that develops somewhere else in the body. These regular examinations can also help with the management of any late or long-term side effects from cancer treatment.

A common follow-up care 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 ongoing treatment.

Cancer rehabilitation may be recommended, and this could mean any of a wide range of services, such as physical therapy, occupational therapy, career counseling, pain management, nutritional planning, and/or emotional counseling. The goal of rehabilitation is to help people regain control over many aspects of their lives and remain as independent as possible. Learn more about cancer rehabilitation. 

Learn more about the importance of follow-up care.

Watching for recurrence

One goal of follow-up care is to check for a recurrence, which means that the cancer has come back. 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 health care provider familiar with your medical history can give you personalized information about your risk of recurrence. Your medical provider will ask specific questions about your health. Some people may have blood tests or imaging tests done as part of regular follow-up care, but testing recommendations depend on several factors, including the type and stage of cancer first diagnosed and the types of treatment given.

If a person uses tobacco, it is important to be monitored for possible second cancers that may occur in the lung, esophagus, and other locations in the head and neck, even without recurrence of the first cancer. Joining a clinical trial researching new ways to prevent these diseases may be an option.

The anticipation before having a follow-up test or waiting for test results may add stress to you or a family member. This is sometimes called “scanxiety.” Learn more about how to cope with this type of stress.

Managing long-term and late side effects

Most people expect to have 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. Other side effects called late effects may develop months or even years after treatment has ended. Long-term and late effects can include both physical and emotional changes.

Talk with your medical provider about your risk of developing such side effects based on your diagnosis, your individual treatment plan, and your overall health. If you had a treatment known to cause specific late effects, you may 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.

Cancer rehabilitation

Rehabilitation is a major part of follow-up care after treatment for head and neck cancer. However, people should meet with all rehabilitation specialists before their treatment begins. Following treatment, people may receive physical therapy to maintain range of movement and speech-language therapy to regain such skills as talking and swallowing. When the cancer treatment impairs swallowing, exercise plans can often be designed to strengthen and maintain the ability to eat and swallow. Many people who have been treated for head and neck cancer have difficulty eating. Listen to a podcast about managing eating challenges after treatment.

It is important that people receive early evaluation by a speech language 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. A registered dietitian may be helpful to consult.

Sometimes rehabilitation requires developing a new voice. Options include:

  • Esophageal speech. Some people can learn to use the throat muscles of the esophagus to produce sound. This is called esophageal speech.

  • Electrolarynx. Some people use a mechanical battery-powered device called an electrolarynx to speak. This device produces vibration that is transmitted through the tissues of the neck or is delivered into the mouth through a plastic tube to produce speech.

  • 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 before laryngectomy. A small, removable device, called a voice prosthesis, sits inside the stoma and allows air from the lungs to pass into the esophagus for sound production. The sound then travels into the mouth for speech.

Not every person is interested in or can learn all of these voice methods. It is important to meet with an experienced speech language pathologist before surgery to understand what rehabilitation will be needed and to select the best method or methods for the individual, if necessary.

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 discuss any concerns you have about your future physical or emotional health. ASCO offers forms to help keep track of the cancer treatment you received and develop a survivorship care plan when treatment is completed

This is also a good time to talk with your doctor about who will lead your follow-up care. Some survivors continue to see their oncologist, while others transition back to the care of their primary care 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 them and with 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. It describes how to cope with challenges in everyday life after a cancer diagnosis. Use the menu to choose a different section to read in this guide.