Oral cancers are the commonest cancers in the Indian sub-continent. After finishing oncologic treatment these patients are generally followed up three monthly for first two years, six monthly for next three years and annually thereafter. In any oncology set up, follow up assessment of such patients forms the major work load in the out-patient department. It has been observed that patients can identify new symptoms indicating recurrence. Symptoms mentioned by patients help in diagnosing majority of recurrences (66-80%) No change was seen in DFS and OS between the groups where recurrence was detected by patient versus the doctor. In a study, where they evaluated 3645 patient visits, it was found that recurrence/ second primary was suspected in 5% of the patients. 79% of the patients suspected to have a recurrence had identified new symptoms themselves. In absence of symptoms, recurrence was rare and seen in only 1.2% of the patients.  A study on head and neck cancer patients showed that recurrence was suspected in only 10% of patients seen routinely and in 68% of those who requested for a consultation. They found that 56% of those who requested for a consultation actually had a recurrence, whereas recurrence was found to be there in only 0.3% of asymptomatic patients.  There are other studies which have shown that when followed up for 5 years, loco-regional recurrence may be seen in 25-50% of the patients and second primaries in 3-5%  of the cases. According to another study, ‘numbers needed to see’ to detect one asymptomatic recurrence was 99.  It has been seen that even when patients are followed up intensively, salvage therapy remains feasible in only 20-65% of them The salvage rates depend upon the sub-site and whether the recurrences are local or regional or loco-regional. Local recurrences generally fare better than regional ones. It has also been observed that patients tend to wait for their regular follow up rather than present early when they detect a symptom. When patients with recurrences who have been salvaged are followed up 3 and 5 year overall survival has been found to be about 52.6% and 48% respectively. Majority of the data available is from the more developed countries. In Indian sub-continent, the patients are not that well educated and don’t have ample resources to make frequent long distance trips for frequent surveillance. Data is scarce regarding the exact proportion of asymptomatic patients who are detected with recurrence on routine clinical examination, the salvage rates of patients detected to have recurrent disease and the outcomes of salvage treatment. We intend to gather data related to asymptomatic recurrences and the sensitivity of telephone based questionnaire in detecting recurrences in patients of oral cancer after finishing the curative intent treatment.

Hypothesis: A nurse led telephone-based interview can reliably identify patients at risk for recurrence on follow up after radical treatment with oral cancers