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Follow-Up Care

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Long-term side effects from the initial treatment plan can develop and emerge years later. For this reason, follow-up evaluations are essential. A health care professional should give your loved one a schedule of follow-up visits and outline what evaluations he or she should have done based on his or her cancer type, stage and treatments.

Factors that influence follow-up care

The type of therapy received during the treatment of head and neck cancer will determine the type of follow-up assessments performed.

If radiation therapy was administered to the neck region, then there is an increased likelihood of developing impaired thyroid gland functioning. One in four patients who were administered surgery and radiation therapy combinations develop hypothyroidism, or an underactive thyroid gland, post-treatment. Hypothyroidism can result in a variety of symptoms that negatively impact quality of life such as weight gain, fatigue, weakness, hair loss, pain or depression.Because of this increased risk of developing hypothyroidism, if the patient received irradiation to the neck region, then he or she will need to undergo periodic assessments of thyroid gland function.

If your loved one received chemoradiation therapy, then the cancer care team will recommend frequent speech and swallowing evaluations. Researchers found that one year after chemoradiation therapy, 44 percent of patients did not have a normal diet, while 22 percent did not have a functional swallow.

The health care professionals should suggest how frequently your loved one should have follow-up evaluations. Your loved one may need to undergo the following evaluations, depending on the type of therapy administered and any emergent symptoms that may develop:

  • History and physical
  • Imaging to evaluate for the presence of new or recurrent cancer
  • Thyroid-stimulating hormone levels (to assess thyroid functioning if your loved one’s neck was irradiated during treatment)
  • Nutrition, hearing, speech and swallowing evaluations
  • Dental evaluation, especially if the oral cavity was irradiated
  • Surveillance for symptoms of depressions
  • Potential monitoring for Epstein-Barr virus and routine annual imaging (for nasopharyngeal cancer patients)

Your loved one should take steps to decrease the likelihood of developing cancer again.

Smoking and excessive alcohol consumption are known risk factors for various types of head and neck cancer. If your loved one has a history of smoking, chest imaging may be recommended during follow-up. If your loved one needs help to stop smoking or drinking excessive amounts of alcohol, you may want to request counseling for your loved one with an addiction specialist.

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The nurses and therapists were terrific at working with me and giving me exercises to learn how to swallow and speak again. Barry W. (palatomaxillary and low grade adenocarcinoma of minor salivary gland cancer survivor)

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