Guideline issued for survivors of head and neck cancers

The American Cancer Society recently issued a head and neck cancer survivorship care guideline, including consensus-based strategies for primary care clinicians treating patients who have had head or neck cancer.

The clinical practice guideline addresses 5 key areas: surveillance for recurrence, screening for second primary cancers, assessment and management of physical and psychosocial long-term and late effects, health promotion, and care coordination and practice implications.

The guideline appeared March 22 in CA: A Cancer Journal for Clinicians.

It recommends that primary care clinicians individualize clinical follow-up care provided to survivors based on age, specific diagnosis, and treatment protocol, as recommended by the treating oncology team, and also conduct a detailed cancer-related history and physical examination every 1 to 3 months for the first year after primary treatment, every 2 to 6 months in the second year, every 4 to 8 months in years 3 to 5, and annually after 5 years.

Primary care clinicians should educate and counsel all survivors about the signs and symptoms of local recurrence and refer patients to a subspecialist if there are signs and symptoms of local recurrence. They also should screen survivors for other cancers as they would patients in the general population, adhering to the American Cancer Society Early Detection Recommendations.

Recommendations for evaluating and treating specific long-term cancer treatment-associated complications (such as nerve damage, dysphagia, and gastrointestinal reflux) are provided.

The guideline also addresses recommendations for fatigue, altered or loss of taste, sleep disturbance/sleep apnea, disturbances to speech/voice, and oral and dental surveillance.