Follow-up After treatment of a cancer in the oral cavity has been completed, it will be important to watch not only the area where the cancer originally began but also other areas of the body to make sure there are no signs of the tumor coming back. This is called patient follow-up. The treating physician may request that the patient be seen every 4 to 6 weeks for the first year after treatment to have evaluation for possible signs of regrowth of the original tumor. Such evaluation will include thorough physical exams of the head and neck region: examining the area of the tumor’s original position and examining the neck closely for possible spread to lymph nodes. A chest x-ray and blood tests, such as liver function tests, may also be obtained periodically to check for spread to of cancer to the lungs or liver. Imaging studies such as a CAT scan or MRI may also be obtained periodically to check for any changes that may indicate return of the tumor. These follow-up visits also provide important opportunities for patients to ask their caregivers specific questions concerning persistent symptoms or functional limitations relating to their treatment. Follow-up visits also provide the opportunity for the caregiver to specifically ask questions that may be suspicious for return of the tumor. Such questions include: New ear pain? New pain with swallowing? New difficulty with swallowing or speaking? New weight loss, although you are taking in the same amount of calories? Etc. As time goes on, the frequency of such follow-up visits will decrease. Because as time goes on tumors are less and less likely to recur. In general, about 70 percent of all the tumors that return after treatment will do so within the first year after the completion of treatment. Ninety percent of the tumors that return after treatment will do so within the first 18 months after treatment. Eventually, follow-up visits may be required once or twice a year. During these visits, the greater concern is not the possibility of the original cancer coming back, but concern for a possible second cancer developing in the head and neck region. This is especially concerning in patients who continue to use tobacco and alcohol after their treatment. If a new cancer (called a second primary cancer) were to occur, it would be important to identify it while it is small and often early-stage to achieve the best cure rate with the least invasive means of treatment. For these reasons, close follow-up after treatment is essential in patients with cancers of the oral cavity.
Most parathyroid tumors are benign. Only about 100 cases of parathyroid cancer are diagnosed each year in the US. Parathyroid cancer causes the parathyroid to make too much PTH, increasing the amount of calcium in the blood. People with a family history of parathyroid tumors or a hereditary condition called multiple endocrine neoplasia (MEN) type 1 or 2 have a greater risk of developing this type of cancer. Symptoms include a lump in the neck, bone pain, kidney problems, and other disorders related to having too much calcium in the blood.