This week the Head and Neck series turns to what happens when local therapy isn't enough — recurrent, relapsed, and metastatic disease. Using the case of a woman with a laryngeal cancer recurrence, we work through the first and most important question (recurrence versus second primary), the workup and biomarkers that steer therapy, local salvage options, the CPS-driven first-line systemic algorithm, second-line and beyond, the distinct world of nasopharyngeal cancer, oligometastatic disease, and the central role of early palliative and supportive care. As always, if you haven't heard the earlier episodes in this series, start there first.**This episode is sponsored by Primum! Sign up for your free account at primum.co/fellows** Want to review the show notes for this episode and others? Check out our website. Love what you hear? Tell a friend and leave a review on our podcast streaming platforms!Twitter: @TheFellowOnCallInstagram: @TheFellowOnCallListen in on: Apple Podcast, Spotify, and Youtube

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“What did the council decide on item 42?” — answered with the speaker and the moment.

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