Oral and Oropharyngeal Cancer: Follow-Up Care

Approved by the Cancer.Net Editorial Board, 09/2017

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 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.

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. A common follow-up schedule 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 thereafter.

People treated for oral or oropharyngeal cancer have a higher risk of developing secondary cancers. If you smoke, you should be monitored for possible secondary cancers in the lung, esophagus, and head and neck. Researchers are studying the use of chemotherapy to prevent second cancers from developing, called chemoprevention. This may become a part of follow-up care for oral and oropharyngeal cancer.

Learn more about the importance of follow-up care.

Cancer rehabilitation

Rehabilitation is a major part of follow-up care after head and neck cancer treatment. People may need physical therapy and speech and swallowing therapy. Palliative care to manage symptoms and maintain nutrition during and after treatment may be recommended.

Depending on the size and location of the tumor and the type of cancer treatment used, a person may have problems with their ability to chew and move food through the digestive system. People who have been treated for oral or oropharyngeal cancer can have long-term swallowing problems. It is important that they continue to swallow their saliva and as much food as they can throughout treatment to prevent these problems from developing. Special nutritional care and support is often needed during treatment and immediately following treatment. Some people may need to learn new ways to eat or prepare foods differently.

If the cancer treatment changes oral structures or limits movement, a patient’s ability to talk will be affected. Speech pathologists can help people work toward their normal functions. 

People treated for oral or oropharyngeal cancer may look different, feel tired, and be unable to talk or eat the way they did before treatment. They may experience swelling in the area, called lymphedema. Many people experience depression. The health care team can help people adjust and connect them with both physical and emotional support services.

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.

People treated for oral or oropharyngeal cancer should receive regular follow-up medical and dental examinations to check for signs of recurrent cancer or a new type of cancer. Most recurrences of oral and oropharyngeal cancer happen within the first 2 to 3 years after diagnosis, so follow-up visits will be more frequent in the years right after treatment.

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 originally diagnosed and the types of treatment given.

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 “scan-xiety.” Learn more about how to cope with this type of stress.

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. 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 have certain physical examinations, scans, or blood tests to help find and manage them.

Surgery and radiation therapy used to treat oral and oropharyngeal cancer can affect a person’s thyroid gland. If your thyroid gland could have been affected by treatment, then thyroid function tests should be part of your follow-up care to find out if thyroid hormone medication is needed. Special dental care may also be needed to manage or avoid long-term dental problems.

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 create a treatment summary to 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 decide who will lead your follow-up care. Some survivors continue to see their oncologist, while others transition back to the 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 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. You may use the menu to choose a different section to read in this guide.