Medical follow-up includes check-up appointments with your health care team, physical exams, blood tests, and imaging (e.g. x-rays, mammograms, or CT scans.)
The purpose of follow-up is to:
- Determine the effectiveness of your treatment
- Assess any side effects
- Manage any late effects
- Detect any remaining or new disease
During treatment your health care team may have included a family doctor, nurse practitioner, specialist(s), surgeon, an oncologist, a General Practitioner in Oncology (GPO), nurses, radiation therapists and more.
In British Columbia, long-term cancer follow-up is generally done by an oncologist, General Practitioner in Oncology (GPO) or a primary care provider (family doctor or nurse practitioner) in your home community.
The exact schedule of tests and appointments will depend on the type of cancer you have had. But everyone who has had cancer treatment should focus on at least two appointments at the end of treatment:
1. An “end of treatment” appointment with your GPO (General Practitioner in Oncology) or oncologist (cancer specialist). At this appointment you will learn about any common late effects and who to talk to about different concerns.
2. An “end of treatment” appointment with your family doctor or nurse practitioner. At this appointment you can talk about your specific side effects and make a plan for follow-up.
At these “end of treatment” appointments you will be given a schedule of the tests and appointments you will need.
Pay close attention to how you feel and keep your health care team informed. If you feel unwell, seek medical attention. Your doctor may have “same-day” appointments available.
Seeing your family doctor or nurse practitioner is part of returning to normal. Family doctors and nurse practitioners use guidelines to understand cancer side effects and to determine the tests and imaging you will need over the long term. Your family doctor or nurse practitioner will consult with or refer you back to a cancer specialist if there are questions or concerns.
Your family doctor or nurse practitioner will also continue to address your health care needs that are not related to cancer, such as a sore throat or injury.
You may feel nervous before your regular check-ups. You may be worried that you will be told your cancer has come back. This fear is common. It may help to:
- Take a close friend or family member with you
- Write down your questions before the appointment
- Plan to do something special for yourself after the appointment, like watching a favourite movie or buying yourself a treat
When you meet with your oncologist near the end of treatment, ask for information about the treatment you had and any side effects or late effects you can expect.
Here is a list of questions from the National Cancer Institute:
- What was my cancer diagnosis?
- What treatments and drugs have I been given?
- Is there a handout or document that outlines my treatment and follow-up plan?
- What was the purpose of the treatments?
- Which doctor should I see for my follow-up cancer care?
- What are the chances that my cancer will come back or that I will get another type of cancer?
- What follow-up tests should I have, and when?
- What symptoms should I watch for?
- If I develop any of these symptoms, whom should I call?
- What are the common long-term and late effects of the treatment I received?
- What should I do to maintain my health and well-being?
It is important that you tell your doctor about anything that could affect your follow-up care. For example, certain vitamins and herbs can influence the way that pharmaceutical medications affect your body.
Your doctor may ask about:
- Any symptoms that they think may be a sign that your cancer has returned
- Any pain that bothers you
- Any physical problems that interfere with daily life or are bothersome, such as fatigue, changes in thinking, memory, and attention, difficulty with bladder, bowel, or sexual function, trouble sleeping, and weight gain or loss
- Any medicines, vitamins, or herbs you are taking and any other complementary treatments you are using (such as a chiropractor)
- Any emotional problems you are experiencing, such as anxiety or depression
- Any changes in your family medical history, including any new cancers
A wide range of therapies are considered complementary, including natural health products and supplements, diets, exercise, yoga, acupuncture, naturopathy, and Traditional Chinese Medicine.
Complementary and alternative medicines work best when paired with a healthy lifestyle, including eating a healthy diet, getting plenty of exercise, maintaining an optimal weight, quitting smoking, and practicing sun safety.
Many people use some form of complementary or alternative medicine (CAM) during or after cancer treatment. People may use these to address side effects, or improve well being.
Talk with your health care provider if you are using CAM as part of your survivorship wellness plan. Some CAMs can influence the effect of pharmaceutical medications on your body.