Your personalized OncoLife Survivorship Care Plan gives you information about the health risks you may face as a result of cancer therapies. Your level of risk can vary based on the doses and duration of your treatment and the combination of treatments received.
You should discuss this plan with your oncology team to better understand your personal risks. These results can be concerning, but not every survivor experiences every side effect, and some survivors do not experience any long-term effects. Learning about these risks can help you develop a plan with your healthcare provider to monitor for or reduce your risk for these side effects through screening and a healthy lifestyle.
The information in your plan is broken down by:
- Cancer therapies you received and related risks
- Future screening recommendations
- Healthy living tips
- Psychosocial issues you may face
You may see a particular side effect in more than one section because more than one therapy can cause the same long-term effect.
The information in this plan is based on the available research and literature concerning cancer survivors. This area is continually growing, and as new information becomes available, it will be added to the program. You may want to redo your plan periodically.
You received the following treatments for Breast Cancer
- Lumpectomy
- Sentinel Node Biopsy
- Cyclophosphamide (Cytoxan®, Neosar®)
- Doxorubicin (Adriamycin®, Rubex®)
- Tamoxifen (Nolvadex®)
- Radiation treatment for breast cancer after lumpectomy
Information from your oncology office
Coordinating Your Care
As a survivor, it is important that you keep a journal or notebook of your care. Include your doctor’s contact information, a list of past and current medications, therapies received, laboratory and radiology studies. (Visit the OncoPilot section on OncoLink for forms you can use to organize this material). While some survivors continue to see an oncologist, many return to a primary care provider or internist for routine care, many of whom are uncertain how to care for you. Developing the OncoLife Survivorship Care Plan can help you and your primary care provider understand what issues to look for, and how to handle them.
If you are being followed only by a primary care practitioner, it is a good idea to maintain a relationship with an oncologist or late effects clinic, should you need any guidance or referrals with regards to late effects. Call the cancer center where you were treated to ask if they have a survivor’s clinic, or find one by searching OncoLink’s Survivorship Clinic List (though this list is not exhaustive). A survivorship clinic will review the therapies you received, discuss your risks with you, and act as a consultant to your primary care team. Your OncoLife Survivorship Care Plan includes a “Healthcare Provider Summary” (found on the right side of your results), which is an abbreviated summary of recommendations that you can give to healthcare providers for reference.
Follow Up Care After Cancer
After receiving treatment for cancer, it is important for survivors to adhere to their oncology team’s plan for follow-up care. This includes physical examinations, radiology studies, blood tests, and reporting concerning symptoms to their healthcare provider. The oncology team should provide a specific follow up plan.
Follow Up Care For Acute Lymphocytic Leukemia
After receiving treatment for ALL, it is important for survivors to adhere to their oncology team’s plan for follow-up care. This includes physical examinations, bone marrow biopsies, radiology studies, blood tests, and reporting concerning symptoms to their physician. General recommendations for ALL follow-up care state that survivors should be monitored with:
- Periodic complete blood count (CBC) and bone marrow biopsy / aspirate if these results are abnormal.
- Other tests as needed, including liver function tests, cerebrospinal fluid testing and cardiac testing.
- Physical exam, every 1-2 months for the first year after completing chemotherapy, every 3 months for the second year and every 6 months thereafter.
- Any new, unusual and/or persistent symptoms should be brought to the attention of your care team.
Follow Up Care For Acute Myeloid Leukemia
After receiving treatment for AML, it is important for survivors to adhere to their oncology team’s plan for follow-up care. This includes physical examinations, radiology studies, blood tests, and reporting concerning symptoms to their physician. General recommendations for ALL follow-up care state that survivors should be monitored with:
- Have a complete blood count (CBC) checked every 1-3 months for 2 years, then every 3-6 months for up to 5 years.
- A bone marrow biopsy / aspirate is only necessary if these results are abnormal.
- Any new, unusual and/or persistent symptoms should be brought to the attention of your care team.
Follow Up Care For Anal Cancer
After receiving treatment for anal cancer, it is important for survivors to adhere to their oncology team’s plan for follow-up care. This includes physical examinations, radiology studies, blood tests, and reporting concerning symptoms to their physician. General recommendations for anal cancer follow-up care include:
- Be seen and examined by their physician as often as every 3 months for at least 2 years. This visit should include digital rectal exam, anoscopy (visual exam of the anus), and evaluation of the lymph nodes in the groin area.
- Blood tests and imaging tests such as CT scans may be used to monitor for recurrence in higher risk disease.
- Any new, unusual and/or persistent symptoms should be brought to the attention of your care team.
Follow Up Care For Appendiceal Cancer
After receiving treatment for cancer of the appendix, it is important for survivors to adhere to their oncology team’s plan for follow-up care. This includes physical examinations, radiology studies, blood tests, and reporting concerning symptoms to their physician. There are no formal guidelines for follow up care; therefore, your physician will determine your monitoring plan. Typical monitoring includes:
- Abdominal CT scan every 6 months for 3-5 years, then at the discretion of the oncology team.
- Tumor markers may be evaluated every 3-6 months if they were initially elevated at the time of diagnosis (these can include CEA, CA-125 and CA 19-9).
- Any new, unusual and/or persistent symptoms should be brought to the attention of your care team.
Follow Up Care For Bladder Cancer
Follow up care for bladder cancer varies widely, depending on the stage and grade of the tumor, and the treatments received. It is important for survivors to adhere to their oncology team’s plan for follow-up care. This includes physical examinations, radiology studies, blood tests, and reporting concerning symptoms to their physician. The recommended follow-up care for patients with bladder cancer according to the stage and grade of the cancer are as follows:
- Non invasive, low grade tumors (Ta, low grade):
- Cystoscopy every 3 months initially, with increasing time intervals between cystoscopies as deemed appropriate.
- Early stage tumors (Ta – high grade, T1 – low and high grade).
- Cystoscopy with urine cytology every 3-6 months for 2 years, then increasing intervals as appropriate. Your physician may choose to check urinary tumor markers as well.
- Radiology tests (CT, MRI) every 1-2 years may be considered in the case of high-grade tumors.
- Muscle invasive tumors treated with the intent to cure:
- Laboratory testing (urine, liver function, electrolytes, and creatinine) and chest x-ray every 6-12 months.
- Radiologic imaging (CT, intravenous pyelogram [IVP], ultrasound, etc.) of the upper urinary tracts, abdomen and pelvis every 3-6 months for 2 years, then as indicated.
- If bladder-sparing surgery has been performed: cystoscopy with cytology every 3-6 months for 2 years, then at increasing intervals as deemed appropriate.
- Follow up after cystectomy (removal of the bladder):
- Laboratory work (urine cytology, creatinine and electrolytes) every 3-6 months for 2 years, then as indicated.
- Imaging (CT, MRI) of the chest, abdomen and pelvis every 3 to 12 months for 2 years (based on the risk of recurrence), then as indicated.
- Urethral washings cytology every 6-12 months.
- If the surgery was a partial cystectomy, follow up should also include cystoscopy every 3-6 months for 2 years, then at increasing intervals to monitor for relapse in the bladder.
- All survivors: any new, unusual and/or persistent symptoms should be brought to the attention of your care team.
Follow Up Care For Brain Cancer
There are a number of different types of brain tumors, each with its own treatment and follow up recommendations. It is important for survivors to adhere to their oncology team’s plan for follow-up care, including physical examinations, radiology studies, blood tests, and reporting concerning symptoms to their physician.
Key Takeaways
The following are general recommendations to discuss with your oncology team:
- Physical exam and brain MRI every 2-6 months (depending on tumor type) for 2-3 years, then every 6-12 months (also determined by tumor type).
- Be sure to promptly let your team know if you experience any concerning symptoms, such as depression, vision changes, headaches, dizziness, difficulty remembering things or concentrating, feeling unbalanced or difficulty walking, any numbness or tingling.
- Discuss the possibility of seizures and whether you need anti-seizure medication. If seizures are a concern, discuss safety implications, including your ability to operate a vehicle.
Leave a Reply