The Importance of Follow-up Care

Cancer care does not end when you finish treatment. You will continue seeing your health care team for what doctors call "follow-up care." They will watch for signs of the cancer coming back, manage any side effects from treatment, and check your general health.

Planning your follow-up care after cancer

You and your health care team will work together to plan your follow-up care. Your plan will be designed just for you, and it will guide your health care for the months and years after treatment. It will probably include regular physical examinations and medical tests.

A follow-up care plan is often based on the medical guidelines for your specific type and stage of cancer. Your doctor will also keep your needs and wishes in mind when planning follow-up care.

Having a follow-up care plan can help you feel more in control as you go back to your everyday life after treatment and over time. When you have a medical support system in place, it can help you feel better physically and emotionally.

Watching for signs of cancer recurrence or a second cancer

Watching for signs of cancer is an important part of follow-up care. Your doctor will check for recurrence, which is cancer that comes back after treatment. Cancer can come back when very small areas of cancer cells are still in the body and cannot be seen on test results. These cells may grow until they show up on test results or cause symptoms.

The chance that a cancer will come back depends on the type you originally had and other factors. This also determines when and where the cancer is likely to recur. Unfortunately, no doctor can be certain if your cancer will come back or not. But a doctor who knows your medical history can talk with you about the risk and suggest ways to lower it.

A second cancer is a new cancer that happens in someone who has had cancer before. It is a different type of cancer than the cancer that was original diagnosed. Your risk of developing a second cancer depends on many factors, but it is important to watch for signs of a second cancer.

During your follow-up visits, your doctor will ask specific questions about your health. You might also have blood tests or imaging tests. Testing depends on several factors:

• The type and stage of cancer originally diagnosed
• The treatment you received
• Whether research shows testing could improve your health or help you live longer

Your doctor may ask you to watch for specific signs of cancer coming back. Learn more about cancer recurrence and second cancers.

How are long-term side effects managed after cancer treatment?

You probably expect to have some side effects during cancer treatment. But you may be surprised to have some that continue after treatment. These are called long-term side effects. Some side effects may not happen until months or even years after treatment ends, called late effects. Long-term and late effects of cancer and cancer treatment can include physical and emotional changes.

Talk with your health care team about your risk of developing these types of effects from treatment. Your risk will depend on the type of cancer you had, the treatment you received, and your overall health. If you had a treatment that is known to cause specific late effects, your follow-up care might include certain tests. Examples include:

• A yearly thyroid gland examination if the patient had radiation therapy to the head, neck, or throat.
• Lung function tests if the patient received a drug called bleomycin (Blenoxane) or had a bone marrow (stem cell) transplant. Lung function tests show how much air your lungs can hold and how quickly air moves in and out of them.
• Regular electrocardiograms (EKGs) if radiation therapy was given to the chest. EKGs are also used when chemotherapy included drugs that can affect how the heart works.
• Regular mammograms if radiation therapy was given to the chest of a younger patient.
• Imaging tests or blood tests to check for signs of cancer coming back. These may include X-rays or computed tomography (CT) scans.

Ask your doctor about the most appropriate tests for you. Learn more about side effects of cancer treatments and ways to manage them.

Who manages follow-up care after cancer?

You might continue to see the doctor who treated you for cancer after treatment ends. Or you might see your family doctor or another health care professional. Who you see depends on several factors, including:

• Your type and stage of cancer
• Any side effects you have
• Your health insurance company's rules
• Your personal wishes

How to keep your medical records

Information about your specific cancer diagnosis and the treatment(s) you received is valuable to all health care professionals who will care for you during your lifetime. You might want to fill out a cancer treatment summary. A member of your health care team may be able to help you with this.

ASCO offers forms to keep track of the cancer treatment you received and your doctor's recommendations for follow-up care.

Cancer treatment summaries usually include:

• Date of diagnosis
• The type of cancer you had, including tissue or cell type, stage, and grade (if known)
• A list of the treatments you received and the dates you received them, including the type of treatment, dose, and number of treatments and treatment cycles
• Any medical information from your time in treatment, such as the side effects you had and how they were managed
• The results of any tests you had
• Information about what tests you will need as a part of your follow-up care
• Your risk of developing long-term or late effects

Information about the treatments you received and follow-up care recommendations are especially important to your primary care doctor. They may not have been part of your regular cancer care team. These forms will help them supervise your follow-up care and make sure your health is on track. Keeping this information is also helpful in case you change doctors in the future.

Questions to ask your health care team

Consider asking your health care team these questions about your follow-up care.

• What is the chance of the cancer coming back? Are there symptoms I should watch for?
• What should I do if I notice one of these symptoms?
• What long-term side effects or late effects are possible from my treatment?
• How can I get a treatment summary and follow-up care plan for my personal records?
• Who will be in charge of my follow-up care? Do they have experience with cancer survivors?
• How often do I need follow-up visits?
• What screening tests do you recommend, based on my treatments?
• How long will I need these tests?
• Do I need to take any special medicines or eat a special diet?
• Do I need to see a specialist?
• How can I lower my risk of the cancer coming back or of getting a second cancer?
• Who can I talk with if I am very anxious or worried about the cancer returning?
• What survivor support services are available to me? To my family?

This information was originally published at https://www.cancer.net/survivorship/follow-care-after-cancer-treatment/importance-follow-care.