Follow-up after treatment for nasopharyngeal cancer

Follow-up after treatment is an important part of cancer care. Follow-up for nasopharyngeal cancer is often shared among the cancer specialists (radiation oncologist, medical oncologist and head and neck surgeon) and your family doctor. Your healthcare team for follow-up care may also include a speech therapist and a dentist. Your healthcare team will work with you to decide on follow-up care to meet your needs.

Don’t wait until your next scheduled appointment to report any new symptoms and symptoms that don’t go away. Tell your healthcare team if you have:

  • nosebleeds
  • nasal blockage
  • any new lump or swelling
  • a constant cough
  • difficulty swallowing or breathing
  • pain

The chance that nasopharyngeal cancer will come back (recur) is greatest within 2 years. But there is a risk that it can come back up to 7 years after treatment, so you will need close follow-up during this time.

Schedule for follow-up visits

Follow-up visits for nasopharyngeal cancer are usually scheduled every 2 to 3 months for the first 3 years after treatment and then less often. Regular follow-up visits usually continue for up to 7 years because of the risk of a late recurrence.

During follow-up visits

During a follow-up visit, your healthcare team will usually ask questions about the side effects of treatment and how you’re coping.

Your doctor may do a physical exam, including checking for:

  • swollen lymph nodes in the neck
  • difficulty speaking or swallowing
  • good mouth care
  • problems with vision and hearing

Tests are often part of follow-up care. You may have:

  • imaging tests such as CT, MRI or PET-CT scans to check if the cancer has spread
  • vision and hearing tests
  • blood tests to check thyroid function once or twice a year
  • a blood test to check for the presence of the Epstein-Barr virus (EBV) antibodies
  • speech and swallowing tests to check on your recovery
  • dental exams to check for cavities
  • a chest x-ray to check if the cancer has spread to the lungs
  • nasopharyngoscopy or panendoscopy to look at the original tumour site and other areas in the throat and to biopsy any abnormal areas

If the cancer has come back, you and your healthcare team will discuss a plan for your treatment and care.

Questions to ask about follow-up

To make the decisions that are right for you, ask your healthcare team questions about follow-up.

Expert review and references

  • American Cancer Society. Treating Oral Cavity and Oropharyngeal Cancer. 2021.
  • Chua MLK, Lechner M, Ma BBY. Cancer of the nasopharynx. DeVita VT Jr, Lawrence TS, Rosenberg S. eds. DeVita Hellman and Rosenberg's Cancer: Principles and Practice of Oncology. 12th ed. Philadelphia, PA: Wolters Kluwer; 2023: Kindle version, chapter 24, https://read.amazon.ca/?asin=B0BG3DPT4Q&language=en-CA.
  • National Comprehensive Cancer Network . NCCN Clinical Practice Guidelines in Oncology: Head and Neck Cancer Version 2.2023 . 2023: https://www.nccn.org/guidelines/category_1.

Medical disclaimer

The information that the Canadian Cancer Society provides does not replace your relationship with your doctor. The information is for your general use, so be sure to talk to a qualified healthcare professional before making medical decisions or if you have questions about your health.

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