In this article, we discuss the importance of a follow-up program after completion of cancer treatment, and how every cancer survivor needs a personalized plan of care.
With better awareness and access to modern healthcare, more and more people with cancer now undergo potentially curative treatment.
1. Surveillance for cancer recurrence: The chance of recurrence of cancer depends on many factors, including the type of cancer and the stage at diagnosis. Also, different cancers have different patterns of recurrence, and the follow-up protocol (tests required as well as their frequency) must be tailored accordingly. The risk of recurrence is higher in the initial period after treatment and reduces with time. Therefore, follow-up is more frequent in the beginning, and reduces with time. For some cancers, the risk of recurrence after a certain time is so low that follow-up for disease recurrence is no longer required once that period is complete.
2. Screening for second cancer: People who get certain cancers have a risk of developing another cancer in the same organ. For example, colon cancer survivors have a tendency to develop polyps in their remaining colon which can transform into another cancer. For such people, a colonoscopy once in five years can pick up and remove new polyps well before they can become cancerous.
3. Long-term sequelae of cancer or its treatment: Treatment for some cancers can have long-term sequelae. Breast cancer patients who have undergone surgery need to be monitored for arm swelling due to lymphedema. People who have had gastrectomy for stomach cancer have to be evaluated periodically for iron and vitamin deficiencies. In addition, cancer survivors can also have mental, emotional, and social issues which need to be addressed.
To summarize, while successful completion of treatment is a major milestone, a disciplined follow-up program is crucial to ensure a long and healthy life for every cancer survivor.