Definition and Overview
An oncology follow-up refers to regular medical checkups that are required for all cancer patients both during and after their treatment. During the checkup, a physical exam, lab tests, and imaging scans may be expected. The goal of this checkup depends on the patient’s condition. In patients undergoing treatment, the goals are to detect any changes in the patient’s condition and address any problems caused by the disease itself or by the treatment. In patients who are in remission, the goal is to check for signs of a recurrence. An oncology follow-up check plays a key role in dealing with the ongoing effects that the disease may have even when treatment becomes successful.
Who Should Undergo and Expected Results
An oncology follow-up is a critical part of care for:
- Cancer patients undergoing treatment
- Cancer survivors
The checkup is expected to determine and address the following:
- Any changes in the patient’s condition, such as changes in the tumor size
- Side effects of treatment
- Metastatic cancer, or if cancer has spread
- Recurrence in patients in remission
- Any late effects or long-term side effects of the disease either during treatment or after a successful treatment
At the end of a follow-up visit, the treatment plan may be modified to take into consideration some recent changes in the patient’s condition and any side effects of the treatment will be addressed. Also, by giving patients the opportunity to constantly update their doctor about their condition, follow-ups help detect recurrences almost as soon as they occur. The checkup may also help determine whether a cancer survivor requires some form of counseling during the rehabilitation period that follows a successful treatment.
How Does the Procedure Work?
An oncology follow-up is a necessary part of cancer treatment, and is also important for cancer survivors especially during the first five years following remission. However, the frequency and manner in which it is conducted may differ based on the patient’s unique condition. Thus, each cancer patient will require a unique follow-up care plan.
Scheduling - In general, cancer patients are asked to undergo a follow-up check every 3 to 6 months during the first 3 years of treatment, every 6 to 12 months during the fourth and fifth years, and once a year in every succeeding year. However, some cases may require more frequent checkups, such as terminal stage cancer, cases wherein the patient is suffering severe symptoms, when the tumor seems to be growing rapidly, or when some complications arise.
Some special visits may be required, such as one visit scheduled a year after a mammogram or six months after a successful radiation therapy.
Manner - The specific manner in which checkups are conducted also depends on certain factors. In general, the patient can expect to undergo the following procedures during an oncology follow up:
- A physical examination
- Imaging scans to monitor cancer, such as CT scans or mammography
- Blood work
- Endoscopy, such as colonoscopy or rectosigmoidoscopy
- Other lab tests
The tests may also be scheduled during specific visits. For example, a patient who survived colorectal cancer will need a complete set of physical exam, scans, and endoscopic tests in the first year, but may no longer need a colonoscopy during the second and third years and a CT scan during the fourth and fifth years, unless some complications are detected.
Over time, if the patient’s physical condition seems positive and no new symptoms are reported, lab tests may no longer be necessary and a physical exam may suffice.
At the start of each visit, the patient will be asked some questions to determine his overall condition. These include questions about:
- Physical symptoms, especially new ones that they didn’t experience before
- New medications, vitamins, and supplements they plan on taking
Some physical symptoms to report include:
- Bowel problems
- Loss of sexual function
- Difficulty concentrating
- Difficulty breathing properly
- Difficulty remembering things
- Sleeping problems
- Sudden weight gain
- Sudden weight loss
- Persistent headaches
- Breast lumps
- Nipple discharge
- Unusual rashes
It is also important to inform the doctor of any changes in the patient’s family history, as this could be relevant to the patient’s risk of metastatic or recurrent cancer.
Possible Risks and Complications
An oncology follow-up generally requires routine scans and lab tests that do not pose any risk to the patient. Some lab tests may cause minimal discomfort, but are usually free from complications.
While these follow-ups do not guarantee a direct or immediate improvement in the patient’s condition or ensure the patient’s survival, they may help detect and address any risks and complications relating to the patient’s condition in a timely manner. As such, they help reduce potentially lasting effects, and may also help improve the patient’s chances of survival, especially when they help detect recurrences or metastatic cancers early.
- The American Cancer Society