Cancer survivors: What to expect with follow-up care

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Cancer survivors: What to expect with follow-up care

Cancer survivors — What to expect from follow-up care after cancer treatment.

Congratulations on finishing your cancer treatment and becoming a cancer survivor. Being declared cancer-free can be both joyful and frightening. You're happy that your cancer treatment was successful, but what do you do now?

One important part of your life as a cancer survivor is follow-up care. Here's a guide to the steps you can take once your cancer treatment ends to help ensure you receive the care you'll need as a cancer survivor.

Choose a doctor for your follow-up care

Choosing a doctor you feel comfortable with for your follow-up care as a cancer survivor is important. You usually have options when it comes to whom you'll see. You might choose to see the same doctor who treated your cancer. Or you might feel more comfortable with your family (primary care) doctor, especially if you've seen the same doctor for many years.

Many cancer survivors see both their cancer specialists and their family doctors after cancer treatment. The cancer specialist does checkups related to cancer, and the family doctor takes care of routine health matters. This team approach works well for many cancer survivors.

If your health insurance plan only allows you to see your family doctor, get a schedule of recommended follow-up tests from your cancer specialist. Your cancer specialist can tell you what types of tests you'll need and when to have them, and then your family doctor can follow that plan. If any problems arise, your cancer specialist can be consulted.

Develop a checkup schedule for your follow-up care

When you go for your first post-treatment visit, ask your doctor to design a schedule of follow-up care appointments for you. Your follow-up care appointment schedule depends on the type of cancer you had, the treatments you received and any side effects you experienced. Your doctor might recommend checkups every three or four months for the first few years after your treatment, then once or twice a year after that. Be aware that your health insurance plan may limit the number of follow-up care visits.

During follow-up care appointments, your doctor will usually review your medical history, evaluate your current symptoms and examine you. Your doctor is looking for signs that:

  • Your cancer has come back (recurrence)
  • Your cancer has spread (metastasis)
  • You've developed another type of cancer (second primary cancer)
  • You're experiencing continued side effects of your cancer treatment
  • You've developed late side effects of your cancer treatment
  • You've developed other medical conditions

Depending on the type of cancer and treatment you've had, your doctor may also do other tests. These might include blood tests or imaging studies, such as X-rays and scans. In some instances, your doctor may order physical or occupational therapy to help enhance your recovery.

Examples of general screening guidelines for follow-up testing for certain cancers.
Type of cancer Recommended screening
Breast cancer
  • Monthly breast self-exam, annual mammogram, physical exam every four to six months for first five years and then annually
  • Blood tests to look for medication side effects
  • Annual pelvic exam, Pap test and bone density screening for some women, including those taking certain medications
Colon cancer
  • Checkups every three to six months for the first two years, then every six months for the next three years
  • Carcinoembryonic antigen (CEA) testing every three to six months for the first two years
  • Colonoscopy one year after treatment and three years later, then every five years
Melanoma
  • Complete skin exam annually, more often if cancer was more advanced
Ovarian cancer
  • Pelvic exam every two to four months for the first two years and every six months for the following three years
  • May include blood test for cancer antigen 125 (CA 125)
Prostate cancer
  • Annual digital rectal exam (DRE)
  • Prostate-specific antigen (PSA) test every six months for the first five years, followed by annual PSA testing

Source: National Comprehensive Cancer Network, 2006-2007

Note: Individualized follow-up care is based on your current health, your age, medications you're taking and any other health conditions you might have.

You might be reluctant to go back to your doctor for follow-up care for fear that your doctor will find more cancer. But checkups after treatment can also put your mind at ease, confirming that you're doing all you can to make sure your cancer doesn't recur.

Develop a long-term wellness plan

Ask your doctor what you can do between checkups to stay healthy. A wellness plan might include getting regular exercise, decreasing stress, quitting smoking, or including more fruits and vegetables in your diet. These steps can help your body heal after treatment.

A wellness plan should also include keeping your mind healthy. While it's common to fear that your cancer will come back or to feel unsure of yourself after treatment, talk to your doctor about a plan to lessen these feelings. A wellness plan for your mind might include joining a support group or a prayer group, or trying meditation or yoga.

Understand what you should be watching for

After your treatment, you might be worried that any small change in your body could be a sign of cancer recurrence. Even a cold, sore throat, or small aches and pains might worry you. It's natural to think that every sign and symptom is a sign of your cancer coming back. Talk to your doctor about what signs to watch for. And don't be afraid to report any unusual or persistent symptoms.

Each time you visit your doctor, tell him or her about:

  • Any signs or symptoms you fear may be a sign of cancer recurrence
  • Any side effects that make daily life difficult, such as fatigue and pain
  • Any feelings you have, such as depression, that make daily life difficult
  • Any changes in your family medical history
  • Any other health problems you have

Keep copies of your medical records

Keep copies of your medical records after you complete treatment. Obtain copies of your pathology and surgical reports. Write down what treatments you received and what side effects you experienced.

Your records carry pertinent information about your cancer and your treatment that your next doctor — or any doctors you have in the future — will need to know. The records hold keys to what late side effects or complications of cancer treatment you'll likely face. And if your cancer does recur, your records will show which treatments you've received and what treatments could be considered in the future.

Cancer Records Checklist (PDF file requiring Adobe Reader).

Last Updated: 10/02/2007
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