Life After Treatment

 The post-treatment time period is from the completion of treatment through two years after the completion period. Your post-treatment care will involve periodic follow-up visits with your doctor to make sure your cancer does not return. You may also need ongoing rehabilitation for speaking, swallowing and nutritional needs.

 Post-Treatment Care

 Deficits in functioning (e.g., swallowing) for patients who received radiation therapy were evaluated at baseline and post-treatment. Most patients exhibited swallowing impairments at baseline, such as a decreased ability to retract the tongue, delayed swallowing or decreased tongue strength. During the first months to one-year post-treatment, there was little change in the swallowing impairments for most patients.

 Rehabilitation

 Depending on the treatment and treatment-related side effects, the ability to speak or eat may be compromised post-treatment. Working with a speech pathologist may improve a patient’s ability to speak.

 Swallowing function can be impaired even several years after the completion of surgery, radiation therapy or chemoradiation therapy. Rehabilitation can include any of the following type of exercises: swallowing manoeuvres, such as effortful swallow or Mendelsohn manoeuvre (prolonged swallow); range of motion exercises (e.g., jaw, tongue); tongue strengthening exercises; and tactile stimulation.

 Depending on the changes that occurred to your anatomy post-treatment (e.g., decrease in size of muscles, surgical removal of structures), you may require voice rehabilitation. Between 34 to 70 percent of head and neck cancer survivors will develop a speech impairment. A wide variety of tools can be used as a part of voice rehabilitation. These range from the use of prosthetic devices to help with vocalisation to surgical reconstruction.

 Follow-Up Care

 Some long-term side effects from the initial treatment plan can develop later. For these reasons, follow-up evaluations will need to occur.

 For example, if radiation therapy was administered to the neck region, then there is an increased likelihood of developing impaired functioning. For example, 25 percent of patients who were administered surgery and radiation therapy combinations developed hypothyroidism post-treatment.

 For this reason, every six to 12 months, you will need to undergo tests to evaluate the thyroid gland.

You can work with your health care professionals to obtain advice as to how frequently you should have follow-up evaluations to confirm that you are not experiencing long term-side effects.

 You should take steps to decrease the likelihood of developing cancer again. Smoking and excessive alcohol consumption are known risk factors for various types of head and neck cancer. If you need help with the cessation of these behaviours, you may want to seek counselling.

 Finally, if you have not yet returned to work, you can begin to take steps to resume your job as you feel able to do so.