OncoLife Care Plan

You received the following treatments for Head & Neck: Tongue, Lip, Oropharynx, Nasopharynx

Laryngectomy
Cisplatin (Platinol®)
Docetaxel (Taxotere®)
Radiation treatment for head and neck cancers
X-ray based radiation- IMRT

Information from your oncology office

What's In Your Care Plan

Your Summary

Follow Up Care For Head & Neck Cancers: Tongue, Lip, Oropharynx, Nasopharynx

Surgery Side Effects

Laryngectomy

Risks Related to Medications

Peripheral Neuropathy
Development of Kidney Problems
Hearing Changes or Loss
Elevated Cholesterol Levels
Risk of Developing Osteoporosis
Raynaud's Phenomenon
Understanding Chemo-Brain
Fertility and Sexuality Concerns for Male Survivors
Risk of Cardiac (Heart) Problems Related to Cisplatin
Risk of Developing a Secondary Cancer
What We Do Not Know

Side Effects of Radiation

Head & Neck Cancer Radiation
Spinal Cord
Eyes
Ears
Salivary Glands (Parotid)
Sinuses
Throat / Upper Airway
Thyroid
Bone
Skin

Healthy Living After Cancer

General Cancer Screening for Men after Head & Neck Cancer: Tongue, Lip, Oropharynx, Nasopharynx
Fatigue

Surgery Side Effects

Laryngectomy

Key Takeaways

Safety is a concern after laryngectomy because your voice and sense of smell will change.
- It is important to notify your local 911 and EMS that you are unable to talk. You should wear a medical alert bracelet and carry something to use as an alarm to get help in an emergency. Carry a pen and paper to communicate when needed.
- You should also have working smoke detectors.
You should use filters and covers to protect your stoma when showering. Ensure you are in a clean air environment and use a humidifier.
Work with a speech-language pathologist to manage speech and swallowing concerns.

Risks Related to Medications

Peripheral Neuropathy

Key Takeaways

Peripheral neuropathy can be a long-lasting side effect that can require physical therapy, changes in your daily life for safety, and managing pain with medication.

Development of Kidney Problems

Key Takeaways

Have blood pressure checked every year during your physical exam.

Hearing Changes or Loss

Key Takeaways

Report the following symptoms to your healthcare provider and request an audiogram and referral to an audiologist:

Hearing loss:
- Trouble hearing the TV, or need for increased TV volume.
- Trouble hearing others in meetings or at large gatherings.
Ringing in your ears.
Dizziness/spinning and/or loss of balance.

Elevated Cholesterol Levels

Key Takeaways

Have cholesterol checked after completing therapy and annually thereafter.

Risk of Developing Osteoporosis

Key Takeaways

Avoid smoking, caffeine, and excessive alcohol intake.
Perform weight-bearing and strength training exercise 2-3 times per week.
Calcium intake of 1000-1200mg per day plus Vitamin D 800iu to 1000iu per day (ideally from food sources, and supplements when your diet is not sufficient).
Consider screening with DEXA scan.

Raynaud's Phenomenon

Key Takeaways

Avoid smoking and medications that constrict blood vessels.
Protect affected areas from cold exposure.
Have your blood pressure checked every year.

Understanding Chemo-Brain

Key Takeaways

There is no proven treatment for chemo brain, but cognitive rehabilitation / brain games, avoiding becoming fatigued, regular exercise, and a healthy diet can be helpful.
Create reminders by making lists, using to-do apps or alarms on a phone to help you stay on track.
If you believe you are experiencing chemo brain you should consult your care provider to rule out other health issues including thyroid problems, depression and anxiety.

Fertility and Sexuality Concerns for Male Survivors

Key Takeaways

Survivors wishing to become pregnant or father a child should consult with a fertility specialist familiar with cancer survivors.
Survivors dealing with erectile dysfunction (ED) should seek the help of an urologist who specializes in ED.

Risk of Cardiac (Heart) Problems Related to Cisplatin

Key Takeaways

Maintain healthy lifestyle:
- Avoid smoking.
- Maintain a healthy weight.
- Exercise regularly.
- Eat a well-balanced diet.
Female survivors should consider a cardiac exam by a cardiologist prior to becoming pregnant.
- Have an annual physical exam that includes a cardiac exam, checking blood pressure and cholesterol levels.
Report the following symptoms to your healthcare provider:
- Shortness of breath (with or without exertion).
- Difficulty breathing when lying down.
- Chest pain.
- Palpitations.
- Dizziness/lightheadedness.
- Swelling of the arms or legs.

Risk of Developing a Secondary Cancer

Key Takeaways

There is a small risk of developing a blood cancer years after your treatment is completed.
Report the following symptoms to your healthcare provider promptly:
- more tired or weaker than usual.
- shortness of breath.
- loss of appetite.
- weight loss.
- chills, fever, night sweats.
- painless swelling of a lymph node.
- easily bruising, nose bleeds, bleeding from the gums.
Your provider will monitor your labs closely. Consider having a complete blood count with differential checked annually by your healthcare provider if you received high-risk therapies.

What We Do Not Know

Key Takeaways

Many cancer treatments today have not been available long enough to determine what effects they may cause in years after treatment.
Always let your healthcare team know if you notice any new or worsening symptoms. Remember, you know your body best.
Periodically look for new information about your treatment and talk to your healthcare team to see if they have anything new to report.

Side Effects of Radiation

Long term effects of radiation therapy vary greatly depending on the areas included in the field of radiation and the radiation techniques that were used, as these continue to develop and improve. One issue that is consistent across all tissues is the possibility of developing a second cancer in or near the radiation field. Secondary cancers develop as a result of the exposure of healthy tissue to radiation. Newer radiation techniques are designed to limit this exposure, but it is not always possible to prevent all exposure and still achieve the desired outcomes.

Head & Neck Cancer Radiation

Key Takeaways

Scar tissue caused by radiation can lead to a number of issues including changes in swallowing, muscle strength and movement, swelling or pain in the head, face or neck, or trouble opening your mouth. These can happen even years after treatment. You should call your provider if you have any of these issues.
Long term side effects are often best managed when treated early.
Physical therapy, lymphedema (swelling) specialists and cancer rehabilitation specialists can be helpful in managing these long term and late effects.
Diligent mouth care and seeing a dentist regularly is important to prevent issues such as cavities.

Spinal Cord

Key Takeaways

You should call your provider right away if you are having any new back pain, trouble holding your bowels or bladder, weakness, or suddenly not being able to move your arms or legs. You may need an x-ray to figure out what is causing these symptoms.
If you are having shock-like pains in the arms or legs, your provider may suggest you see a neurologist.
If you have any new curvature of the spine, you should be seen by an orthopedist.

Eyes

Key Takeaways

Your provider will tell you how often you should be seen by an eye doctor. If you have any changes in your vision you should call your provider right away.

Ears

Key Takeaways

If you have a loss of hearing, pain, or ringing in the ears you should contact your provider. A hearing test may be done by your provider or you may be referred to an audiologist.

Salivary Glands (Parotid)

Key Takeaways

Damage to the parotid (salivary) glands can lead to dry mouth. This lack of saliva can lead to dental issues, so you should brush twice a day and floss daily.
You see should have a dental check-up and cleaning every 6 months.
You should call your provider if you are having any new or worsening jaw pain.
Ask to speak to a dietitian if eating is hard due to decreased saliva, decreased taste/ smell, or difficulty chewing or swallowing.

Sinuses

Key Takeaways

Talk to your provider if you have having chronic sinus headaches or post-nasal drip. It might be helpful to be seen by an otolaryngologist (ear, nose and throat provider).

Throat / Upper Airway

Key Takeaways

If you are having trouble breathing due to upper airway problems, develop a hoarse voice, or a new or worsening cough, you may need to be seen by an otolaryngologist (provider who specializes in issues of the ear, nose and throat).
You and your provider should make sure that you are eating a proper diet and maintaining a healthy weight.
You may be seen by a dietitian if you are not able to eat enough because you are having trouble swallowing.

Thyroid

Key Takeaways

Each year during your annual physical, your provider should feel your thyroid to see if there are any noticeable changes.
You may have your thyroid levels checked with a blood test each year or if you start to have symptoms of a possible thyroid issue.

Bone

Key Takeaways

If you are having pain after any trauma, such as a fall or car accident, you should be evaluated for any damage to your bones.
If you develop arthritis, you may be given medications to decrease pain and inflammation.
Working with a physical or occupational therapist may also be helpful.

Skin

Key Takeaways

The area of skin that was affected by radiation may be more sensitive. Care for your skin using mild soaps and moisturizers. Use sunscreen daily to prevent burns.
Contact your provider if you have any changes to your skin.

Healthy Living After Cancer

Survivors often wonder what steps they can take to live healthier after cancer. There is no supplement or specific food you can eat to assure good health, but there are things you can do to live healthier, prevent other diseases, and detect any subsequent cancers early.

In addition to medical problems and screening, cancer survivors also sometimes have issues with insurance, employment, relationships, sexual functioning, fertility, and emotional issues because of their treatment and we will discuss those in this care plan.

No matter what, it is important to have a plan for who will provide your cancer-focused follow up care (an oncologist, survivorship doctor or primary care doctor). You have taken the first step by developing a survivorship plan of care. If you would like to find a survivorship doctor to review your care plan you can contact cancer centers in your area to see if they have a survivor's clinic or search for a clinic on OncoLink's survivorship clinic list.