Many cancer patients complete their treatment. These patients may be on a path to ‘cured’ but after a bout with cancer, managing physical and emotional health is a delicate balance. On one hand, patients are eager to regain their energy and return to the daily routines that they might have had to put on hold during treatment; on the other, patients are aware that cancer can come back and must take precautions to protect their health.
But how can patients enjoy their lives with the risk of recurrence hanging over their heads? One way is through personalized tumor surveillance, which is a flexible approach to follow-up care based on a patient’s individual cancer, recurrence risk, and life goals.
How does tumor surveillance work?
During tumor surveillance, doctors monitor the ongoing health of patients who complete cancer treatment. The goal is to actively look for indications that a cancer has returned, which often can be determined in three ways:
- Conversations about any new symptoms patients are experiencing
- Imaging scans to look for tumors or masses
- Blood tests to search for cancer markers
Tumor surveillance can last from three months to the rest of a patient’s life, depending on the cancer type, the person’s general health, and life goals. The American Society of Clinical Oncology offers tumor surveillance guidelines for select cancers, such as colorectal cancer, but the time between visits will vary from patient to patient.
Cancer recurrence occurs most often during the first year after treatment. As years go by, recurrence becomes less and less likely. The medical community generally considers the risk very slim after five years although not impossible because some cancer cells can remain in the body after treatment. Hormone-positive breast cancer, for example, can come back even 10 years after treatment.
Do all patients need tumor surveillance?
We recommend follow-up care for nearly every patient who undergoes cancer treatment. Most patients I see understand the need for monitoring and the value in continued visits. Confirming that the cancer has not returned can give patients and doctors relief, validation, and inspiration.
However, some patients get “scanxiety,” or anxiousness about being scanned. Some patients want only occasional scans or prefer to have blood work and conversations only, if possible. Others might choose a less intensive strategy, preferring not to know that a stage 4 cancer has returned or spread to other parts of the body until they have symptoms. Providers and patients should work together to develop a sound strategy that provides patients with the best care and the lowest level of stress.
Every day, people who have survived cancer must make decisions that affect their ongoing health and happiness. I’m of the opinion that patients have to live their lives: Take vacations, spend time with family, attend weddings and birthday parties. Tumor surveillance allows patients to enjoy their lives while reducing the stress of managing their health after cancer treatment.
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