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 head and neck 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. Doctors want to keep track of your recovery in the months and years ahead.
Cancer rehabilitation may be recommended (see "Rehabilitation," below), 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 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. If it occurs, cancer recurrence most commonly happens within the first 2 or 3 years after diagnosis, so follow-up visits will be more frequent during the first 2 to 3 years.
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 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. Diagnostic examinations, such as CT scans, may be needed to watch for any signs of recurrence or to monitor how well the current treatment is working.
The anticipation before having a follow-up test or waiting for test results can 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 doctor 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.
Rehabilitation is a major part of follow-up care after head and neck cancer treatment. People may receive physical therapy and speech therapy to regain skills, such as talking and swallowing. Some people may need to learn new ways to eat or adjust to eating foods that have been prepared differently. Palliative care to manage symptoms and maintain nutrition during and after treatment may be recommended. Listen to a podcast about managing eating challenges after treatment.
After surgery, a prosthodontist can help with the restoration and rehabilitation of any oral cavity structures that were removed during surgery. Rehabilitation of physical changes resulting from a maxillectomy often requires a prosthesis. Many times when a maxillectomy is done, fluid will accumulate in the middle ear on the side of surgery. Surgery to the eardrum, called a myringotomy, to drain this fluid may be required.
Frequently, especially after craniofacial surgical resection, people will lose their sense of smell, called anosmia. It is important for these people to receive special coping strategies to adapt to this change, especially around the house and work area, in case of chemical spills, smoke from a fire, and other potentially harmful situations.
Prevention of tooth decay with fluoride treatments is very important to avoid losing existing teeth. Special eye care may also be necessary. If an eye was removed, rehabilitative services can help you cope with vision loss.
People who have received radiation therapy should protect the skin that received treatment from the sun. If radiation therapy included the neck, the thyroid gland should be regularly checked with blood tests.
People who have received treatment for nasal cavity or paranasal sinus cancer may look different, feel tired, and be unable to talk or eat the way they did before treatment. Many people experience depression. The health care team can help people cope with these physical and emotional changes and connect them with support services. Support groups may help people cope with changes following treatment.
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.