Care After Cancer Treatment
Getting active in your follow-up care after cancer treatment can make a world of difference.
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.
Many patients will receive follow-up care from their oncologist, the cancer specialist who treated them, while others will get follow-up care through another doctor, such as an internist or gynecologist.
During follow-up, doctors also check for side effects of cancer treatment. Three months out of chemotherapy, Ronan says his side effects have been limited to skin discoloration on his arms. But his doctor will also watch for effects of chemotherapy that include increased risk of infection, organ damage and infertility.
Some risks from cancer treatment can show up a decade or more later. In Hodgkin's disease, leukemia can develop five to 10 years after chemotherapy. Also, lung, breast, or stomach cancers can occur 10 or more years after treatment. In another example, women who have undergone chest radiation face increased risk of breast cancer. "They needed to have mammography done at more frequent intervals," McCabe says.
Because cancer treatment can cause pain, fatigue, swelling of limbs, sleep disturbances, premature menopause, and other problems, survivors may benefit from other forms of follow-up care, too. For example, some will need physical therapy to restore lost mobility, while others will require pain management, infertility treatment, or counseling for depression.
Get Active in Your Follow-Up Care
During follow-up, a cancer survivor's cooperation is key, Raghavan says. "It's important not to miss appointments." Follow-up also allows survivors a chance to take part in their own care and to regain a sense of control that they lost during treatment. They may want to ask their doctor the following:
- How often should I come in for follow-up appointments?
- Which follow-up tests do I need? How often?
- What symptoms should I watch for? Which ones might show that cancer has come back?
- Whom should I call if I see these symptoms?
- What can I do to relieve pain related to cancer treatment?
- Do I need to see any other doctors?
- What are the potential long-term effects of my cancer treatment?
- Where can I get reliable information about my type of cancer?