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After completing cancer treatment patients are often faced with the concern of what to expect and the uncertainty of what the future holds. Worry and anxiety are common feelings shared among people newly diagnosed as “cancer free”. After finishing treatment and receiving the good news people expect to feel like they did before they were diagnosed. Many have the impression that they can jump back into their old routines, soon to find that they are unable to return to what was once considered normal. Now they find their selves worried and anxious because they fear the cancer has returned. Understanding what to expect after cancer treatment is very important. After finishing treatment the patient should ask their physician or nurse what to expect. If the patient and their families have the knowledge and an understanding of what to expect after treatment they can prepare and make lifestyle changes, while staying positive. After the treatments are finished follow-up care will begin, during this period the patient will have many questions and should speak with their physician.
Here is a list of questions that a patient should ask their physician
- Should I continuing seeing you or see my family physician?
- How often will I need to come to the doctor?
- Will tests be run to check to see if the cancer has came back?
- If problems arise after treatment who should I contact?
- How long will it take to return to feeling like myself?
- How should I expect to feel? What is “normal” after treatment?
- Is there anything I should avoid?
If you or family members have worries or concerns do not be afraid to discuss it with your physician.
Types of Biopsies
- Fine-needle aspiration: a fine needle is used with a syringe to remove (suction) clumps of cells from a mass or tumor. To qualify for this procedure, the tumor must be large and not located near a hollow organ or blood vessel. This can often be performed without anesthesia.
- Needle Biopsy: A small core of tissue is obtained through a large-bore needle and local anesthetic.
- Incisional Biopsy: The surgical removal of a small area of tissue. This can be performed with local anesthesia and on an outpatient basis.
- Excisional Biopsy: The removal of an entire tumor for analysis through surgical removal. This procedure requires local or general anesthetic. Normally used for breast tumors that are less than an inch in diameter, procedure called a lumpectomy. Before undergoing a biopsy there are questions that you should ask your physician. Below are samples of the types of questions that you should ask.
Prior to undergoing a biopsy
- How long will the procedure take?
- Will I be awake and will it hurt?
- After the procedure how soon will the results be back?
- If the results come back indicating cancer who will talk to me about treatment?
- When will treatment begin? Should treatment begin immediately?
In some cases the true extent of a tumor’s development is not known until the patient undergoes surgery. Surgery will be performed by a surgical oncologist who can determine the size of the tumor and the extent that it has spread. This is known as tumor staging.
Tumor staging is important because it plays a vital role in determining a patient’s prognosis, what treatment and therapy is appropriate and if it is successful or not. After the pathologist has determined the classification of the tumor the diagnosis begins.
The physician will determine the “stage” or the extent of the cancer. This is how the physician determines the best treatment for a specific type of tumor. The physician may order more tests to determine if the cancer has spread and if so, to what parts of the body. Lymph nodes near the tumor may be removed to check for cancer cells. If cancer is present in the lymph nodes this may indicate that the cancer has spread to other areas of the body and to other organs. The earlier cancer is diagnosed the greater the opportunity for survival and a cure.
What is follow-up care? Follow-up care is very important because the physician monitors the patient to make sure that the cancer has not returned or spread to other parts of the body (metastasis). The physician checks to see if the patient has any side effects from treatment and will perform regular medical checkups by reviewing the medical history and examining the body. The physician may run diagnostic tests and take blood work as precautionary measures. The physician that provided your cancer treatment will normally be the physician you will see for the follow-up care. The decision will be up to the patient.When you go for your first follow-up appointment your physician will recommend a schedule. Normally during the first 2 to 3 years a patient will return to their physician every 3 to 4 months. After three years of being cancer free the physician will generally want to see the patient once or twice a year for follow-up appointments but you must remember each case is different. Follow-up care will depend upon the person, the type of cancer, and their general health.
When planning your follow-up care it is always a good idea to check with your insurance company to see if there are any restrictions on follow-up care, for example, how many visits are allowed in a year?
After treatment some people fear that the cancer has returned. It is important to notice any changes that occur. Be sure to discuss the changes with your physician so that he/she can determine if the cancer has returned, if it is related to the treatment, or an unrelated health problem. In most cases if the cancer comes back a patient will detect it before their physician because the patient continually monitors any changes that occur in their body.
If the cancer returns, it important to stay positive and not lose hope. Today many people are living with cancer and continue to live good lives for many years.
Talking with Your Physician
People often have anxiety when talking with their physician because they are afraid to ask questions for fear of sounding stupid. Many times physicians use terminology that patients do not understand.Talking with your physician about concerns, worries, and symptoms is very important. It is important that your physician be aware of how you feel physically and mentally. If he/she uses words that you do not understand, stop him/her and ask that he/she explains. The physician is there to help you and you must remember that. While speaking with your physician here are some points to go over:
- What tests and follow-up care you need, and how often.
- If there will be any physical problems from the treatment and if there is, is there anything you can do to relieve pain, reduce side effects, or prevent them.
- Any long-term effects of the treatment and if so, are there any warning signs to watch for indicating a side effect.
- Signs that indicate that the cancer has returned and if so what to do and who to call.
- Any fears, concerns, or worries.
At each visit it is important to discuss with your physician any pain that concerns you, any physical problems that get in the way of normal everyday activities, and any symptoms that you have.
Every survivor (presently going through treatment or finished with treatment) wants to know what symptoms indicate that their cancer has returned. Everyone is different and every cancer is different, you must remember that there are over 400 different cancers so the symptoms that indicate a return for one type of cancer might not apply to another type. There are symptoms that are common to certain cancer recurrences, but they do not always apply. This is why it is important to speak with your physician and to notice any changes in your body.
Complementary and Alternative Medicine
Today there are a number of complementary and alternative medicines available. People turn to these medicines to help prevent illness, reduce stress, prevent or reduce side effects, or control or cure disease. Methods that are called complementary are often used with the treatments that are prescribed by their physician while alternative are used instead of methods prescribed by their physician. Some people turn to yoga, visualization, relaxation, acupressure, acupuncture, messages, herbal supplements, vitamins, or relaxation.If you are considering using any complementary or alternative medicines it is important to discuss with your physician even if you have finished your treatment. It is important to discuss any medicines or therapies you are considering using because they could be harmful to you or interfere with your treatment or current medications.
It is a good idea that while; a patient is undergoing follow-up care that they keep records of their health history. This is important because a patient may not always see the same physician and having their own health records would be beneficial to the new physician as well as to the patient.When keeping medical records here is information that should be included.
- Type of cancer, diagnosis.
- Date of diagnosis.
- Type of cancer treatment; include dates and where treatment was received. Include any surgeries, names and doses of all medications, and radiation therapy.
- Names, addresses, phone numbers of all physicians who treated you along with the dates of treatment. Include name of physician providing follow-up care.
- Complications during treatment and after treatment.
- Keep documentation of all phone calls to the office concerning pain, nausea, etc. and the information received.