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:
- nasal blockage
- any new lump or swelling
- a constant cough
- difficulty swallowing or breathing
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.
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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.
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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.
American Cancer Society. Nasopharyngeal Cancer. 2015: https://www.cancer.org/cancer/nasopharyngeal-cancer.html.
BC Cancer Agency. Pharynx. BC Cancer Agency; 2016: http://www.bccancer.bc.ca/health-info/types-of-cancer/head-neck/pharynx.
Carr E . Head and neck malignancies. Yarbro CH, Wujcki D, Holmes Gobel B, (eds.). Cancer Nursing: Principles and Practice. 8th ed. Burlington, MA: Jones and Bartlett Learning; 2018: 56: 1573 - 1598.
National Cancer Institute. Nasopharyngeal Cancer Treatment (PDQ®) Health Professional Version. 2015: https://www.cancer.gov/types/head-and-neck/hp/nasopharyngeal-treatment-pdq#section/all.
Ng WT, Ngan RKC, Chan SH, et al . Management of nasopharyngeal carcinoma. Bernier J (ed.). Head and Neck Cancer: Multimodality Management. Springer; 2016: 26: 445 - 473.