ON THIS PAGE: You will read about your medical care after cancer treatment is completed and why this follow-up care is important. Use the menu to see other pages.
Care for people diagnosed with cancer does not end when active treatment has finished. Your health care team will continue to check that the cancer has not come back, manage any side effects, and monitor your overall health. This is called follow-up care.
Your follow-up care may include regular physical examinations, medical tests, or both. Doctors want to keep track of your recovery in the months and years ahead. During this period, tell your doctor or nurse about any new problem that lasts for more than 2 weeks.
Cancer rehabilitation may be recommended, and this could mean any of a wide range of services, such as physical therapy, career counseling, pain management, nutritional planning, and/or emotional counseling. The goal of rehabilitation is to help people regain control over many aspects of their lives and remain as independent as possible. Learn more about cancer rehabilitation.
Learn more about the importance of follow-up care.
Watching for recurrence or second cancer
One goal of follow-up care is to check for a recurrence, which means that the cancer has come back. Cancer recurs because small areas of cancer cells may remain undetected in the body. Over time, these cells may increase in number until they show up on test results or cause signs or symptoms. During follow-up care, a doctor familiar with your medical history can give you personalized information about your risk of recurrence. Your doctor will ask specific questions about your health. Some people may have blood tests or imaging tests done as part of regular follow-up care, but testing recommendations depend on several factors including the type and stage of cancer first diagnosed and the types of treatment given.
People who develop lung cancer are also at higher risk for developing a second lung cancer. Your doctor will recommend scans to watch for both a recurrence and any new lung cancer.
Different organizations, including ASCO, have developed different follow-up care recommendations for SCLC in the United States. ASCO recommends that most people who were successfully treated for stage I to stage III (limited stage) SCLC receive imaging scans every 6 months for the first 2 years after treatment to watch for a recurrence. The preferred test is a chest CT scan (see Diagnosis). After the first 2 years, people should receive a low-dose chest CT scan once a year. Those who did not receive radiation therapy to the brain, also known as prophylactic cranial irradiation or PCI (see Types of Treatment), should receive a brain MRI every 3 months for the first year after treatment and then once every 6 months during the second year after treatment. Periodic brain MRIs may also be recommended for people who did receive PCI. ASCO does not recommend using PET-CT scans with fluorodeoxyglucose (FDG) or blood tests as routine tests to watch for cancer recurrence.
This information is based on ASCO recommendations for Lung Cancer Surveillance After Definitive Curative-Intent Therapy. (Please note that this link takes you to a separate ASCO website.)
Another organization called the National Comprehensive Cancer Network recommends imaging scans every 3 months for the first 2 years after treatment for limited stage SCLC, then every 6 months for the third year, then annually after that.
The anticipation before having a follow-up test or waiting for test results may add stress to you or a family. This is sometimes called “scan-xiety.” Learn more about how to cope with this type of stress.
Managing long-term and late side effects
Most people expect to experience side effects when receiving treatment. However, it is often surprising to survivors that some side effects may linger beyond the treatment period. These are called long-term side effects. Other side effects called late effects may develop months or even years afterwards. Long-term and late effects can include both physical and emotional changes.
Talk with your doctor about your risk of developing such side effects based on the type of cancer, your individual treatment plan, and your overall health. If you had a treatment known to cause specific late effects, you may have certain physical examinations, scans, or blood tests to help find and manage them.
Common post-treatment problems include pain, fatigue, and shortness of breath. Your doctor, nurse, and social worker can help you develop a plan to manage any problems that persist after treatment.
Survivors of SCLC who have smoked cigarettes in the past also have a high risk of heart disease, stroke, emphysema, and chronic bronchitis. Certain cancer treatments can also increase these risks. Even for those who don’t smoke, healthy lifestyle choices after cancer are important for overall well-being.
Keeping personal health records
You and your doctor should work together to develop a personalized follow-up care plan. Be sure to discuss any concerns you have about your future physical or emotional health. ASCO offers forms to help keep track of the cancer treatment you received and develop a survivorship care plan when treatment is completed.
This is also a good time to talk with your doctor about who will lead your follow-up care. Some survivors continue to see their oncologist, while others transition back to the care of their primary care doctor or another health care professional. This decision depends on several factors, including the type and stage of cancer, side effects, health insurance rules, and your personal preferences.
If a doctor who was not directly involved in your cancer care will lead your follow-up care, be sure to share your cancer treatment summary and survivorship care plan forms with them and with all future health care providers. Details about your cancer treatment are very valuable to the health care professionals who will care for you throughout your lifetime.
The next section in this guide is Survivorship. It describes how to cope with challenges in everyday life after a cancer diagnosis. Use the menu to choose a different section to read in this guide.