The American Society of Clinical Oncology (ASCO) has endorsed the American Cancer Society (ACS) guideline on head and neck survivorship care, emphasizing the need for multidisciplinary care for head and neck cancer survivors.1
Despite the limited availability of high-quality evidence to support many of the ACS’s recommendations, an ASCO Expert Panel determined that the ACS Head and Neck Cancer Survivorship Care Guideline, which was published in 2016, is clear, thorough, clinically practical, and helpful.
The ASCO Expert Panel stressed the necessity for multispecialty, multidisciplinary, coordinated, and collaborative care. Specifically, the care of head and neck cancer survivors should take a team-based approach that includes primary care clinicians, oncology specialists, otolaryngologists, dentists, and other allied professionals.
Because head and neck cancer survivors may experience late effects and morbidities, the Panel emphasized that the head and neck cancer team should educate primary care clinicians about the potential late and long-term effects of treatment and that primary care clinicians should evaluate for these effects during regular visits with survivors when regular follow-up with the head and neck cancer team ceases.
Primary care clinicians should be aware of signs, symptoms, and physical examination findings related to disease recurrence or second malignancies; however, the ASCO Panel notes that specific investigations for surveillance of recurrences, such as imaging or endoscopies, should remain the responsibility of head and neck cancer specialists.
The ASCO Panel also underscored the importance of screening and follow-up for depression, anxiety, and other psychosocial late effects among survivors of head and neck cancer. Primary care clinicians should discuss smoking cessation, alcohol consumption, appropriate dental hygiene, reduction of cardiovascular risk factors, nutrition strategies, and regular physical activity with survivors, as well.
1. Nekhlyudov L, Lacchetti C, Davis NB, et al. Head and neck cancer survivorship care guideline: American Society of Clinical Oncology Clinical Practice guideline endorsement of the American Cancer Society guideline. J Clin Oncol. 2017 Feb 27. doi: 10.1200/JCO.2016.71.8474. [Epub ahead of print]