Follow-Up Care for Adenoid Cystic Carcinoma

Executive Summary:

Adenoid Cystic Carcinoma is aggressive and has shown recurrence in individuals who had successful treatment initially. Hence, integrating into follow-up care is considered a critical approach. Follow-up care mainly involves the regular visit of the patient to their healthcare provider post-treatment for regular medical check-ups and screening to evaluate the progress and disease condition. It also includes routine physical examinations, various medical tests (blood tests, urine tests) and scans to monitor a patient’s overall health status. Follow-up care focuses on addressing a patient’s physical health issues and prioritizes their mental well-being. Rehabilitation is the critical follow-up care approach involving different services such as therapies (physical and mental), pain management, career counselling, emotional counselling, diet and nutrition planning. An experienced oncologist may require follow-up care after radiation therapy procedures in case of ACC. In the surgery of ACC, the specialist recommends necessary care of managing and getting relief from any discomfort or pain. Adenoid Cystic Carcinoma follow-up care effectively works and relieves the side effects of cancer treatment. 

Follow-up care for Adenoid Cystic Carcinoma

Adenoid Cystic Carcinoma is a rare, malignant form of adenocarcinoma that affects the body’s epithelial tissues. It primarily affects the head and neck region’s major and minor salivary glands. ACC tumors can also be found in the lungs, breast, brain, eye, uterus, and other body locations. ACC can be aggressive and is seen to recur in people who have had successful treatment initially. It is in such a context that follow-up care becomes extremely important.

Cancer care doesn’t end with active treatment. The health care team will develop a strategy as per a patient’s disease condition. Every cancer survivor should have a proper follow-up care routine. Follow-up care refers to seeing the health care provider post-treatment for regular medical check-ups and screening to evaluate your progress and disease condition. 

The follow-up care will include routine physical examinations, various medical tests (blood tests, urine tests) and scans to monitor a patient’s overall health status. These tests and scan results will help the doctor analyze and detect any variation in the patient’s well-being, any other complication, symptoms or signs indicating any disease or side effects due to cancer treatment. Follow-up care focuses on addressing a patient’s physical health issues and prioritizes their mental well-being. Cancer survivors should utilize the opportunity to address any emotional mental concerns to their doctor or health care team. 

A survivorship care plan will consist of a full, detailed summary of your cancer treatment and a follow-up plan designed as per your health condition and requirements. This plan will function as a tracker to monitor your condition post-treatment. It will ensure that you get regular, competent care to prevent any chance of the cancer condition recurring or any side effects of treatment becoming worse. Follow up care should not be missed, especially in the case of tumors like Adenoid Cystic carcinoma, as these cancers are notorious for recurring back in the body even after successful treatment. Doctors can check for recurrence or distant metastasis through these follow-up check-ups and help treat them.

In Follow-up care, the doctor may recommend cancer rehabilitation. Cancer rehabilitation includes various services such as therapies (physical and mental), pain management, career counselling, emotional counselling, diet and nutrition planning. The ultimate goal of rehab is to aid survivors to regain control over their lives and encourage them to be self-sufficient, active and productive as much as possible. In the case of adenoid cystic carcinoma, people who have had treatments centering the neck and head region would face difficulties in chewing and swallowing or may experience extreme pain. Hence in such cases providing rehabilitation care is extremely important. Rehabilitative therapies and sessions help cope with, treat, and relieve these symptoms or side effects post successful cancer treatment. 

Surgical treatments around the head and neck region or parotid neoplasms may also cause facial nerve dysfunction and Frey syndrome. Frey syndrome is also called gustatory flushing and sweating and auriculotemporal syndrome. And studies claim that Frey syndrome is successfully treated with “botulinum toxin A” injections. Follow-up care and cancer rehabilitation focus on improving the quality and comfort of the life of cancer survivors. 

In some cases, Adenoid Cystic Carcinoma tumors may also require follow-up care after procedures like radiation therapy ​1​. Suppose any part of the mouth or jaw has been subjected to major surgery. In that case, the prosthodontist will prescribe the necessary dental care to be followed to manage and relieve any discomfort or pain ​2​. A prosthodontist is a dental specialist specializing in restoring and replacing cracked or broken teeth with bridges, crowns, or removable prosthetics such as dentures. 

Coping with mental stress, anxiety, and depression is essential for post-cancer care. Today, most cancer care Centers have support groups and services that offer survivors the support they require. These support services will have various therapies, counselling and other sessions to address the emotional concerns of the survivors.

The primary goal of follow-up care post successful cancer treatment is to check for any possible recurrence. Recurrence occurs when small areas of cancer cells remain undetected during diagnosis and treatment. The tumor grows once again or sometimes metastasizes to other body parts in such cases. A doctor who is familiar with your medical history will be able to guide you with personalized information regarding your risk of cancer recurrence during follow-up check-ups.

The doctor may ask you different questions to evaluate your health condition. Depending on your cancer condition’s type, stage, and gravity during the initial diagnosis and treatment, the doctor may prescribe various medical tests (blood/urine/imaging tests) and scans.

Survivors can get triggered by anxiety and stress while coming for follow-up check-ups and waiting for the test results. They will be constantly worried about cancer recurring again in the body. In such cases, survivors are encouraged to openly communicate their fears with their doctor, who will help them get the necessary support. 

Another critical aspect of Adenoid Cystic Carcinoma follow-up care is managing and relieving the side effects of cancer treatment. People may experience many long-term and short-term side effects while receiving treatment for cancer. The late side effects or long term side effects tend to last for a more extended period (even months or years) post-treatment. These side effects can affect the physical and mental well-being of a survivor.

Patients should talk with their doctor or health care team regarding the treatment they will receive as per their cancer condition and what side effects they should expect, well before the treatment begins. If any side effects are expected to cause troubles, proper treatment and care should be managed and relieved.

Cancer survivors and the doctor should work together to design a personalized follow-up check-up and care plan. Survivors should make it a point to address or discuss any fears or concerns regarding their mental and physical health with their health care provider. Also, survivors should record all their treatments and medical history for future reference. 

Also Read: George Francis (Metastatic Adenoid Cystic Carcinoma): Keep fighting with zeal.

Survivors can also enquire about who will lead their follow-up care to their doctor. Some people continue to see their oncologists or health care team, whereas others transition back to the supervision of another medical professional or their family doctor. Several factors like the type, grade, gravity of cancer, possible side effects, personal preferences etc., shape such decisions. 

If, in case, a medical professional who was not a part of your cancer treatment led the follow-up care, be sure to share all relevant medical history and survivorship plans with them. It applies in the case of all future health care providers. It is essential, as the new doctor will plan your care depending on your past medical details.

References

  1. 1.
    Orlandi E, Alfieri S, Simon C, Trama A, Licitra L, RARECAREnet Working Group. Treatment challenges in and outside a network setting: Head and neck cancers. Eur J Surg Oncol. 2019;45(1):40-45. doi:10.1016/j.ejso.2018.02.007
  2. 2.
    Ishida E, Ogawa T, Rokugo M, et al. Management of adenoid cystic carcinoma of the head and neck: a single-institute study with over 25-year follow-up. Head Face Med. 2020;16(1):14. doi:10.1186/s13005-020-00226-2