A new guideline from the American Cancer Society (ACS) provides clinicians with recommendations on key areas of clinical follow-up care for survivors of head-and-neck cancer—a growing population numbering approximately 436,060 individuals and accounting for 3% of all cancer survivors in the United States.
Head-and-neck cancer will account for an estimated 61,760 new cancer cases in the U.S. in 2016, and long-term survival is increasingly common in this population. Tobacco use and alcohol consumption account for an estimated 75% of cases of head-and-neck cancer. Human papillomavirus is also a risk factor, accounting for as many as 70% of oropharyngeal cancers.
The National Cancer Survivorship Resource Center, a collaboration among the ACS, the George Washington University Cancer Institute, and the Centers for Disease Control and Prevention, convened a multidisciplinary expert workgroup to review existing guidelines and available evidence to develop guideline recommendations using the highest level of evidence. The panel included members with expertise in primary care, dentistry, surgical oncology, medical oncology, radiation oncology, clinical psychology, speech language pathology, physical medicine and rehabilitation, and nursing, along with a head-and-neck cancer survivor, who provided a patient perspective.
The comprehensive guideline, published in CA: A Cancer Journal for Clinicians, includes recommendations on surveillance for the recurrence of head-and-neck cancer; screening for and early detection of second primary cancers; the assessment and management of potential physical and psychosocial long-term and late effects of head-and-neck cancer and its treatment; health promotion strategies for nutrition; physical activity and tobacco cessation; and key elements of care coordination, including survivorship care plans, communication with other providers, and the inclusion of caregivers.
“The guideline was developed in response to the need for guidance on how best to care for the growing number of head-and-neck cancer survivors who potentially face both acute and chronic disability,” write the authors. “Head-and-neck cancer survivors should be provided with timely and appropriate support and referral to address physical, psychosocial, and practical effects after treatment.”