Fast Facts: Screening and Follow Up Care
- Follow-up care for cancer includes coping with side effects of treatment and lowering the risk of recurrence including screenings and regular healthcare checkups and vaccinations.
- Recommendations for follow-up care include regular visits to your doctors and the coordination of care between your oncologist and your primary care or family doctor.
- Regular screening, assessment, and education and appropriate treatments are important in developing a healthy life beyond cancer.
- Keep in mind that every person treated for cancer is different. These recommendations for screening and follow up care are not meant to replace those of your healthcare providers. Decisions you make should be based on your individual circumstances.
Follow-up cancer care involves regular medical checkups that include a review of a patient’s medical history and a physical exam. Follow-up care may include imaging, endoscopy, blood work and other tests. Follow-up care is important because it helps to identify changes in health. The purpose of follow-up care is to check for recurrence (the return of cancer in the primary site) or metastasis (the spread of cancer to another part of the body). Follow-up care visits are also important to help in the prevention or early detection of other types of cancer, address ongoing problems due to cancer or its treatment, and check for physical and psychosocial effects that may develop months to years after treatment ends.
Cancer survivorship care plans (hot link) can be helpful in identifying follow up care and screening specific to your cancer and the types of treatment you received.
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Fast Facts: Late Effects of Cancer Treatment
- Not all cancer survivors will experience late effects; some may appear soon after treatment, others may occur years after treatment ends.
- Late effects may be due to surgery, chemotherapy or radiation or the combination of these cancer treatments.
- In most cases, the earlier these late effects are identified, the easier they are to treat. Ask your health care team about what late effects could occur for your type of cancer and the treatment you received.
- Late effects may be both physical and psychosocial. Late effects of cancer can affect a survivor’s day-to-day life activities, body image, family and personal relationships.
In addition to talking with your health care team about what late effects you might expect for your type of cancer and treatment, it may also be helpful to talk with other cancer survivors. There are likely to be others who have been through similar experiences and sharing information may help in finding ways to manage challenges. For more information on cancer advocacy and survivorship groups in your area, visit MyHealthFinder and search under the “Cancer Care” category. Your oncology team will probably continue to see you for a period after treatment is done. Your health care will then be returned to your primary care physician for most health matters. However, many providers are not trained in the aftereffects of cancer. Contact your oncology provider or a cancer survivorship clinic near you if you begin to have problems that may be related to cancer or its treatment.
Cancer Survivorship Follow Up Care Questions for Clinic Visits
For Cancer Patients Transitioning from Treatment
- Will I need to have any additional treatment after the active treatment phase has finished?
- Who will be part of my health care team after active treatment ends, and what will each member do?
- Are there groups or online resources you would recommend to help me learn more about survivorship after my specific diagnosis?
- Whom should I contact if I have any questions or concerns?
- How should I best share my treatment plan and survivorship plan with my primary care and other treating physicians including my dentist?
- Who will oversee my medical care after I finish treatment?
- How much experience do you have providing survivorship care?
- Are there any survivorship clinics, survivorship centers of excellence, or other survivorship resources you would recommend?
- How often should I return for a follow-up visit with you? With my family doctor?
- What tests will I need during my follow-up visits?
- Can you provide me with a summary of my cancer treatment?
- Can you provide me with a cancer survivorship plan with specific information for any potential treatment late effects?
For Cancer Survivors and Caregivers
- How likely is it that the cancer will return?
- What symptoms may be signs of a potential recurrence?
- Which symptoms should I report to you right away?
- Which symptoms should I report at my regular followup visits?
- What can I do to lower my risk of the cancer coming back after treatment?
Questions about Late Effects including Psychosocial, Emotional and Financial Concerns
- What can be done to manage any side effects that continue after treatment including fatigue, pain and neuropathy or tingling in my hands and feet?
- What are the most common late effects that may develop based on my treatment plan?
- What should I do if I notice a late effect?
- What screening tests do you recommend based on my cancer history?
- Are there other doctors/specialists I should see, such as a cardiologist or endocrinologist?
- What is my risk of developing another type of cancer?
- What can I do to support my emotional health during my transition into survivorship?
- What are some healthy ways for me to deal with my feelings and fears ?
- What support services are available to me? To my family?
- What are some things I can do to manage my fears?
- Where can I get information about fertility?
- Where can I get information about concerns for sexual health?
- Could my treatment plan affect my sex life? If so, how and for how long?
- Where can I get information about financial and insurance assistance?
- How can I manage feelings like guilt, confusion, or anger?
- Are there religious or spiritual organizations in my community that provide specialized support or services for cancer survivors?
- Where else can I find emotional or spiritual support?
- How can I be mindful of the ways cancer could affect the way I parent?
- If I have difficulty talking to my children about my cancer and survivorship concerns, who can help?
- Could my treatment plan affect my sex life? If so, how and for how long?
- Can you refer me to another health care professional who can help facilitate discussions with my friends and family?
Cancer Screening Resources
Scientists are trying to better understand which cancer survivors are more likely to have their cancer recur or to develop additional types of cancer. They also study the things we do and the things around us to see if they cause cancer. This information helps doctors recommend which cancer survivors should be screened for cancer, which screening tests should be used, and how often the tests should be done. Certain types of cancer treatments, including radiation and chemotherapy may increase survivors’ risks for other cancers. The links below provide information on different cancer screening tests.
Tests to Detect Colorectal Cancer and Polyps
BRCA1 and BRAC2: Cancer Risk and Genetic Testing
Follow-Up Care for Late Effects
Follow-up care gives doctors the chance to monitor survivors’ response to current or past treatments in order identify recurrence of the disease, if any and detect long-term or late effects. Cancer survivors should see their primary care doctors for general health and physical examinations yearly or more often, as needed. They should see their oncologists for follow-up cancer care. Regular examinations may include screening for cancer recurrence, for the development of a secondary cancer or for other late effects of treatment. The links below provide additional information on screening and follow-up care for late effects.
Follow-Up Care After Cancer Treatment
Managing Long-Term and Late Effects
Long-Term Follow-Up Guidelines for Survivors of Childhood and AYA Cancer
References
Last Updated 5.6.2015
DeSantis, C. E., Lin, C. C., Mariotto, A. B., Siegel, R. L., Stein, K. D., Kramer, J. L., … & Jemal, A. (2014). Cancer treatment and survivorship statistics, 2014. CA: a cancer journal for clinicians, 64(4), 252- 271.
Bower, J. E., Bak, K., Berger, A., Breitbart, W., Escalante, C. P., Ganz, P. A., … & Ogaily, M. S. (2014). Screening, assessment, and management of fatigue in adult survivors of cancer: an American Society of Clinical oncology clinical practice guideline adaptation. Journal of Clinical Oncology, 32(17), 1840-1850.
De Moor, J. S., Mariotto, A. B., Parry, C., Alfano, C. M., Padgett, L., Kent, E. E., … & Rowland, J. H. (2013). Cancer survivors in the United States: prevalence across the survivorship trajectory and implications for care.Cancer Epidemiology Biomarkers & Prevention, 22(4), 561-570.
Cowens‐Alvarado, R., Sharpe, K., Pratt‐Chapman, M., Willis, A., Gansler, T., Ganz, P. A., … & Stein, K. (2013). Advancing survivorship care through the National Cancer Survivorship Resource Center. CA: a cancer journal for clinicians, 63(3), 147-150.
Resources
MyHealthFinder
is a mobile web and iOS/Android app to help cancer survivors find resources for healthy living.
