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.
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This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the treatment of primary CNS lymphoma. It is intended as a resource to inform and assist clinicians who care for cancer patients. It does not provide formal guidelines or recommendations for making health care decisions.
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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.
Follow-Up Exams May Be Frequent
In general, survivors see their doctors for follow-up exams about every three or four months during the first two to three years after treatment, according to the National Cancer Institute. But follow-up schedules vary from person to person, depending on one's age, general health, the type of cancer, the treatment received, and other factors. "Different standard approaches depend on the intensity of treatment and the chance of recurrence," says Derek Raghavan, MD, PhD, who serves as chairman of The Cleveland Clinic Taussig Cancer Center.
Many, but not all, patients will require testing. That, too, is individualized. Common follow-up tests include: imaging procedures (such as CT scans, X-rays, and ultrasound); endoscopy (inserting a thin, lighted tube into the body to examine organs), and blood tests.