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Follow up

The purpose of follow up in cancer medicine is as follows:

To asses the illness during its course:

Once a cancer is diagnosed, the medical oncologist should plan for a long term management of that patient. This planning begins with evaluation of the stage and extent of the illness at the time of diagnosis. After completion of all treatments, the patients have to followed for a very long period of time. Initially, they will be seen more often and as time goes on they will have less frequent follow ups. Depending on the cancer and its treatment and after 3-5 years, patient will then be seen once a year for rest of their lives.

To evaluate the response of the cancer to treatment:

One aspect of follow up pertains to the evaluation of response to treatment, that is to see whether the cancer has or has not responded to treatments. This kind of work up is normally done within two to three months after initiation of treatment. Method of work up as well as the types of the tests that may be used will all depend on the type and extent of the cancer at the time of initial diagnosis. If the cancer was detected on an examination, like in patients with enlargement of lymph glands, follow up could be done by a simple physical examination of these areas. In patients who have no visible disease, X-Rays or CT scans can be used to evaluate the response.

To asses and evaluate the occurrence of side effects from treatments and their extent:

Throughout and after completion of the treatments, patients have to be evaluated to determine the extent and degree of side effects from chemotherapy, radiation, etc. Degree of side effects depends on the dosage as well as type of treatment.

To evaluate the possibility of cancer recurrence:

After completion of a treatment, and in any combination that might have taken place, patients need to remain under surveillance for possibility of recurrence of cancer.

The frequency of follow up:

The frequency of follow up depends on the many factors such as:

• Reason for follow up

• Type and stage of cancer

• Type of treatment

• Age of the patient

In patients with very early stages of cancers and those who are cured with surgery, follow up does not need to be as intense. For patients with advanced disease, follow up visits should be scheduled on a regular basis. The frequency of follow up will depend on the condition of the patient and their disease. In each follow up visits, patients are examined, blood tests, X-rays and other studies may need to be done.