- Once cancer treatment has finished, a person should receive follow-up care to watch for and manage a cancer recurrence (return of the cancer) and any long-term effects of treatment.
- Talk with your doctor or health care team member about getting a summary of your cancer treatment and a plan for follow-up care.
After cancer treatment ends, survivors often describe feelings ranging from relief to anxiety and fear. During treatment, people feel actively involved in their cancer care, and the relationships made with the oncology team provided a sense of support and security. After treatment, the biggest question for cancer survivors is often what to do next.
Treatment summaries and survivorship care plans
After treatment, getting follow-up care and having access to support is important to people who have survived cancer. Many cancer survivors choose to continue follow-up care with their oncologist, and others may return to their primary care doctor or family doctor. If you are returning to your primary care doctor, ask for a detailed summary of all previous treatments and the risk for developing late effects from your oncologist. This information is important to your primary doctor, who may not have been involved in many of the parts of your cancer treatment. It gives him or her the information necessary to plan your follow-up care. This summary should include:
- Date of diagnosis
- The type of cancer, including tissue/cell type, stage, and grade (if known)
- Dates of treatment and a list of treatments received, including the type of treatment/drug name, dose of drug or radiation, and number of treatment cycles
- Any related medical findings during the course of treatment (such as the side effects you experienced)
- The results of any diagnostic tests
- A schedule of required tests needed to evaluate your health after cancer treatment
- Risks for developing long-term side effects of cancer treatment
In addition to knowing what type of treatment you received, you may want to ask for a survivorship care plan. This is a document that describes what tests you should have and how often you should have them.
Screening for late effects
For adults, there are few data-based recommendations for screening cancer survivors for late effects. Most of the information is based on long-term studies of survivors of childhood, adolescent, and young adult cancers and is summarized at www.survivorshipguidelines.org. Some examples of screening tests are:
- Yearly thyroid examination for people who have had radiation therapy to the head, neck, or throat
- Testing the function of the lung (such as how much air your lungs can hold and how quickly air moves in and out of your lung) for people who received bleomycin or a stem cell transplant
- Regular EKGs for people who received radiation therapy to the chest and/or who received high doses of a class of drugs called anthracyclines, such as doxorubicin
- Regular mammography (x-rays of the breast) starting at an early age for those who had radiation therapy to the chest at a young age
- Periodic imaging tests (such as x-rays or computed tomography [CT] scans) and/or blood tests to watch for a second cancer
It is important to talk with your doctors about appropriate tests based on your cancer history. Finally, keep a copy of both the treatment summary and survivorship care plan with your own records, in case you need to share the information with another health care provider.
Questions to ask the doctor
Here are some questions that may be useful when you talk with your doctor about your follow-up care:
- Which doctor or other member of the health care team will provide my follow-up care? Does he or she have experience with cancer survivors?
- How often should I return for a follow-up visit?
- What tests will I need when I go for my follow-up visits?
- What screening tests do you recommend based on the treatments I had?
- How long will I need to continue to go for screening tests?
- Do I need to take any special medications or follow a special diet?
- What signs or symptoms should I be looking for after my cancer treatment is completed? What should I do if I notice one of these symptoms?
- Do I need to be referred to a specialist?
- What can I do to lower my risk of the cancer coming back or developing a second cancer?
- Can you provide me with a summary of my cancer treatment?
National Cancer Institute: Follow-Up Care After Cancer Treatment
National Coalition for Cancer Survivorship: Life After Cancer
Last Updated: April 16, 2013