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Metastatic Lymph Nodes

What to Expect After Treatment is Completed

Once you have made it through treatment, you need to have close follow-up with your doctor. Your particular follow-up plan will depend on the recommended plan for your primary cancer type. Patients who are treated for CUP must undergo surveillance to make certain that there is no recurrence in the neck and no emergence of the primary cancer. The current NCCN Guidelines recommend this follow-up plan after being treated for cancer with an unknown primary (CUP):6Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers V.2.2013. © National Comprehensive Cancer Network, Inc 2013. All rights reserved. Accessed June 20, 2013. To view the most recent and complete version of the guideline, go online to www.nccn.org. NATIONAL COMPREHENSIVE CANCER NETWORK®, NCCN®, NCCN GUIDELINES®, and all other NCCN Content are trademarks owned by the National Comprehensive Cancer Network, Inc.

  • Visit your head and neck specialist on a regular schedule (or earlier if you have any concerning symptoms). This allows your doctor to examine you for any signs that the cancer has come back.
    • For the first year, visits every one to three months are recommended.
    • For the second year, visits every two to six months are recommended.
    • For the third to fifth year, visits every four to eight months are recommended.
    • After five years, visits every year are recommended.
  • Your doctor should select a scan to be performed in the first six months after treatment. The first scan serves as a “baseline” study for the purpose of comparing future studies. This will depend on the type and location of your cancer. Your imaging could range from something as simple as a quick chest X-ray to more extensive tests such as CT scans, MRI scans and PET scans. If something suspicious comes up, you might need another biopsy.
  • Chest imaging to check for any signs of lung cancer may be recommended by your doctor if you have a smoking history.
  • Check your thyroid function every six to twelve months if you had radiation to the neck area.
  • Get help with a therapist as needed for difficulties with speaking, hearing and swallowing.
  • Stop smoking and stop drinking.
  • See a dentist.
References

1 Patterns of cervical lymph node metastasis from squamous carcinomas of the upper aerodigestive tract. Patterns of cervical lymph node metastasis from squamous carcinomas of the upper aerodigestive tract. The American Journal of Surgery. 1990;160(4):405-409.

2 Patterns of Cervical Node Metastases From Squamous Carcinoma of the Larynx. Arch Otolaryngol Head Neck Surg. 1990;116(4):432-435.

3 Zhang MQ, El-Mofty SK, Dávila RM. Detection of human papillomavirus-related squamous cell carcinoma cytologically and by in situ hybridization in fine-needle aspiration biopsies of cervical metastasis: a tool for identifying the site of an occult head and neck primary. Cancer. 2008;114(2):118-23.

4 Morton DL, Wen DR, Foshag LJ, Essner R, Cochran A. Intraoperative lymphatic mapping and selective cervical lymphadenectomy for early-stage melanomas of the head and neck. J Clin Oncol. 1993;11:1751-1756.

5 Civantos FJ, Zitsch RP, Schuller DE, Agrawal A, Smith RB, Nason R, Petruzelli G, Gourin CG, Wong RJ, Ferris RL, El Naggar A, Ridge JA, Paniello RC, Owzar K, McCall L, Chepeha DB, Yarbrough WG, Myers JN. Sentinel lymph node biopsy accurately stages the regional lymph nodes for T1-T2 oral squamous cell carcinomas: results of a prospective multi-institutional trial. J Clin Oncol. 2010;28(8):1395-400.

6 Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers V.2.2013. © National Comprehensive Cancer Network, Inc 2013. All rights reserved. Accessed June 20, 2013. To view the most recent and complete version of the guideline, go online to www.nccn.org. NATIONAL COMPREHENSIVE CANCER NETWORK®, NCCN®, NCCN GUIDELINES®, and all other NCCN Content are trademarks owned by the National Comprehensive Cancer Network, Inc.

7 Balaker AE, Abemayor E, Elashoff D, St. John MA. Cancer of unknown primary: does treatment modality make a difference? Laryngoscope.2012;122(6):1279-82. doi: 10.1002/lary.22424. Epub 2012 Apr 26.