10/22/2026
A University of Pittsburgh study found that starting multidisciplinary survivorship care before or early in radiation therapy improves outcomes for head and neck cancer patients
PITTSBURGH – A University of Pittsburgh study found beginning survivorship care for head and neck patients before or early in radiotherapy was linked to better survival and lower cancer recurrence. The findings were published Oct. 22, 2026, in JAMA Otolaryngology–Head & Neck Surgery.
Key Takeaways
- A University of Pittsburgh study found that head and neck cancer patients who began survivorship care before or early in radiation therapy had better survival and lower recurrence than those who started after treatment.
- The study analyzed 471 head and neck cancer patients treated through UPMC Hillman Cancer Center, 148 of whom received early survivorship care.
- Patients who received early survivorship care were about half as likely to miss or stop radiation therapy, and earlier care was linked to lower risk of recurrence and death three years after treatment, even after accounting for treatment adherence.
- The findings, published in JAMA Otolaryngology–Head & Neck Surgery, are among the first to link the timing of survivorship care to cancer survival.
- Researchers, led by senior author Marci Lee Nilsen, Ph.D., R.N., of Pitt’s School of Medicine and the UPMC Head & Neck Cancer Survivorship Clinic, say the results support moving multidisciplinary survivorship visits earlier in treatment and propose a future randomized controlled trial to confirm the effect.
What is survivorship care, and why does its timing matter?
Survivorship care provides long-term, multidisciplinary support for cancer patients and survivors, focusing on mental and physical health, managing symptoms and monitoring for cancer recurrence. Ideally, the care begins at diagnosis and extends through the end of the patient's life. In practice, it is more commonly emphasized after treatment ends.
"Survivorship care does vary across cancers, but generally, the standard is that all cancer survivors have access to survivorship resources after treatment," said senior author Marci Lee Nilsen, Ph.D., R.N., professor of otolaryngology of Pitt’s School of Medicine and the UPMC Head & Neck Cancer Survivorship Clinic. "This study challenges that paradigm. I questioned why we intervene after symptoms and side effects have developed, when we could intervene earlier and hopefully prevent or mitigate them."
At the UPMC Hillman survivorship clinic, patients see a multidisciplinary team—including specialists in speech-language pathology, physical therapy, nutrition and dental care—in a single same-day visit. The visit ends with a treatment summary and survivorship care plan shared with the patient, their oncology team and their primary care clinician.
Study of 471 patients links early survivorship care to lower recurrence and death risk
Researchers analyzed data from 471 head and neck cancer patients, 148 of whom received early survivorship care. Patients who participated in early survivorship care were about half as likely to miss or stop radiation therapy. Earlier care was also associated with a lower risk of recurrence and death three years after treatment, even after adjusting for treatment adherence, suggesting the benefit is not solely due to completing radiation therapy.
"I think a lot of times survivorship care is seen as just something that is nice to have but is not essential," Nilsen said. "This study shows that if we just shift survivorship care a bit earlier, patients have better outcomes, better adherence to treatment. And even when you control for treatment adherence, you see an association between earlier care and survival."
The study is among the first to show that timing of survivorship care is associated with patient outcomes, and unlike many factors in cancer care, it can be modified relatively easily.
Future studies will investigate how adjusting the timing of survivorship care affects cost and utilization. The researchers also propose a randomized controlled trial to isolate the impact of survivorship care timing from other aspects of cancer care.
Frequently Asked QuestionsQ: What did the study find about the timing of survivorship care for head and neck cancer patients?
A: Patients who began multidisciplinary survivorship care before or early in radiation therapy had better three-year survival and lower recurrence rates than those who started care after treatment, even after accounting for treatment adherence.
Q: How many patients were included in the study?
A: Researchers analyzed data from 471 head and neck cancer patients, 148 of whom received early survivorship care.
Q: What does a survivorship care visit at UPMC Hillman Cancer Center include?
A: Patients see a multidisciplinary team—including speech-language pathology, physical therapy, nutrition and dental care specialists—in one same-day visit that ends with a treatment summary and survivorship care plan for the patient, their oncology team and their primary care clinician.
Additional Resources
- Earlier Survivorship Care Linked to Lower Risk of Head and Neck Cancer Recurrence and Death | JAMA Otolaryngology–Head & Neck Surgery
- Earlier survivorship care linked to lower risk of head and neck cancer recurrence and death | EurekAlert!
- Pre-radiotherapy multidisciplinary survivorship care and patient-reported outcomes in head and neck cancer survivors | Supportive Care in Cancer
- Radiation Oncology Treatment Services | UPMC Hillman Cancer Center
- UPMC Head & Neck Cancer Survivorship Clinic | Department of Otolaryngology–Head & Neck Surgery
Authors and Funding
Authors: Katie Carlson, M.P.H., Maryanna Owoc, M.D., Ph.D., Rida Ashraf, Jennifer Hetrick, Seungwon Kim, M.D., Jose Zevallos, M.D., M.P.H., Matthew Spector, M.D., Kevin Contrera, M.D., M.P.H., Yvonne Mowery, M.D., Ph.D., Dan Zandberg, M.D., Christopher Wilke, M.D., Ph.D., Jonas Johnson, M.D., and Angela Mazul, Ph.D., M.P.H., all of Pitt, UPMC Hillman Cancer Center or both, and Motassem Bayyoud of Wright State University.
Funding and Disclosures: This research was supported by the National Institutes of Health (P50 CA097190-17, Head and Neck Specialized Program of Research Excellence; P30CA047904) and the Gordon and Betty Moore Foundation through the Betty Irene Moore Fellowship for Nurse Leaders and Innovators (GBMF9048).
