When Don Ronan, a 40-year-old Connecticut salesman and father of three, found out that chemotherapy had put his Hodgkin's disease in remission, he was ecstatic. "The CT scan showed that it was gone from my pelvis, my stomach, my bone marrow. I was cancer-free," he says. "I didn't feel broken anymore."
Ronan has made the momentous crossing from cancer patient to cancer survivor. Now he enters follow-up care, a stage familiar to almost 10 million other Americans who have beaten the disease. When cancer treatment ends, a survivor still undergoes regularly scheduled medical exams and tests to check for signs that the cancer has returned or spread to another part of the body. Doctors also screen for other types of cancers and watch for side effects from cancer treatment. During this important period, patients can work with their doctors to keep an eye out for new problems, cancer experts tell WebMD.
Pheochromocytoma and paraganglioma characteristically form small nests of uniform polygonal chromaffin cells ("zellballen"). A diagnosis of malignancy can only be made by identifying tumor deposits in tissues that do not normally contain chromaffin cells (e.g., lymph nodes, liver, bone, lung, and other distant metastatic sites).
Regional or distant metastatic disease is documented on initial pathology in only 3% to 8% of patients; thus, an attempt has been made...
Surviving cancer is a blessing. "But it comes at a cost," says Mary McCabe, RN, MA, director of Memorial Sloan-Kettering Cancer Center's Cancer Survivorship Program, which develops medical and psychosocial services and educational programs for cancer survivors. While radiation and chemotherapy can offer a cure, they can also create side effects, such as fatigue or infertility -- or even new cancers a decade or two down the road. Through follow-up, "we want to make sure that we minimize the serious side effects that may occur," she says.
Follow-up Care Is Individualized
The period after cancer treatment is fraught with distinct stresses. "When patients finish therapy, they're exhausted physically and emotionally," McCabe says. What's more, there are no more treatments to go through; no more intensive contact with doctors; no more battle mentality. Instead, the follow-up period involves watchfulness, and a cancer survivor may feel dread before appointments or during the anniversary of a cancer diagnosis.
Ronan says that Hodgkin's disease, a cancer of the lymph system, changed his outlook on life. "I'm nervous about tomorrow," he says. He'll need follow-up appointments about every three months for the first two years, then less frequently. He'll also require follow-up scans.