After treatment, you have regular check ups to look for any signs of the cancer coming back or spreading. This is called follow up.
Why you have follow up appointments
You have follow up appointments every few months to check how you are and see whether you have any problems or worries. The appointments also give you the chance to raise any concerns you have about your progress.
People who have had nasopharyngeal cancer are sometimes more at risk of developing a new (second) cancer. So these appointments are very important.
Your doctor or nurse examines you at each appointment. They ask how you are feeling, whether you have had any symptoms or side effects and if you are worried about anything.
You might also have tests at some visits. These could include:
- blood tests
- CT scan
- ultrasound scans
- ear tests
You might have a scan about 3 to 6 months after radiotherapy.
Generally, if everything is going well, you do not need further follow up scans. They are unlikely to provide any new information to you or your doctor. But you might have a yearly chest x-ray.
After having external radiotherapy to your neck, your doctor might want to do regular blood tests to check your thyroid hormone levels. This is because about 30 to 40 out of every 100 people (30 to 40%) develop low thyroid hormone levels (hypothyroidism) after external radiotherapy to the neck. This can cause chronic tiredness. It can be managed with thyroid hormone tablets.
Your doctor might also take blood to check whether your treatment has affected your pituitary gland. Your pituitary gland is in your brain and controls many functions of the body by producing chemical messengers (hormones).
How often you have appointments
At first, you have follow up appointments every 6 weeks or so. As time goes on, and if you stay well, your appointments gradually become less frequent:
- after 1 year your appointments might be every 2 to 3 months
- after 3 years your appointments could be every 6 months, until you reach at least 5 years
- after 5 years you might might have 1 appointment every year, but this can vary
Where you have your appointments
After having radiotherapy or chemotherapy, you have check ups at the cancer clinic.
After surgery, you might go for check ups at the surgical outpatients department at the hospital. The surgeon and the oncologist might share your follow up. This means you see the surgeon sometimes and the oncologist other times
Contact your doctor or specialist nurse if you have any concerns. You should also contact them if you notice any new symptoms between appointments. You don’t have to wait until your next visit.
Many people find their check ups quite worrying. A hospital appointment can bring back any anxiety you had about your cancer.
It can help to tell someone close to you how you’re feeling. Sharing your worries can mean they don’t seem so overwhelming. Many people find it helpful to have counselling after cancer treatment.
You can also ask to see other members of your support team, such as the speech and language therapist or dietician.
Giving up smoking
Your doctor will advise you to try to give up smoking if you still smoke after your treatment for nasopharyngeal cancer.
Giving up smoking can be very difficult, especially if you have smoked for a long time. But it does give you many benefits. You reduce your risk of getting another head and neck cancer, or a different smoking related cancer. Your doctor or specialist nurse can give you contact details of services that can help you stop smoking.