After a big procedure like a radical neck dissection or mandible reconstruct, is it routine for patients to be followed up by their surgeons in the long term (ie 3 mo, 6 mo, 1 yr)? Or, do ENT's mostly act as consultants with follow up done by the referring docs?
Where I trained, cancer was a multidisciplinary effort. Therefore, several services were responsible for f/u of these patients. Regardless, the crucial thing to remember is that ENT's have the ability and experience to examine the head and neck better than any other service. Many rad onc's will to flexible laryngoscopy these days, but the don't have nearly the same experience we do. I think it's great that they do it but it doesn't negate the need for a comprehensive f/u exam with ENT.
For SCCa of the H&N, at my institution we followed patients after treatment like this:
Every month for the first year (more frequently prn)
Every other month for the 2nd year
Every 3rd month in the 3rd year out
In the fourth year it depended on the type of cancer and pt's progress, but it was frequently once a quarter
In the 5th year onward it was often once a year until the pt was comfortable not being seen anymore. If the pt had something like Adenoid Cystic that could recur even 15 years later, then we'd follow those patients once a year indefinitely.
I use those same criteria. Once I operate on a patient, I own them. I follow them very closely. I don't do a ton of head and neck oncology anymore (thyroid cancer excepted) so I really defer follow-up to those who are doing the definitive treatment.
