Nasopharyngeal Cancer: Follow-Up Care

Approved by the Cancer.Net Editorial Board, 06/2022

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 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, 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.

People may receive physical therapy and speech therapy to regain skills, such as speaking and swallowing. Supportive care to manage symptoms and maintain nutrition during and after treatment may be recommended. Some people may need to learn new ways to eat or prepare foods differently. People may look different, feel tired, and be unable to talk or eat the way they used to. Many people experience depression. The health care team can help people adjust and connect them with both physical and emotional support services. Learn more about cancer rehabilitation.

Learn more about the importance of follow-up care.

Watching for recurrence or second cancers

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 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.

People treated for NPC should receive regular follow-up medical and dental examinations to check for signs that the NPC has come back or a second cancer (a different type of cancer) has developed. Your doctor may also recommend an MRI or CT scan 6 to 8 weeks after treatment, called a baseline study. If NPC comes back, the baseline study will help the doctors track when the changes began. When they occur, most recurrences of NPC happen within the first 2 to 3 years after treatment, so follow-up visits will be more frequent during those years.

People who have had NPC have a higher risk of developing a second cancer. Researchers are evaluating the benefits of using chemotherapy as a way to prevent a second cancer from developing. This is called chemoprevention.

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 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.

For NPC, doctors may check your thyroid gland function, vision, and hearing to find any cranial nerve damage from radiation therapy or surgery. Periodic ear examinations may also be necessary to remove any dried earwax that has built up. Prevention of dental cavities is also important. Fluoride application is recommended whenever the oral cavity and the salivary glands receive radiation 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.