It is pretty clear that there is no one definitive answer to Jim's question. I'm being followed at Mass Eye and Ear Infirmary in Boston. I had a CT scan 3 months after treatment (surgery and radiation), 6 months, 12 and 18 months and will have another at 24 months. The early scans were ordered by my radiation oncologist and the 12 month and subsequent ones by my ENT.

As Gary and Vin mentioned, the radiologists must write up every possible abnormality no matter how small. After my 6 month scan, I was told that I had a spot on my lung and would need another scan of my lungs. That scan ultimately showed that my lung was clear but then, at the very bottom of the lung ct, it turned up an enlarged mesothelial lymph node near my small intestine. This led to a CT-guided needle biopsy - fortunately not malignant.

Now, when I have a scan, I have a scan from my head to my lower abdomen to follow the enlarged lymph node. I suppose I should be comforted by the thoroughness of the scan in terms of turning up any possible mets. But at some level, I'm concerned about the amount of radiation.

Ultimately, I think it is the combination of physical exam, scans and close follow up that offer the best chances of early detection of recurrence or metastasis. And if your team is in agreement about the follow up procedures, that's a good start. - Sheldon