Follow-Up Care for Head and Neck Cancer

Executive Summary

Follow-up care for head and neck cancer refers to the after-treatment protocols conducted by the healthcare team to look after recurrence, manage the side effects, and monitor the overall health of the patient. There will be medical and physical examinations included in the follow-up care. Looking out for the recurrence of the cancer is seen in test reports of follow-up care. The methods of follow-up treatment are often related to previous treatment methods, other related therapies, and more.

The doctor will propose checks and testing to check for late effects based on the patient’s head and neck cancer treatment symptoms. Managing the side effects while receiving treatment is a critical follow-up care approach. Personalizing the follow-up care plan is essential for patients with head and neck cancer conducted by the medical care team. Effective communication with the doctor regarding the long-term effects of all the treatments will be effective in the future.

The health care team will develop a post-treatment care strategy as per a the disease condition, called follow-up care. Every disease 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 post-treatment health progress and disease condition. 

Follow-Up Care for Head and Neck Cancer

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 ^​1​. These tests and scan results will help the doctor analyze and detect any variation in the well-being of the patient, any other complication, symptoms, or signs indicating any disease or side effects due to the treatment. Follow-up care focuses on addressing physical health issues and prioritizes their mental well-being. Head and neck cancer survivors should utilize the opportunity to address any emotional or mental concerns to their doctor or health care team. 

You can design a survivorship care plan along with your physician. A survivorship care plan will consist of a full, detailed summary of your treatment, along with 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 disease recurring or any side effects of treatment becoming worse. Follow-up care should not be missed, especially in the case of serious cancers, as their behavior cannot be predicted. The possibility of these cancers recurring post successful treatment also cannot be fully discarded. Doctors can check for recurrence or distant metastasis through these follow-up check-ups and help treat them.

People who have received treatment for head and neck cancers are urged to make healthy life choices. They are encouraged to follow established guidelines like eating a healthy balanced diet, maintaining a healthy body weight, and undergoing screening tests as and when required. They are also encouraged to perform physical activities without straining their bodies. Talk with your doctor or healthcare team, and design a plan to keep up a healthy lifestyle.

Rehabilitation

In Follow-up care, the doctor may recommend rehabilitation. Rehabilitation includes various services such as therapies (physical and mental), pain management, career counseling, emotional counseling, diet, and nutrition planning ^​2​. 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. Rehabilitative therapies and sessions help cope with, treat, and relieve these symptoms or side effects post successful cancer treatment. Follow-up care and rehabilitation collectively focus on improving the quality and comfort of the life of cancer survivors. 

In the case of patients who have received treatment for head and neck cancers, rehab services will include physical therapies to help people in movement and other physical activities. Also, there will be swallowing and speech therapies to help patients regain their basic skills like eating and talking. Timely evaluation and care can prevent patients from developing serious, permanent speech and swallowing problems. A rehabilitation medicine specialist can ensure that the patient gets the most effective rehab services.

Sometimes after treatment, the patient may appear different physically and may find it challenging to perform basic physical tasks like talking, eating, walking etc. Hence, in such circumstances, caregivers and healthcare teams should provide sufficient mental support and encouragement to the patient and help them find support groups or services to strengthen their body and mind.

Proper care and guidance should be provided for patients to cope with mental stress, anxiety, and depression post-treatment of head and neck cancers (or any disease in general). Today, most cancer care centres 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.

Keep in Mind

The primary goal of follow-up care post successful treatment is to check for any possible recurrence. Head and neck cancers can be unpredictable, hence, proper follow-up and check-ups are vital even after successful treatment and cure. A doctor who is familiar with your medical history will be able to guide you with personalized information regarding your risk of recurrence during follow-up check-ups. The doctor may ask you different questions to evaluate your health condition. Depending on your condition, the 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. Open communication of their fears and concerns is essential in such cases which will help them get the necessary support. Another important aspect of follow-up care is managing and relieving the side effects of treatment ^​3​. People may experience many long-term and short-term side effects while receiving treatment for cancer. The 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. Proper treatment and care should be provided to the patients to manage and relieve the side effects. 

Post-treatment check-ups

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.  

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 the disease condition, possible side effects, personal preferences, etc., shape such decisions. 

If, in case, a medical professional who was not a part of your treatment leads your follow up care, be sure to share all relevant medical history and survivorship plans with them. This applies in the case of all future health care providers. This is very important, as it will help the new doctor plan your care based on your past medical details.

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