Follow-up after treatment for oropharyngeal cancer

Follow-up after treatment is an important part of cancer care. Follow-up for oropharyngeal 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 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:

  • a sore throat
  • any new lump or swelling in the neck
  • a constant cough
  • difficulty swallowing
  • pain
  • changes to your voice
  • loss of appetite
  • fatigue

The chance that oropharyngeal cancer will come back (recur) is greatest within 2 to 3 years, so you will need close follow-up during this time. Smoking and drinking alcohol heavily after treatment can increase your risk of oropharyngeal cancer coming back or of developing a second primary cancer.

Schedule for follow-up visits

Follow-up visits for oropharyngeal cancer are usually scheduled:

  • every 1 to 3 months for the first year after initial treatment
  • every 2 to 4 months for the second year
  • every 4 to 6 months for the third to fifth years
  • every year after 5 years

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
  • changes to your voice

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
  • blood tests to check thyroid function once or twice a year
  • a blood test to check for HPV DNA
  • speech and swallowing tests to check your rehabilitation
  • dental exams to check for cavities
  • a chest x-ray to check if the cancer has spread to the lungs
  • a 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