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The Path to Remission

98681721_8Complete remission means the primary symptoms of head and neck cancer will disappear.1National Cancer Institute (NCI) Website. Accessed at http://www.cancer.gov/ on February 19, 2013. The need for your caregiver services may come to an end, either temporarily or permanently. However, you may need to encourage your loved one to keep up with follow-up physical exams to identify and deal with treatment-related toxicities and/or recurrent cancer.2Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers V.2.2016. © National Comprehensive Cancer Network, Inc 2016. All rights reserved. Accessed December 2, 2016. To view the most recent and complete version of the guideline, go online to www.nccn.org.

What does remission mean? What does no evidence of disease mean?

If a person experiences complete remission, the primary symptoms associated with head and neck cancer should disappear.1National Cancer Institute (NCI) Website. Accessed at http://www.cancer.gov/ on February 19, 2013. There should be no evidence of the primary tumor, and CT or MRI scans should also have no evidence of disease at the site of the tumor or in other areas of the body.

Although your friend or family member may now be in remission, continue to be vigilant. There is a higher probability of cancer returning (recurrence) or a new cancer occurring in the first few years.2Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers V.2.2016. © National Comprehensive Cancer Network, Inc 2016. All rights reserved. Accessed December 2, 2016. To view the most recent and complete version of the guideline, go online to www.nccn.org.

Although this may be stressful and cause anxiety for you and your loved one, continue looking for recurring or new cancer with the objective of identifying a cancer at an earlier stage. Most recurrences are actually patient-identified. 2Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers V.2.2016. © National Comprehensive Cancer Network, Inc 2016. All rights reserved. Accessed December 2, 2016. To view the most recent and complete version of the guideline, go online to www.nccn.org. People diagnosed with stage I head and neck cancer have a 90 percent likelihood of being cured, whereas people diagnosed at stage II head and neck cancer have 70 percent likelihood of achieving a cancer-free status.3Argiris A, Karamouzis MV, Raben D, Ferris RL. Head and neck cancer. Lancet. 2008;371:1695-1709.

Encourage your loved one to undergo periodic follow-up physicals, scans and other tests according to a schedule. The specific schedule will depend on the type of cancer your loved one had and the course of treatment he or she received. Clinicians will make careful assessments to confirm that the cancer has not returned and there is still no evidence of disease.2Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers V.2.2016. © National Comprehensive Cancer Network, Inc 2016. All rights reserved. Accessed December 2, 2016. To view the most recent and complete version of the guideline, go online to www.nccn.org.

Changes after achieving remission

Although the patient’s cancer may now be in remission, their stress may persist for some time. In particular, some people report feelings of anxiety before a follow-up exam, which is relieved when their clinician gives them positive test results. The term for this type of stress is “scanxiety.”4Macdonald N, Shapiro A, Bender C, Paolantonio M, Coombs J. Experiences and perspectives on the GIST patient journey. Patient Prefer Adherence. 2012;6:253-62.

Clinicians may identify other issues during follow-up exams. For example, approximately 25 percent of people who had surgery and radiation therapy combinations developed hypothyroidism post-treatment.5Alexander MV, Zajtchuk JT, Henderson RL. Hypothyroidism and wound healing: occurrence after head and neck radiation and surgery. Arch Otolaryngol. 1982 May;108(5):289-91.

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The five-year scan was the best news ever. So for us, it’s like a whole new life. Bonnie S. (wife of a tonsil cancer survivor)

References

1 National Cancer Institute (NCI) Website. Accessed at http://www.cancer.gov/ on February 19, 2013.

2 Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers V.2.2016. © National Comprehensive Cancer Network, Inc 2016. All rights reserved. Accessed December 2, 2016. To view the most recent and complete version of the guideline, go online to www.nccn.org.

3 Argiris A, Karamouzis MV, Raben D, Ferris RL. Head and neck cancer. Lancet. 2008;371:1695-1709.

4 Macdonald N, Shapiro A, Bender C, Paolantonio M, Coombs J. Experiences and perspectives on the GIST patient journey. Patient Prefer Adherence. 2012;6:253-62.

5 Alexander MV, Zajtchuk JT, Henderson RL. Hypothyroidism and wound healing: occurrence after head and neck radiation and surgery. Arch Otolaryngol. 1982 May;108(5):289-91.