| | Joined: Jun 2007 Posts: 10,507 Likes: 7 Administrator, Director of Patient Support Services Patient Advocate (old timer, 2000 posts) | OP  Administrator, Director of Patient Support Services Patient Advocate (old timer, 2000 posts)
Joined: Jun 2007 Posts: 10,507 Likes: 7 | There have been a few discussions about how often we see our doctors and how often to get scanned after being treated for OC. Thanks to Uptown for finding the relevant info to share with us.
ChristineSCC 6/15/07 L chk & by L molar both Stag I, age44 2x cispltn-35 IMRT end 9/27/07 -65 lbs in 2 mo, no caregvr Clear PET 1/08 4/4/08 recur L chk Stag I surg 4/16/08 clr marg 215 HBO dives 3/09 teeth out, trismus 7/2/09 recur, Stg IV 8/24/09 trach, ND, mandiblctmy 3wks medicly inducd coma 2 mo xtended hospital stay, ICU & burn unit PICC line IV antibx 8 mo 10/4/10, 2/14/11 reconst surg OC 3x in 3 years very happy to be alive  | | | | | Joined: Dec 2003 Posts: 2,606 Likes: 2 Patient Advocate (old timer, 2000 posts) | | Patient Advocate (old timer, 2000 posts)
Joined: Dec 2003 Posts: 2,606 Likes: 2 | Current NCCN Follow Up Guidelines:
Printed by Ed Brown on 6/7/2013 10:25:43 AM. For personal use only. Not approved for distribution. Copyright � 2013 National Comprehensive Cancer Network, Inc., All Rights Reserved.
2 � H&P exam:
b Year 1, every 1-3 mo
b Year 2, every 2-6 mo
b Years 3-5, every 4-8 mo b >5 years, every 12 mo
NCCN Guidelines Version 2.2013 Head and Neck Cancers
NCCN Guidelines Index Head and Neck Table of Contents Discussion
FOLLOW-UP RECOMMENDATIONS1
(based on risk of relapse, second primaries, treatment sequelae, and toxicities)
� Post-treatment baseline imaging of primary (and neck, if treated) recommended within 6 mo of treatment3 (category 2B) b Further reimaging as indicated based on signs/symptoms; not routinely recommended for asymptomatic patients
� Chest imaging as clinically indicated for patients with smoking history (See NCCN Guidelines for Lung Cancer Screening)
� Thyroid-stimulating hormone (TSH) every 6-12 mo if neck irradiated
� Speech/hearing and swallowing evaluation4 and rehabilitation as clinically indicated
� Smoking cessation and alcohol counseling as clinically indicated
� Dental evaluation
b Recommended for oral cavity and sites exposed to significant intraoral radiation treatment
� Consider EBV monitoring for nasopharynx
1Most recurrences are reported by the patient.
2For mucosal melanoma, a physical exam should include endoscopic inspection for paranasal sinus disease.
3For cancer of the oropharynx, hypopharynx, glottic larynx, supraglottic larynx, and nasopharynx: imaging is recommended for T3-4 or N2-3 disease only. 4See Principles of Nutrition (NUTR-A).
Note: All recommendations are category 2A unless otherwise indicated.
Clinical Trials: NCCN believes that the best management of any cancer patient is in a clinical trial. Participation in clinical trials is especially encouraged.
Version 2.2013, 05/29/13 � National Comprehensive Cancer Network, Inc. 2013, All rights reserved. The NCCN Guidelines and this illustration may not be reproduced in any form without the express written permission of NCCN�.
�
FOLL-A
SCC Stage IV, BOT, T2N2bM0
Cisplatin/5FU x 3, 40 days radiation
Diagnosis 07/21/03 tx completed 10/08/03
Post Radiation Lower Motor Neuron Syndrome 3/08.
Cervical Spinal Stenosis 01/11
Cervical Myelitis 09/12
Thoracic Paraplegia 10/12
Dysautonomia 11/12
Hospice care 09/12-01/13.
COPD 01/14
Intermittent CHF 6/15
Feeding tube NPO 03/16
VFI 12/2016
ORN 12/2017
Cardiac Event 06/2018
Bilateral VFI 01/2021
Thoracotomy Bilobectomy 01/2022
Bilateral VFI 05/2022
Total Laryngectomy 01/2023
| | | | | Joined: Dec 2003 Posts: 2,606 Likes: 2 Patient Advocate (old timer, 2000 posts) | | Patient Advocate (old timer, 2000 posts)
Joined: Dec 2003 Posts: 2,606 Likes: 2 | NCI Follow Up Guidelines:
"Following treatment, it is important to have careful head and neck examinations to look for recurrence. Check-ups will be done monthly in the first year, every 2 months in the second year, every 3 months in the third year, and every 6 months thereafter."
I didn't see anything about scans. This is the schedule for exams I followed when treated at the newest NCI member.
SCC Stage IV, BOT, T2N2bM0
Cisplatin/5FU x 3, 40 days radiation
Diagnosis 07/21/03 tx completed 10/08/03
Post Radiation Lower Motor Neuron Syndrome 3/08.
Cervical Spinal Stenosis 01/11
Cervical Myelitis 09/12
Thoracic Paraplegia 10/12
Dysautonomia 11/12
Hospice care 09/12-01/13.
COPD 01/14
Intermittent CHF 6/15
Feeding tube NPO 03/16
VFI 12/2016
ORN 12/2017
Cardiac Event 06/2018
Bilateral VFI 01/2021
Thoracotomy Bilobectomy 01/2022
Bilateral VFI 05/2022
Total Laryngectomy 01/2023
| | | | | Joined: Jul 2012 Posts: 3,267 Likes: 4 Patient Advocate (old timer, 2000 posts) | | Patient Advocate (old timer, 2000 posts)
Joined: Jul 2012 Posts: 3,267 Likes: 4 | Scans info is at the bottom of the follow-up page. i have 2013 guidelines, and will try to copy in regards to scanning. It's not much. I can't copy, it's on page 83, follow-up guidelines, but this is what it says.
"Post-treatment baseline imaging of primary (and neck, if treated) recommend within 6 mo of treatment 3 (category 2b)
>further reimsging as indicated on signs/symptoms; not routinely recommended for asymptomatic patients."
Bottom of page 3 notation:
"For cancer of the oropharynx, hypopharynx, glottis pharynx, supra glottis larynx, nasopharyngeal: imaging is recommended for T3-4 or N2-3'disease only."
What I get from this is no post treatment scan for oral cancer, other types, and only certain cancers named above, if T3-4 or N2-3 disease only. I hope we can find more clarification, and appears some don't follow, which is a guideline, not a must do, but their recommendation are like the gold standard
Sorry Ed, I did not what I added was already in your post and missed it until I added mine.
Last edited by PaulB; 06-07-2013 12:53 PM.
10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Remove IORT 10Gy PNI
12/13 25 Protons 50Gy 6 Wks Carbo
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fib Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent
02/19 Finally Cancer Free Took 10 yrs
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